Anti-SARS-CoV-2 and Autoantibody Profiles in the Cerebrospinal Fluid of 3 Teenaged Patients With COVID-19 and Subacute Neuropsychiatric Symptoms.

Autor:	Bartley CM; Hanna H. Gray Fellow, Howard Hughes Medical Institute, Chevy Chase, Maryland.; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco., Johns C; Department of Pediatrics, University of California, San Francisco., Ngo TT; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco., Dandekar R; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., Loudermilk RL; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., Alvarenga BD; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., Hawes IA; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco.; Biomedical Sciences Graduate Program, University of California, San Francisco., Zamecnik CR; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., Zorn KC; Department of Biochemistry and Biophysics, University of California, San Francisco., Alexander JR; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., Wapniarski AE; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., DeRisi JL; Department of Biochemistry and Biophysics, University of California, San Francisco.; Chan Zuckerberg Biohub, San Francisco, California., Francisco C; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., Nash KB; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Pediatrics, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., Wietstock SO; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., Pleasure SJ; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco., Wilson MR; Weill Institute for Neurosciences, University of California, San Francisco.; Department of Neurology, University of California, San Francisco.
Jazyk:	angličtina
Zdroj:	JAMA neurology [JAMA Neurol] 2021 Dec 01; Vol. 78 (12), pp. 1503-1509.
DOI:	10.1001/jamaneurol.2021.3821
Abstrakt:	Importance: Neuropsychiatric manifestations of COVID-19 have been reported in the pediatric population. Objective: To determine whether anti-SARS-CoV-2 and autoreactive antibodies are present in the cerebrospinal fluid (CSF) of pediatric patients with COVID-19 and subacute neuropsychiatric dysfunction. Design, Setting, and Participants: This case series includes 3 patients with recent SARS-CoV-2 infection as confirmed by reverse transcriptase-polymerase chain reaction or IgG serology with recent exposure history who were hospitalized at the University of California, San Francisco Benioff Children's Hospital and for whom a neurology consultation was requested over a 5-month period in 2020. During this period, 18 total children were hospitalized and tested positive for acute SARS-CoV-2 infection by reverse transcriptase-polymerase chain reaction or rapid antigen test. Main Outcomes and Measures: Detection and characterization of CSF anti-SARS-CoV-2 IgG and antineural antibodies. Results: Of 3 included teenaged patients, 2 patients had intrathecal anti-SARS-CoV-2 antibodies. CSF IgG from these 2 patients also indicated antineural autoantibodies on anatomic immunostaining. Autoantibodies targeting transcription factor 4 (TCF4) in 1 patient who appeared to have a robust response to immunotherapy were also validated. Conclusions and Relevance: Pediatric patients with COVID-19 and prominent subacute neuropsychiatric symptoms, ranging from severe anxiety to delusional psychosis, may have anti-SARS-CoV-2 and antineural antibodies in their CSF and may respond to immunotherapy.
Databáze:	MEDLINE
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