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Does CSF Antibody Testing Confirm Coronavirus in the Brain?

Reporter: Irina Robu, PhD

It is still uncertain how COVID-19 invades the brain, but testing for antibodies in the cerebrospinal fluid may give some indication.  COVID-19 is typic Is characterized by respiratory illness and viral pneumonia with fever, cough, shortness of breath, and in severe cases, progression to acute respiratory distress syndrome. Recently, there have been a few investigations on what neurological complications can COVID-19 produce.

A case series of three patients attending an inner-city US hospital who had severe, laboratory-confirmed COVID-19 and encephalitis indicated that while only one had abnormal white blood cells or protein present in cerebral spinal fluid, all had evidence of immunoglobulin (IgM) antibodies. The cases include a 31-year-old woman with sickle cell disease who had a recent pulmonary embolus, a 34-year-old woman with sign of fever, shortness of breath and hypertension and a 64-year-old with hypertension. Dr. Benameur, from Emory University assessed cerebrospinal fluid inflammatory proteins and completed testing for SARS-CoV-2 using reverse transcription polymerase chain reaction (PCR).

The results show that two of the patients had normal white blood cell counts and protein levels. Yet, according to Dr. Benameur, even though the PCR in cerebral spinal fluid is negative, it doesn’t mean that the virus didn’t make it into the brain. The PCR test is good for some viruses, but it is not as reliable for this new coronavirus. Even though, all patients had encephalitis, the female patients also developed encephalomyelitis as indicated by inflammation in her brain and spinal cord.

Altogether, patients had symptoms affecting cortical and brainstem function at the peak of neurologic illness.

SOURCE

https://www.medscape.com/viewarticle/931964?src=mkm_covid_update_200608_mscpedit