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'Rogue' antibodies found in brains of teens with delusions and paranoia after COVID-19 - Livescience.com
Oct 25, 2021 2 mins, 3 secs

Two teens developed severe psychiatric symptoms such as paranoia, delusions and suicidal thoughts during mild COVID-19 infections.

The researchers spotted these rogue antibodies in two teens who were examined at the University of California, San Francisco (UCSF) Benioff Children’s Hospital after catching COVID-19 in 2020, according to a new report on the cases published Monday (Oct. 25) in the journal JAMA Neurology.

But while such antibodies may attack brain tissue, it's too early to say that these antibodies directly caused the troubling symptoms in the teens, the researchers wrote in the new study.

"So, we suspect that either the COVID autoantibodies" — meaning antibodies that attack the body rather than the virus — "are indicative of an out of control autoimmune response that might be driving the symptoms, without the antibodies necessarily causing the symptoms directly," he said.

And they also hint that, in some cases, treatments that "calm down" the immune system may help resolve psychiatric symptoms of COVID-19, she told Live Science in an email. .

Both teens in the study received intravenous immunoglobulin, a therapy used to essentially reset the immune response in autoimmune and inflammatory disorders, after which the teens' psychiatric symptoms either partially or completely remitted.

Prior to their research in teens, the study authors published evidence of neural autoantibodies in adult COVID-19 patients.

But "in the case of these teens, the patients had quite minimal respiratory symptoms," Pleasure said.

From this group of pediatric patients, the study authors recruited three teens who underwent neurological evaluations and became the focus for the new case study. .

All three patients had elevated antibody levels in their CSF, but only the CSF of patients 1 and 2 carried antibodies against SARS-CoV-2, the virus that causes COVID-19.

These findings hint that the autoantibodies might contribute to a runaway immune response that causes psychiatric symptoms in some COVID-19 patients, but again, the small study cannot prove that the antibodies themselves directly cause disease.

That said, the team is now collaborating with several groups studying long COVID, who are collecting CSF samples from patients with and without neuropsychiatric symptoms, Pleasure said

"In adults, it is not uncommon to have patients be willing to undergo a spinal tap for research purposes with appropriate informed consent and institutional review." Using these samples, as well as some studies in animal models, the team will work to pinpoint the autoimmune mechanisms behind these troubling neuropsychiatric symptoms, and figure out how autoantibodies fit into that picture. 

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