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Cerebrospinal fluid findings in patients with neurological manifestations in post-COVID-19 syndrome

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Item Type:Article
Title:Cerebrospinal fluid findings in patients with neurological manifestations in post-COVID-19 syndrome
Creators Name:Boesl, F., Goereci, Y., Gerhard, A., Bremer, B., Raeder, V., Schweitzer, F., Hoppmann, U., Behrens, J., Bellmann-Strobl, J., Paul, F., Wildemann, B., Jarius, S., Prüss, H., Audebert, H.J., Warnke, C. and Franke, C.
Abstract:BACKGROUND: Information on cerebrospinal fluid (CSF) findings in patients with neurological manifestations in post-COVID-19 syndrome is scarce. METHODS: Retrospective evaluation of 84 CSF samples in patients fulfilling post-COVID-19 criteria in two neurological post-COVID-19 outpatient clinics. RESULTS: In 68% of samples, all CSF parameters were normal. The most frequent pathological CSF finding was elevation of total protein (median total protein 33.3 mg/dl [total range 18.5-116.2]) in 20 of 83 (24%) samples. The second most prevalent pathological finding was a blood-CSF barrier dysfunction as measured by elevation of QAlb (median QAlb 4.65 [2.4-13.2]) in 11/84 (13%). Pleocytosis was found in only 5/84 (6%) samples and was mild in all of them. CSF-restricted oligoclonal bands were found in 5/83 (6%) samples. Anti-neuronal autoantibodies in CSF were negative in most cases, whilst 12/68 (18%) samples were positive for anti-myelin autoantibodies in serum. PCR for herpesviridae (HSV-1/-2, VZV, EBV, CMV, HHV6) showed, if at all, only weakly positive results in CSF or EDTA whole blood/plasma. CONCLUSIONS: The majority of samples did not show any pathologies. The most frequent findings were elevation of total protein and blood-CSF barrier dysfunction with no signs of intrathecal inflammation. CSF analysis still keeps its value for exclusion of differential diagnoses.
Keywords:Post-COVID, Long-COVID, Cerebrospinal Fluid, Blood-CSF Barrier Dysfunction, Neurology, Post-Acute Sequelae of SARS-CoV-2 Infection
Source:Journal of Neurology
ISSN:0340-5354
Publisher:Springer
Volume:271
Number:1
Page Range:59-70
Date:January 2024
Official Publication:https://doi.org/10.1007/s00415-023-12092-4
PubMed:View item in PubMed

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