Evolving data show a variable expression of clinical neurological manifestations in patients suffering with coronavirus disease 2019 (COVID-19) from early disease onset. The most frequent symptoms and signs are fatigue, dizziness, impaired consciousness, ageusia, anosmia, radicular pain, and headache, as well as others. Based on the high number of series of cases reported, there is evidence for the implication of the immune system in the pathological mechanism of COVID-19. Although the exact role of the immunological mechanism is not elucidated, two main mechanisms are suggested which implicate the direct effect of severe acute respiratory syndrome coronavirus 2 infection in the central nervous system and neuroinflammation. In the context of neurological manifestations associated with COVID-19, neuropsychiatric disorders show an exacerbation and are described by symptoms and signs such as depression, anxiety, mood alterations, psychosis, post-traumatic stress disorder, delirium, and cognitive impairment, which appear to be common in COVID-19 survivors. A worsened score on psychopathological measures is seen in those with a history of psychiatric comorbidities. We review the neuropsychiatric manifestations associated with COVID-19 and some critical aspects of the innate and adaptive immune system involved in mental health disorders occurring in COVID-19.

Background The aim of this study was to investigate serum S100B and brain-derived neurotrophic factor (BDNF) in systemic lupus erythematous (SLE) patients, with and without neuropsychiatric (NP) manifestation activity. Methods We assessed 47 SLE patients and 20 selected healthy individuals. Disease activity was assessed according to the SLE disease activity index (SLEDAI). Serum BDNF and S100B were measured by enzyme-linked immunosorbent assay. Results Serum S100B protein was significantly higher in SLE patients. BDNF levels were significantly decreased in active SLE, when compared with inactive SLE, but not when compared with controls. S100B was clearly higher in the NPSLE group, when compared with the non-NPSLE or control groups. Receiver operating characteristic analysis of S100B revealed an area under the curve of 0.706 that discriminated NPSLE patients with peripheral polyneuropathy. Conclusions Our findings reinforce the use of serum S100B as a biomarker in SLE, particularly for NPSLE. Moreover, we found a strong association between serum S100B and peripheral neuropathy, indicating a specific utility for this biomarker in SLE that warrants clinical investigation.

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RESUMEN -I n t roducción: El diagrama de las razones de Reiber o re i b e rgrama cobra cada día mayores usos para la caracterización de la síntesis intratecal de proteínas. El re i b e rgrama fue definido para las clases m a y o res de inmunoglobulinas pero luego ha sido utilizado para evaluar otras proteínas basado en la teoría de la difusión molecular/velocidad de flujo del líquido cefalorraquídeo (LCR). Método: El C3c, producto de la degradación del factor del complemento C3 y con una masa molecular de 145 KDa, se acerca a las características moleculares de la IgG para las leyes de la difusión de Fick. Se asume las constantes de la IgG en la fórmula de Reiber para evaluar la síntesis intratecal de C3c así como su correspondiente re i b e rg r a m a . Se estudiaron 27 pacientes y 27 controles a los que se les dosificó albúmina y C3c en suero y LCR por inmunodifusión radial. Resultados: Con el re i b e rgrama propuesto para el C3c se evaluaron estos pacientes. Se comprueba la validez de este re i b e rgrama para distintas condiciones de barrera con o sin síntesis intratecal de C3c. Conclusion: El re i b e rgrama y su fórmula correspondiente propuesto para la C3c puede ser usado para la evaluación de la síntesis intratecal de C3c.PALABRAS CLAVES: C3c, albúmina, inmunodifusión, nefelometría, reibergrama, síntesis intratecal. Reibergram for C3c intrathecal synthesis evaluationABSTRACT -I n t roduction: Reiber´s quotient diagram or re i b e rgram has a growing apply for characterize the intratecal synthesis of proteins. Firstly re i b e rgrama was used for the major classes of immunoglobulins but later it was used to evaluate other proteins based on the theory about molecular flux/cere b ro s p i n a l fluid (CSF) flow rate. Method: C3c is a degradation product of complement factor C3 with 145 KDa and a p p roaches to IgG molecular characteristics according with Fick´s diffussion laws. It was assumed IgG constants and graphic for IgG constants and graphic to evaluate the intrathecal synthesis of C3c. Twentyseven patients and 27 controls were studied. Serum and CSF C3c and albumin were quantified by i m m u n o d i ff u s i o n . Results: The patients with the C3c proposed re i b e rgram were evaluated. It has been p roved its validity under several CSF blood barrier conditions. Conclusion: R e i b e rgram for C3c can be used for the evaluation of the intrathecal synthesis of this protein.