1. INTRODUCTION
Coronavirus (COVID-19) is a respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus [1], [2]. The World Health Organization declared this a pandemic in March 2020 due to the virus spreading around the world very quickly [3], [4]. The latest statistics in October 2024 showed that the number of cases of coronavirus worldwide about 770 million [5], [6]. In addition, the number of deaths related to coronavirus exceeded 6.96 million [7], [8]. Some countries are still recording new cases and deaths, especially with the emergence of new mutants, despite the relative control of the virus thanks to extensive vaccination [9], [10]. COVID-19 begins to enter the human body, it starts attacking the respiratory system; then, tissues start falling in the lung [11], [12]. Hence, the immune system starts reacting, causing damage to the healthy tissues in the lung and leading to difficulties in breathing [13], [14].
Autoantibodies are immune system proteins that mistakenly attack the body’s own tissues instead of foreign invaders such as bacteria and viruses [15], [16]. Normally, the immune system produces antibodies to recognize and treat pathogens [17]. Sometimes, the immune system malfunctions and produces autoantibodies, which can lead to autoimmune diseases [18], [19]. The function of autoantibodies is to attach to the body’s cells and tissues, mistakenly marking them for destruction by the immune system [20]. This leads to inflammation and damage to the organs of the body [21]. There are many types of autoantibodies: Thyroid antibodies (TA), antinuclear antibodies (ANA), and TA [22], [23]. In addition, research has shown that COVID-19 can trigger the production of autoantibodies in some patients, which can worsen disease outcomes [24]. Research has found that COVID-19 can lead to the production of autoantibodies in some patients, which may lead to deterioration of disease outcomes [25].
Neuroscience is the scientific discipline of the nervous system knowledge [26]. It is a multidisciplinary science that integrates biology, chemistry, medicine, physics, cytology, psychology, anatomy, statistics, and computer science to understand the function and structure of the nervous system and the disorders it causes [27]. It is concerned with the study of the brain, spinal cord, and networks of nerve cells that control all behavior and functions of the body [28]. Recently, scientific studies of the nervous system have increased dramatically [29]. This is due to great advances in electrophysiology, molecular biology, and computational neuroscience [30]. This has led scientists and researchers to study the nervous system in detail: how it works, how it is built, how it breaks down, and how it is modified and developed, in addition, the introduction of generative artificial intelligence leading to big data neuroscience [31].
2. METHODS AND MATERIALS
2.1. Study Publications Distribution Based on Years
The Corona pandemic began in December 2019, so research on this topic was limited after that, i.e. in 2020, and continued to increase gradually. Combining Autoantibodies, COVID-19, and Neuroscience as keywords in our search on Science Direct database to get 243 articles. The period is between 2020 and 2025. The publication rates in the 5 years are 2020 (2.8%), 2021 (22.2%), 2022 (24.7%), 2023 (30.5%), 2024 (18.9%), and 2025 (0.9%) as shown in Fig. 1. The year 2020 has a lower rate because COVID-19 just started; then, the other years increased gradually.
Fig. 1. Publications distribution based on years.
2.2. Study Publications Distribution Based on Article Type
According to the classifying based on the type of research, we notice that there are different types of publications as demonstrated in Fig. 2. The effective types of publications are review articles (28%), research articles (23.4%), book chapters (11.5%), conference abstracts (10.3%), case reports (4.2%), and correspondence (4.2%) in addition to others (9.5%). Hence, the most effective publication types are review articles (28%) and research articles (23.4%), in addition, the main aim focusing on the research articles to be our guided in the research.
Fig. 2. Publications distribution based on article type.
2.3. Study Publications Distribution Based on Article Subject Area
According to the classifying based on the article subject area, we notice that there are different types of subject areas publications. These publications are sorted starting from higher rate as demonstrated in Fig. 3. The higher rates of publications according to the subject area are focused on the first four areas: Medicine and dentistry (41%), neuroscience (28.9%), immunology and microbiology (12.9%), and biochemistry, genetic and molecular biology (10.6%), combining all these four areas together leading to 93.4% of publications that are dominant most of publications.
Fig. 3. Publications distribution based on article subject area.
