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SARS-CoV-2 proteins

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    High frequency of cerebrospinal fluid autoantibodies in COVID-19 MESHD patients with neurological symptoms

    Authors: Christiana Franke; Caroline Ferse; Jakob Kreye; Momsen Reincke; Elisa Sanchez-Sendin; Andrea Rocco; Mirja Steinbrenner; Stefan Angermair; Sascha Treskatsch; Daniel Zickler; Kai-Uwe Eckardt; Rick Dersch; Jonas Hosp; Heinrich J. Audebert; Matthias Endres; Christoph J. Ploner; Harald Pruess

    doi:10.1101/2020.07.01.20143214 Date: 2020-07-06 Source: medRxiv

    COVID-19 MESHD intensive care patients occasionally develop neurological symptoms MESHD. The absence of SARS-CoV-2 in most cerebrospinal fluid (CSF) samples suggests the involvement of further mechanisms including autoimmunity. We therefore determined whether anti-neuronal or anti-glial autoantibodies are present in eleven consecutive severely ill COVID-19 MESHD patients presenting with unexplained neurological symptoms MESHD. These included myoclonus MESHD, cranial nerve involvement, oculomotor disturbance, delirium MESHD, dystonia MESHD and epileptic seizures MESHD. Most patients showed signs of CSF inflammation MESHD and increased levels of neurofilament light chain. All patients had anti-neuronal autoantibodies in serum or CSF when assessing a large panel of autoantibodies against intracellular and surface antigens relevant for central nervous system diseases using cell-based assays and indirect immunofluorescence on murine brain sections. Antigens included proteins well-established in clinical routine, such as Yo or NMDA receptor, but also a variety of specific undetermined epitopes on brain sections. These included vessel endothelium, astrocytic proteins MESHD and neuropil of basal ganglia MESHD, hippocampus or olfactory bulb. The high frequency of autoantibodies targeting the brain in the absence of other explanations suggests a causal relationship to clinical symptoms, in particular to hyperexcitability ( myoclonus MESHD, seizures MESHD). While several underlying autoantigens still await identification in future studies, presence of autoantibodies may explain some aspects of multi-organ disease in COVID-19 MESHD and can guide immunotherapy in selected cases.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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