Medical Faculty Mannheim, Heidelberg University
Department of Neurology

Author Of 1 Presentation

COVID-19 Late Breaking Abstracts

LB1268 - No evidence for SARS-CoV-2 transcripts and disease exacerbation in COVID-19 multiple sclerosis brain (ID 2166)

Abstract

Background

Although primarily targeting the respiratory system, coronavirus disease 2019 (COVID-19) also manifests with central nervous system (CNS)-related symptoms. Yet, little is known about the clinical course of CNS autoimmune disease and concurrent SARS-CoV-2-infection. Whether multiple sclerosis (MS) renders patients more susceptible to CNS involvement and / or infection during COVID-19 and the impact of SARS-CoV-2 infection on disease activity remain elusive.

Objectives

Here, we assessed whether an impaired blood-brain barrier in MS facilitates viral CNS entry, and whether COVID-19 infection is associated with MS disease exacerbation.

Methods

To that end, we combined an in-depth histopathological assessment with spatial transcriptomic analysis using multiplex in situ hybridization analysis for immune and SARS-CoV-2 transcripts in autoptic brain tissue of an untreated MS patient, who died from COVID-19-associated respiratory failure, compared to a cohort of non-MS COVID-19, non-MS non-COVID-19, and non-COVID-19 viral encephalitis controls.

Results

Despite a general microglia activation in COVID-19 brain parenchyma, we found neither evidence for active demyelinating activity nor presence of SARS-CoV-2 transcripts in COVID-19 MS lesions.

Conclusions

We conclude that neither clinical and morphological signs of MS disease exacerbation nor presence of viral transcripts in MS brain lesions are observed in COVID-19 patients and that no SARS-CoV-2-specific abnormalities are present in MS COVID-19 and non-MS COVID-19 patients. Future studies will yield further insights into the risk profile of COVID-19 in MS and related CNS autoimmune diseases.

Collapse