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J Neurol . Cerebrospinal fluid cytokines in COVID-19: a review and meta-analysis

tetano

Editor, Senior Moderator
J Neurol


. 2023 Aug 15.
doi: 10.1007/s00415-023-11928-3. Online ahead of print. Cerebrospinal fluid cytokines in COVID-19: a review and meta-analysis

Lily Devlin[SUP] 1 [/SUP], Grace Y Gombolay[SUP] 2 [/SUP]



Affiliations
Abstract

Introduction: Neurological involvement can occur in patients with SARS-CoV-2 infections, resulting in coronavirus disease 2019 (COVID-19). Cytokine alterations are associated with neurological symptoms in COVID-19. We performed a review of cytokines in the cerebrospinal fluid (CSF) of patients with COVID-19.
Methods: Two reviewers independently searched PubMed for all relevant articles published prior to November 11, 2022. Active SARS-CoV-2 infection and CSF cytokine analyses were required for inclusion.
Results: Three-hundred forty-six patients with COVID-19 and 356 controls from 28 studies were included. SARS-CoV-2 PCR was positive in the CSF of 0.9% (3/337) of patients with COVID-19. Thirty-seven different cytokines were elevated in the CSF of patients with COVID-19 when compared to controls and the standards set forth by individual assays used in each study. Of the 37 cytokines, IL-6 and IL-8 were most commonly elevated. CSF IL-6 is elevated in 60%, and CSF IL-8 is elevated in 51% of patients with COVID-19.
Conclusion: Levels of several inflammatory cytokines are elevated in the CSF of patients with COVID-19, and SARS-CoV-2 PCR is often not isolated in the CSF of patients with COVID-19. Many patients with COVID-19 have neurological symptoms and given the cytokine elevations in the absence of detectable viral RNA in cerebrospinal fluid; further study of the CSF cytokine profiles and pathogenesis of neurological symptoms in COVID-19 is needed.

Keywords: COVID-19; CSF cytokines; Coronavirus-19; Neurological symptoms in COVID-19; SARS-CoV-2.

 
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