TY  - JOUR
AU  - Skripuletz, Thomas
AU  - Möhn, Nora
AU  - Franke, Christiana
AU  - Prüß, Harald
TI  - Neuroimmunologie von COVID‑19.
JO  - Der Nervenarzt
VL  - 92
IS  - 6
SN  - 0028-2804
CY  - Heidelberg
PB  - Springer
M1  - DZNE-2022-00801
SP  - 521 - 530
PY  - 2021
AB  - Many neuroimmunological diseases, such as encephalopathy, encephalitis, myelitis and acute disseminated encephalomyelitis (ADEM) have occurred more frequently after infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which indicates a parainfectious or postinfectious association. The most likely underlying mechanisms include virus-triggered overactivation of the immune system with hyperinflammation and cytokine storm but potentially also the development of specific autoantibodies against central nervous system (CNS) tissue. These were predominantly detected in the cerebrospinal fluid of severely ill coronavirus disease 2019 (COVID-19) patients. In contrast, direct damage after invasion of SARS-CoV‑2 into the brain and spinal cord does not seem to play a relevant role. Susceptibility to infection with SARS-CoV‑2 in patients with multiple sclerosis, myasthenia or other neuroimmunological diseases including the risk for severe disease courses, is not determined by the administered immunotherapy but by known risk factors, such as age, comorbidities and the disease-related degree of disability. Therefore, immunotherapy in these patients should not be delayed or discontinued. The contribution of neuroimmunological mechanisms to long-term sequelae after survival of a COVID-19 illness, such as fatigue, impairment of memory, sleep dysfunction or anxiety, will require long-term clinical follow-up, preferentially in COVID-19 register studies.
KW  - Brain Diseases
KW  - COVID-19
KW  - Encephalitis
KW  - Humans
KW  - Neuroimmunomodulation
KW  - SARS-CoV-2
KW  - Autoantibodies (Other)
KW  - Encephalitis (Other)
KW  - Hyperinflammation (Other)
KW  - Immunotherapy (Other)
KW  - Myelitis (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:33651117
C2  - pmc:PMC7923405
DO  - DOI:10.1007/s00115-021-01077-1
UR  - https://pub.dzne.de/record/164145
ER  -