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Needham, Edward J; Ren, Alexander L; Digby, Richard J; Norton, Emma J; Ebrahimi, Soraya; Outtrim, Joanne G; Chatfield, Doris A; Manktelow, Anne E; Leibowitz, Maya M; Newcombe, Virginia F J; Doffinger, Rainer; Barcenas-Morales, Gabriela; Fonseca, Claudia; Taussig, Michael J; Burnstein, Rowan M; Samanta, Romit J; Dunai, Cordelia; Sithole, Nyarie; Ashton, Nicholas J; Zetterberg, Henrik; Gisslén, Magnus; Edén, Arvid; Marklund, Emelie; Openshaw, Peter J M; [...]

Brain injury in COVID-19 is associated with dysregulated innate and adaptive immune responses

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  • Medientyp: E-Artikel
  • Titel: Brain injury in COVID-19 is associated with dysregulated innate and adaptive immune responses
  • Beteiligte: Needham, Edward J; Ren, Alexander L; Digby, Richard J; Norton, Emma J; Ebrahimi, Soraya; Outtrim, Joanne G; Chatfield, Doris A; Manktelow, Anne E; Leibowitz, Maya M; Newcombe, Virginia F J; Doffinger, Rainer; Barcenas-Morales, Gabriela; Fonseca, Claudia; Taussig, Michael J; Burnstein, Rowan M; Samanta, Romit J; Dunai, Cordelia; Sithole, Nyarie; Ashton, Nicholas J; Zetterberg, Henrik; Gisslén, Magnus; Edén, Arvid; Marklund, Emelie; Openshaw, Peter J M; [...]
  • Erschienen: Oxford University Press (OUP), 2022
  • Erschienen in: Brain
  • Sprache: Englisch
  • DOI: 10.1093/brain/awac321
  • ISSN: 1460-2156; 0006-8950
  • Schlagwörter: Neurology (clinical)
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:p>COVID-19 is associated with neurological complications including stroke, delirium and encephalitis. Furthermore, a post-viral syndrome dominated by neuropsychiatric symptoms is common, and is seemingly unrelated to COVID-19 severity. The true frequency and underlying mechanisms of neurological injury are unknown, but exaggerated host inflammatory responses appear to be a key driver of COVID-19 severity.</jats:p> <jats:p>We investigated the dynamics of, and relationship between, serum markers of brain injury [neurofilament light (NfL), glial fibrillary acidic protein (GFAP) and total tau] and markers of dysregulated host response (autoantibody production and cytokine profiles) in 175 patients admitted with COVID-19 and 45 patients with influenza.</jats:p> <jats:p>During hospitalization, sera from patients with COVID-19 demonstrated elevations of NfL and GFAP in a severity-dependent manner, with evidence of ongoing active brain injury at follow-up 4 months later. These biomarkers were associated with elevations of pro-inflammatory cytokines and the presence of autoantibodies to a large number of different antigens. Autoantibodies were commonly seen against lung surfactant proteins but also brain proteins such as myelin associated glycoprotein. Commensurate findings were seen in the influenza cohort.</jats:p> <jats:p>A distinct process characterized by elevation of serum total tau was seen in patients at follow-up, which appeared to be independent of initial disease severity and was not associated with dysregulated immune responses unlike NfL and GFAP.</jats:p> <jats:p>These results demonstrate that brain injury is a common consequence of both COVID-19 and influenza, and is therefore likely to be a feature of severe viral infection more broadly. The brain injury occurs in the context of dysregulation of both innate and adaptive immune responses, with no single pathogenic mechanism clearly responsible.</jats:p>
  • Zugangsstatus: Freier Zugang