Neurological Manifestations of COVID-19 Feature T Cell Exhaustion and Dedifferentiated Monocytes in Cerebrospinal Fluid

Overview

Journal Immunity

Publisher Cell Press

Specialty Allergy & Immunology

Date 2020 Dec 31

PMID 33382973

Citations 97

Authors

Michael Heming

Xiaolin Li

Saskia Rauber

Anne K Mausberg

Anna-Lena Borsch

Maike Hartlehnert

Arpita Singhal

I-Na Lu

Michael Fleischer

Fabian Szepanowski

Oliver Witzke

Thorsten Brenner

Ulf Dittmer

Nir Yosef

Christoph Kleinschnitz

Heinz Wiendl

Mark Stettner

Gerd Meyer Zu Horste

Affiliations

Soon will be listed here.

Abstract

Patients suffering from Coronavirus disease 2019 (COVID-19) can develop neurological sequelae, such as headache and neuroinflammatory or cerebrovascular disease. These conditions-termed here as Neuro-COVID-are more frequent in patients with severe COVID-19. To understand the etiology of these neurological sequelae, we utilized single-cell sequencing and examined the immune cell profiles from the cerebrospinal fluid (CSF) of Neuro-COVID patients compared with patients with non-inflammatory and autoimmune neurological diseases or with viral encephalitis. The CSF of Neuro-COVID patients exhibited an expansion of dedifferentiated monocytes and of exhausted CD4 T cells. Neuro-COVID CSF leukocytes featured an enriched interferon signature; however, this was less pronounced than in viral encephalitis. Repertoire analysis revealed broad clonal T cell expansion and curtailed interferon response in severe compared with mild Neuro-COVID patients. Collectively, our findings document the CSF immune compartment in Neuro-COVID patients and suggest compromised antiviral responses in this setting.

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