Emory University School of Medicine, Atlanta, GA, USA.
Children's Healthcare of Atlanta, Division of Pediatric Neurology, Emory University, 1400 Tulle Road NE, 8th Floor, Atlanta, GA, USA.
J Neurol. 2023 Nov;270(11):5155-5161. doi: 10.1007/s00415-023-11928-3. Epub 2023 Aug 15.
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.
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.
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.
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.
严重急性呼吸综合征冠状病毒 2 型（SARS-CoV-2）感染患者可出现神经系统受累，导致 2019 冠状病毒病（COVID-19）。细胞因子改变与 COVID-19 的神经系统症状相关。我们对 COVID-19 患者脑脊液（CSF）中的细胞因子进行了综述。
两名审查员独立检索了截至 2022 年 11 月 11 日在 PubMed 上发表的所有相关文章。纳入标准为有活动性 SARS-CoV-2 感染且对 CSF 细胞因子进行了分析。
纳入了 28 项研究中的 346 例 COVID-19 患者和 356 例对照。COVID-19 患者中有 0.9%（3/337）的 CSF 中 SARS-CoV-2 PCR 阳性。与对照和各研究中使用的检测方法设定的标准相比，COVID-19 患者的 CSF 中有 37 种不同的细胞因子升高。在这 37 种细胞因子中，IL-6 和 IL-8 最常升高。COVID-19 患者的 CSF IL-6 升高占 60%，CSF IL-8 升高占 51%。
COVID-19 患者的 CSF 中几种炎症细胞因子水平升高，且 COVID-19 患者的 CSF 中通常无法分离出 SARS-CoV-2 RNA。许多 COVID-19 患者有神经系统症状，鉴于 CSF 中细胞因子升高而病毒 RNA 不可检测；需要进一步研究 COVID-19 中 CSF 细胞因子谱和神经系统症状的发病机制。