3. RESULTS
A total of 243 publications presented as a literature search applied on ScienceDirect database on October 2, 2024 as demonstrated in Fig. 4. One hundred and nine redundancies and duplications have been found, so, the considered fields are 134 publications. Excluded reports and abstract papers of 25 publications, leading to 109 publications as effective fields. Excluded 16 publications as review papers, leading to 93 publications to be passing to the screening procedure. The first screening operation focused on the paper title, in which 35 papers are excluded as non-relevant items to get 58 papers. The second screening operation focused on the paper abstract, in which 17 papers are excluded as non-relevant items to get 41 papers as a final result. These 40 studies are the ones that are analyzed carefully so that we can reach a table to compare these studies.
Fig. 4. Flow diagram of reporting systematic review.
4. ANALYSIS AND DISCUSSION
Many cleaning steps are implemented in the publications to get the final results of 41 publications as shown in Table 1.
Table 1: Distribution of the publications
Morris et al. (2020) [32] demonstrated Toll-like receptors on endosomes can be inhibited using pharmacological agents that increase endosomal pH, thereby reducing the activity of acid-dependent endosomal proteases required for their activity. This in turn leads to decreased autoantibody secretion, decreased nuclear factor kappa B activity, and decreased production of pro-inflammatory cytokines, that is, suppression of antigen-presenting cell activity. In addition, SARS-CoV-2 inhibits autophagy, rendering infected cells susceptible to apoptosis. Therefore, it is also proposed that further pharmacological inhibition of autophagy may promote apoptotic clearance of SARS-CoV-2-infected cells.
Vaschetto et al. (2020) [33] described a panel of common autoantibodies, including extractable nuclear antigen, ANA, antineutrophil cytoplasmic antibodies, and anti-double-stranded DNA antibodies, was negative. Only a slight alteration of lupus anticoagulant was detected, but without detection of anticardiolipin or anti-Beta2 glycoprotein, suggesting false positivity, as expected in critical care patients. Based on these laboratory results and without a history of systemic autoimmune disease, central nervous system (CNS) vasculitis was suspected.
Hu et al. (2020) [34] explained that coronavirus outbreak began in December 2019 and its symptoms include shortness of breath, cough, and fever, as well as CNS symptoms, especially in those with severe illness. The focus has been on how the virus reaches the CNS and what it will do. Some SARS-CoV-2 diseases share the same receptor, angiotensin-converting enzyme 2, which is present in the brain during infection. An abnormal immune response in the CNS and a direct attack by SARS will contribute to the disease.
Bertin et al. (2021) [35] followed-up of a patient of 58-year-old woman after recovery from COVID-19, who presented with new and persistent symptoms including neurological complications that could be explained by post-eclampsia syndrome. This is because they are independent factors associated with the severity of COVID-19 and the pathophysiological mechanism of post-recovery syndrome is unknown. However, it can be suggested that the virus may persist, especially in the nervous system, and what is present after infection is the occurrence of an inflammatory or autoimmune reaction.
Song et al. (2021) [36] examined B cell responses and activation of CNS-specific fractionated T cells were detected by blood and cerebrospinal fluid cytokine analysis of individuals with COVID-19 who had neurological symptoms by single-cell RNA sequencing. Antibodies to SARS were detected in the cerebrospinal fluid of all individuals with COVID-19. In addition, all individuals with COVID-19 have antibodies in their cerebrospinal fluid.
Dutta et al. (2021) [37] followed-up of a 51-year-old male without any medical history, who presented with a persistent, subacute migraine headache over a period of 14 days, for which he was admitted to the hospital. The headache was accompanied by vomiting. The headache worsened and developed 6 days after vaccination against COVID-19 with the first dose of Covishield vaccine. Then, he started complaining of double vision that appeared in the horizontal gaze with loss of parallelism in the eyeballs. All complete blood count, blood sugar, lipid profile, renal function tests, and liver function tests were normal.
Chakraborty et al., (2021) [38] presented a comprehensive overview from clinical presentation to outcome in eight cases of infectious/post-infectious Guillain-Barré syndrome (GBS). They were reported various extrapulmonary symptoms of COVID-19, and GBS has been widely reported in the literature. GBS is known to be associated with infectious causes, and the association of COVID-19 with Para infectious/post-infectious GBS has been of interest for a long time.
