Inflammatory leptomeningeal cytokines mediate COVID-19 neurologic symptoms in cancer patients Journal Article


Authors: Remsik, J.; Wilcox, J. A.; Babady, N. E.; McMillen, T. A.; Vachha, B. A.; Halpern, N. A.; Dhawan, V.; Rosenblum, M.; Iacobuzio-Donahue, C. A.; Avila, E. K.; Santomasso, B.; Boire, A.
Article Title: Inflammatory leptomeningeal cytokines mediate COVID-19 neurologic symptoms in cancer patients
Abstract: Remsik et al. analyze the cerebrospinal fluid of cancer patients with neurologic symptoms of COVID-19 and detect unique markers of inflammation and neurodegeneration, present weeks after initial SARS-CoV-2 infection. Cytokine storming, both systemically and intracranially, likely contribute to neurologic dysfunction, indicating a potential therapeutic target for investigation. © 2021 Elsevier Inc. SARS-CoV-2 infection induces a wide spectrum of neurologic dysfunction that emerges weeks after the acute respiratory infection. To better understand this pathology, we prospectively analyzed of a cohort of cancer patients with neurologic manifestations of COVID-19, including a targeted proteomics analysis of the cerebrospinal fluid. We find that cancer patients with neurologic sequelae of COVID-19 harbor leptomeningeal inflammatory cytokines in the absence of viral neuroinvasion. The majority of these inflammatory mediators are driven by type II interferon and are known to induce neuronal injury in other disease states. In these patients, levels of matrix metalloproteinase-10 within the spinal fluid correlate with the degree of neurologic dysfunction. Furthermore, this neuroinflammatory process persists weeks after convalescence from acute respiratory infection. These prolonged neurologic sequelae following systemic cytokine release syndrome lead to long-term neurocognitive dysfunction. Our findings suggest a role for anti-inflammatory treatment(s) in the management of neurologic complications of COVID-19 infection. © 2021 Elsevier Inc.
Keywords: cerebrospinal fluid; neuroinflammation; encephalopathy; cancer; covid-19; sars-cov-2
Journal Title: Cancer Cell
Volume: 39
Issue: 2
ISSN: 1535-6108
Publisher: Cell Press  
Date Published: 2021-02-08
Start Page: 276
End Page: 283.e3
Language: English
DOI: 10.1016/j.ccell.2021.01.007
PROVIDER: scopus
PMCID: PMC7833316
PUBMED: 33508216
DOI/URL:
Notes: Article -- Export Date: 1 March 2021 -- Source: Scopus
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MSK Authors
  1. Ngolela Esther Babady
    171 Babady
  2. Neil A Halpern
    151 Halpern
  3. Marc Rosenblum
    424 Rosenblum
  4. Edward Kenneth Avila
    37 Avila
  5. Adrienne Boire
    106 Boire
  6. Behroze Adi Vachha
    28 Vachha
  7. Vikram Dhawan
    16 Dhawan
  8. Jan Remsik
    25 Remsik
  9. Jessica Alice Wilcox
    34 Wilcox