key: cord-268525-j06u3brl
authors: Lucchese, Guglielmo
title: Cerebrospinal fluid findings in COVID-19 indicate autoimmunity
date: 2020-10-07
journal: Lancet Microbe
DOI: 10.1016/s2666-5247(20)30147-6
sha: 
doc_id: 268525
cord_uid: j06u3brl

nan

Bellon and colleagues 3 examined 31 patients. Espíndola and colleagues 4 described eight patients and reviewed literature reports on 30 additional cases. All of these studies showed that SARS-CoV-2 is not detectable in the CSF of patients with COVID-19 and neurological manifestations. The importance of these results, and the reason why researchers at different laboratories are focusing on the same line of research, should be found in the question of how the virus can damage the nervous system. Is it a direct or indirect mechanism? The results from the studies mentioned here point toward an indirect mechanism. [1] [2] [3] [4] Further results 5 support an indirect mechanism, showing a high prevalence of autoantibodies, mainly against unknown autoantigens in the brain, in CSF from patients with COVID-19 and neurological complications. It appears, therefore, that neurological manifestations of COVID-19 are not caused by direct cytopathic effects but indirect immune-mediated mechanisms targeting various unknown elements of the nervous system. Testing the immune reactivity of the CSF of patients with COVID-19 and neurological manifestations against candidate targets for autoimmunity might be the next step to elucidate the mechanisms of damage to the nervous system by SARS-CoV-2.

Systematic SARS-CoV-2 screening in cerebrospinal fluid during the COVID-19 pandemic

Cerebrospinal fluid findings in COVID-19 patients with neurological symptoms

Cerebrospinal fluid features in SARS-CoV-2 RT-PCR positive patients

Patients with COVID-19 and neurological manifestations show undetectable SARS-CoV-2 RNA levels in the cerebrospinal fluid

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