Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report

Case report of meningoencephalitis associated with SARS-CoV-2 infection showing a decrease in idiopathic focal cerebral blood flow

Some neurological complications are associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A 74-year-old man was diagnosed with infection by SARS-CoV-2. Eighteen days after SARS-CoV-2 infection, he developed disturbed consciousness and aseptic meningoencephalitis. An analysis of cerebrospinal flood revealed an elevated cell count (184/μL) and protein level (260 mg/dL). Cranial magnetic resonance imaging showed no abnormalities. By contrast, 123I-N-isopropyl-p-iodoamphetamine single-photon emission computed tomography showed a significant decrease in cerebral blood flow (CBF) in the left parietal and occipital lobes. He died suddenly 3 months after being transferred to a rehabilitation clinic without any clear cause of death. The SARS-CoV-2 infection can cause aseptic meningoencephalitis with a distinctive decrease in CBF pattern without magnetic resonance image abnormality or intracranial artery stenosis.

IL-8 (CXCL8) Correlations with Psychoneuroimmunological Processes and Neuropsychiatric Conditions

Interleukin-8 (IL-8/CXCL8), an essential CXC chemokine, significantly influences psychoneuroimmunological processes and affects neurological and psychiatric health. It exerts a profound effect on immune cell activation and brain function, suggesting potential roles in both neuroprotection and neuroinflammation. IL-8 production is stimulated by several factors, including reactive oxygen species (ROS) known to promote inflammation and disease progression. Additionally, CXCL8 gene polymorphisms can alter IL-8 production, leading to potential differences in disease susceptibility, progression, and severity across populations. IL-8 levels vary among neuropsychiatric conditions, demonstrating sensitivity to psychosocial stressors and disease severity. IL-8 can be detected in blood circulation, cerebrospinal fluid (CSF), and urine, making it a promising candidate for a broad-spectrum biomarker. This review highlights the need for further research on the diverse effects of IL-8 and the associated implications for personalized medicine. A thorough understanding of its complex role could lead to the development of more effective and personalized treatment strategies for neuropsychiatric conditions.

Cerebrospinal fluid cytokines in COVID-19: a review and meta-analysis

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.