@article{10.37349/ei.2024.00132,
abstract = {Aim: The current study aimed to describe various types of myelitis associated with a novel coronavirus infection [coronavirus disease 2019 (COVID-19)] as well as to analyze cytokine profiles and cerebrospinal fluid (CSF) parameters in affected patients and to compare them to patients with other immune-mediated disorders—multiple sclerosis (MS), in order to identify possible common pathogenetic pathways and consequently treatment targets.
Methods: Clinical, radiological, and laboratory characteristics were studied based on patients’ history. CSF from patients with myelitis associated with COVID-19 (11 patients) was compared with CSF of healthy controls (HC) (7 patients) and patients with MS (37 patients) from the non-COVID era. CSF underwent cytological examination, protein levels, oligoclonal bands (OCBs) assessment, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus detection, and cytokine profiling using Bio-Plex Pro Human Inflammation Panel 1, 37-Plex.
Results: In total 11 patients with different types of myelitis developed up to 3 months after COVID-19 were enrolled in the study. Radiological findings were diverse: short transverse myelitis (lesion of fewer than 3 segments) (n = 6), longitudinal extensive transverse myelitis (LETM) (n = 2), multifocal spinal cord lesions (n = 1), and myelitis involving dorsal and lateral columns (n = 2). The most pronounced response to treatment was observed in patients with partial transverse myelitis and patients with anti-myelin oligodendrocyte glycoprotein (MOG) antibodies (MOG Abs). Multiple comparisons have demonstrated decreased levels of interleukin-10 (IL-10), interferon-α2 (IFN-α2), IFN-β, and thymic stromal lymphopoietin (TSLP), and increased IL-19 and B cell activating factor (BAFF) in patients with COVID-19 myelitis (CM) compared to the MS group. The highest BAFF and a proliferation-inducing ligand (APRIL) concentrations were found in patients with the most profound neurological disability.
Conclusions: Myelitis associated with COVID-19 is clinically and radiologically heterogeneous. Evaluation of cytokine profiles in patients with myelitis associated with COVID-19 revealed their relative similarity with ones of MS patients, except for a few cytokines. BAFF/APRIL system as well as IL-10 is well-known for the role in the development and progression of autoimmune diseases, however, their links with COVID-19 and effects on the development of immune-mediated central nervous system (CNS) disorders after SARS-CoV-2 remain to be further studied.},
author = {Kozlova, Aleksandra and Dzharullaeva, Alina and Tukhvatulin, Amir and Zakroyshchikova, Inessa and Simaniv, Taras and Askarova, Lola and Eliseeva, Daria and Stoida, Natalia and Kochergin, Ivan and Baydina, Ekaterina and Zakharova, Maria},
doi = {10.37349/ei.2024.00132},
journal = {Exploration of Immunology},
pages = {115--128},
title = {{Myelitis associated with COVID-19: clinical, radiological, and laboratory characteristics}},
url = {https://www.explorationpub.com/Journals/ei/Article/1003132},
volume = {4},
year = {2024},
number = {1}
}