Anti-SARS-CoV-2 and Autoantibody Profiling of a COVID-19 Patient With Subacute Psychosis Who Remitted After Treatment With Intravenous Immunoglobulin

McAlpine, Lindsay; Lifland, Brooke; Check, Joseph R.; Angarita, Gustavo A.; Ngo, Thomas T.; Chen, Pei-Xi; Dandekar, Ravi; Alvarenga, Bonny D.; Browne, Weston D.; Pleasure, Samuel J.; Wilson, Michael R.; Spudich, Serena; Farhadian, Shelli; Bartley, Christopher M.

doi:10.1016/j.biopsych.2022.09.007

Cited by 2 publications

(6 citation statements)

References 35 publications

(40 reference statements)

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“…Using a broad range of tissues and performing immunofluorescence using total IgG purified from LC participants, we were able to identify a subset of participants with AAB against neurological tissues and symptoms that are more closely associated with those AAB. A recent case report 18 also showed cross-reactive antibodies in the cerebrospinal fluid against several mouse neurological tissues, including meninges and sciatic nerve in a patient with severe neurological symptoms following SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 92%

“…Since many autoimmune diseases (e.g., multiple sclerosis, rheumatoid arthritis, systemic lupus, Sjögren's syndrome) are more frequent in women, we hypothesize autoimmunity may play a central role in the development of LC and other PAIS. Although the root cause(s) of PAIS remain unclear, a wealth of data supports an autoimmune etiology of PAIS 3,[14][15][16][17][18][19][20][21][22][23] . For example, AABs have been found in ME/CFS [24][25][26] , chronic Lyme disease 27,28 , and LC 3,[14][15][16][17][18][19][20][21][22][23] , some of which target GPCRs and GABA receptors involved in neuronal pathways relevant to neurological symptoms.…”

Section: Introductionmentioning

confidence: 99%

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A causal link between autoantibodies and neurological symptoms in long COVID

Santos Guedes de Sa,

Silva,

Bayarri-Olmos

et al. 2024

Preprint

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SummaryAcute SARS-CoV-2 infection triggers the generation of diverse and functional autoantibodies (AABs), even after mild cases. Persistently elevated autoantibodies have been found in some individuals with long COVID (LC). Using a >21,000 human protein array, we identified diverse AAB targets in LC patients that correlated with their symptoms. Elevated AABs to proteins in the nervous system were found in LC patients with neurocognitive and neurological symptoms. Purified Immunoglobulin G (IgG) samples from these individuals reacted with human pons tissue and were cross-reactive with mouse sciatic nerves, spinal cord, and meninges. Antibody reactivity to sciatic nerves and meninges correlated with patient-reported headache and disorientation. Passive transfer of IgG from patients to mice led to increased sensitivity and pain, mirroring patient-reported symptoms. Similarly, mice injected with IgG showed loss of balance and coordination, reflecting donor-reported dizziness. Our findings suggest that targeting AABs could benefit some LC patients.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

A causal link between autoantibodies and neurological symptoms in long COVID

Santos Guedes de Sa,

Silva,

Bayarri-Olmos

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…Neural autoantibodies are commonly reported in neuropsychiatric patients diagnosed with coronavirus 2019 (COVID-19) [ 1 , 2 , 3 , 4 ] secondary to infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Less is known about acute and persisting forms of COVID-19 with neural autoantibodies [ 5 ] and predominant psychiatric manifestation.…”

Section: Psychiatric Disease Manifestation In Covid-19 Associated Wit...mentioning

confidence: 99%

“…Coronavirus disease 2019 (COVID-19) triggering severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection can be fatal and is one of the top ten causes of death worldwide [ 7 ]. Its clinical features vary widely and can lead to psychiatric symptoms such as cognitive impairment in several areas [ 8 ] or psychosis [ 4 ] ( Table 1 ). Psychiatric symptoms and COVID-19 influence each other, as patients with no psychiatric history carry a higher risk for developing a psychiatric disorder.…”

Section: Psychiatric Symptom Spectrum In Covid-19 With Neural Autoant...mentioning

confidence: 99%

“…Indirect immunohistochemical studies on mouse brain sections also revealed the nonspecific binding of neural autoantibodies to hippocampal, cerebellar, olfactory neuropil, or brainstem neuropil tissue and to unknown brain antigens [ 1 ]. Another interesting single report [ 4 ] described a man (whose anti-neural autoantibodies were assessed) with subacute psychosis also suffering from delusions and agitation. The authors detected no specific neural autoantibodies, but his CSF IgG showed immunostaining of the olfactory bulb, cortex, thalamus, and hippocampus.…”

Section: Neural Autoantibodies In Covid-19 With Psychiatric Manifesta...mentioning

confidence: 99%

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Psychiatric Symptoms in Acute and Persisting Forms of COVID-19 Associated with Neural Autoantibodies

Hansen

2023

Antibodies

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(1) Background: In this narrative review, we focus on neural autoantibodies in patients with coronavirus disease 2019 (COVID-19) as a consequence of severe acute respiratory syndrome coronavirus type 2 infection and persisting symptoms of post-COVID-19 syndrome with a psychiatric presentation. (2) Methods: Our methods include using the PubMed database to search for appropriate articles. (3) Results: We first describe the phenomenon of the psychiatric manifestation of COVID-19 in acute and persistent forms, associated with neural autoantibodies, often attributable to encephalopathy or encephalitis. We discuss the spectrum of neural autoantibodies in neuropsychiatric patients affected by COVID-19 and post-COVID-19 syndrome. Evidence from our research suggests that it is highly likely that neural autoantibody production is facilitated by SARS-CoV-2 infection, and that more neuropsychiatric patients than control subjects will present neural autoantibodies. (4) Conclusions: These observations support the hypothesis that acute and persisting forms of COVID-19 promote autoimmune diseases. Our patients therefore require comprehensive evaluation to avoid overlooking such autoantibody-associated psychiatric disorders associated with COVID-19.

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Anti-SARS-CoV-2 and Autoantibody Profiling of a COVID-19 Patient With Subacute Psychosis Who Remitted After Treatment With Intravenous Immunoglobulin

Cited by 2 publications

References 35 publications

A causal link between autoantibodies and neurological symptoms in long COVID

A causal link between autoantibodies and neurological symptoms in long COVID

Psychiatric Symptoms in Acute and Persisting Forms of COVID-19 Associated with Neural Autoantibodies

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