Human Leukocyte Antigen (HLA) includes a large set of genes with important actions in immune response against viral infection. Numerous studies have revealed the existence of significant associations between certain HLA alleles and the susceptibility and prognosis of different infectious diseases. In this pilot study we analyse the binding affinity between 66 class I HLA alleles and SARS-CoV-2 viral peptides, and its association with the severity of the disease.
A total of 45 Spanish patients with mild, moderate and severe SARS-CoV-2 infection were typed for HLA class I; after that, we analysed if an in silico model of HLA I-viral peptide binding affinity and classical HLA supertypes could be correlated to the severity of the disease. Our results suggest that patients with mild disease present Class I HLA molecules with a higher theoretical capacity for binding SARS-Cov-2 peptides and showed greater heterozygosity when comparing them with moderate and severe groups. In this regard, identifying HLA-SARS-CoV-2 peptides binding differences between individuals would help to clarify the heterogeneity of clinical responses to the disease and will also be useful to guide a personalized treatment according to its particular risk.
Background
Headache is a frequent symptom at the onset of Listeria meningitis, accompanied by others such as fever, altered mental status and meningeal signs, but never reported so far as an isolated symptom.
Methods and Results
Two immunocompetent males, with no history of primary headaches, went to the emergency department because of headache. The first after a sudden severe, holocranial headache without other associated symptoms, and the second after a subacute, moderate oppressive headache in temples, which 8 days later added a mild left hemiparesis. None of them had fever or meningeal signs. The initial cranial CT was unremarkable in both cases. Lumbar puncture was diagnostic for Listeria meningitis serotype IVb.
Conclusions
Listeria meningitis may present as an isolated headache, with different clinical patterns, which should be taken into account when evaluating de novo unclassified headaches according to the ICHD‐3 criteria.
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