Neuroimmune disorders in COVID-19

Area of Science:

• Neurology
• Neuroimmunology
• Infectious Diseases

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, with a significant percentage of cases exhibiting neurological manifestations.
• These manifestations range from anosmia and stroke to more severe autoimmune neurological disorders affecting both the central and peripheral nervous systems.

Purpose of the Study:

• To systematically review and synthesize data on the neurology and neuropsychiatry of COVID-19.
• To provide a comprehensive overview of the diagnosis and treatment of immune-mediated neurological complications associated with SARS-CoV-2 infection.

Main Methods:

• Systematic description of data from 133 reported series on the Neurology and Neuropsychiatry of COVID-19 blog.
• Analysis of diagnostic approaches and treatment responses, including immunotherapies.

Main Results:

• Neurological disorders in COVID-19 patients show variable latency and unclear underlying mechanisms.
• While specific autoantibodies were identified in a minority, many patients responded to immunotherapies, suggesting an immune-mediated component.
• The proportion of patients with immune-mediated neurological disorders may be underestimated.

Conclusions:

• Early recognition and immunomodulatory treatment are crucial for improving outcomes and preventing long-term disability in COVID-19 patients with neurological complications.
• The potential benefits of immunotherapy extend even to cases without identified autoantibodies.
• Consideration must be given to managing immunotherapy in patients with pre-existing neuro-immunological conditions.