Persistence of spike protein at the skull-meninges-brain axis may contribute to the neurological sequelae of COVID-19.

Cell Host Microbe

Institute for Tissue Engineering and Regenerative Medicine (iTERM), Helmholtz Munich, Neuherberg, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Ko

Published: December 2024


Article Synopsis

  • SARS-CoV-2 infection can lead to long-term neurological issues, with the mechanisms not fully understood yet.
  • Research found that the spike protein from the virus accumulates in the skull and brain areas of COVID-19 patients, remaining even after the virus is cleared from the body.
  • Additionally, changes in neurodegenerative markers and inflammatory pathways were identified in both humans and infected mice, hinting that the presence of the spike protein may play a role in prolonged neurological symptoms post-COVID.

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Article Abstract

SARS-CoV-2 infection is associated with long-lasting neurological symptoms, although the underlying mechanisms remain unclear. Using optical clearing and imaging, we observed the accumulation of SARS-CoV-2 spike protein in the skull-meninges-brain axis of human COVID-19 patients, persisting long after viral clearance. Further, biomarkers of neurodegeneration were elevated in the cerebrospinal fluid from long COVID patients, and proteomic analysis of human skull, meninges, and brain samples revealed dysregulated inflammatory pathways and neurodegeneration-associated changes. Similar distribution patterns of the spike protein were observed in SARS-CoV-2-infected mice. Injection of spike protein alone was sufficient to induce neuroinflammation, proteome changes in the skull-meninges-brain axis, anxiety-like behavior, and exacerbated outcomes in mouse models of stroke and traumatic brain injury. Vaccination reduced but did not eliminate spike protein accumulation after infection in mice. Our findings suggest persistent spike protein at the brain borders may contribute to lasting neurological sequelae of COVID-19.

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http://dx.doi.org/10.1016/j.chom.2024.11.007DOI Listing

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