Metya et al., (2021) [39] applied several neurological manifestations associated with COVID-19 in the form of post-infectious transverse myelitis and Para infectious transverse myelitis. A 54-year-old female patient was admitted to the hospital with acute urinary retention and bilateral upper motor neuron-type lower limb weakness, 12 days after COVID-19.
Elrashdy et al. (2021) [40], found that coronavirus vaccines have a significant impact in reducing this pandemic. In addition, that vaccines based on lipid nanoparticles cause rare cases of deep vein thrombosis. Some aspects related to the disease and the main risk factors, as well as the specifics of diagnosis and treatment of this rare condition were studied.
Pandey et al. (2021) [41], indicated that the involvement of international organizations is instrumental in mitigating and managing the disease. Most countries have closed their borders and are working remotely, causing the global economy to deteriorate. Poor health, lack of healthy diet, and unhealthy practices among the neighborhood population are the main sources of the spread of disease.
Benjamin et al. (2021) [42], studied a single-center cross-sectional including 106 adult patients: 47 non-neurological COVID-19 cases, 30 neurological COVID-19 cases, and 29 non-COVID-19 cases, studied between March and July 2020. Nine antiphospholipid antibodies were evaluated. There was a high prevalence of antiphospholipid antibodies in the non-neurological COVID group (76.6%) and neurological COVID group (73.3%), as well as a low prevalence of antiphospholipid antibodies in the non-COVID group (48.2%).
Hampshirea et al. (2021) [43], provided that COVID-19 infection has been shown to cause cognitive deficits that persist in recovery. These deficits vary in magnitude with the severity of respiratory symptoms. They cannot be explained by differences in demographic and socioeconomic variables, age, or education, and persist even in those who do not develop any other residual symptoms.
Lin et al. (2021) [44], developed that coronavirus disease in children is mild and sometimes causes serious complications in addition to multisystem inflammatory syndrome in children. Neurological symptoms range from mild headaches to seizures, neuropathy, and encephalopathy. Neurological complications appear differently based on age and comorbidities. A brief study of neurological conditions associated with coronavirus and long-term consequences of the disease in the pediatric population was conducted from preliminary data collected at Morgan Stanley Children’s Hospital.
Evans et al. (2021) [45], studied a long-term, multicenter follow-up of adults over 18 years of age discharged from hospital in the UK with a clinical diagnosis of COVID-19 and followed up 2–7 months after discharge, including detailed recording of symptoms, biochemical, and physiological tests. Multivariable logistic regression was performed and associations with several covariates were investigated.
Dobrindt et al. (2021) [46], explored that the host genes of SARS-CoV-2, human induced pluripotent stem cell-based models, and CRISPR engineering were applied. A single nucleotide polymorphism (rs4702), common in the population and located in the 30 untranslated region of the protease FURIN, affects neurons and alveoli by this virus.
Algahtani et al. (2022) [47], explained that all types of vaccines lead to neurological complications of varying severity. A case of severe cervical dystonia that occurred after the first dose of the BNT162b2 COVID-19 vaccine was described, which had not been previously reported after the vaccine. Thus, one of the rare potential side effects of the COVID-19 vaccine was revealed, in addition to the need to deepen research in this area to identify more complications associated with the vaccine.
Sukocheva et al. (2022) [48], studied the progression of symptoms in patients after COVID-19 infection. Given the pro-inflammatory effects of this virus, clinical complications after COVID-19 are likely to develop in a proportion of the affected population. A debilitating syndrome has been shown to develop, characterized by headache, fatigue, malaise, cognitive impairment, and dyspnea. Understanding the long-term effects of viral infection requires long-term monitoring of patients after COVID-19.
Butler et al. (2022) [49], denoted many authors use the term delirium for post-COVID-19 patients, but use the term acute encephalopathy for clinical syndromes involving rapidly evolving pathological brain processes with additional neurological symptoms.
Das et al. (2022) [50], studied a young patient with two conditions, ischemic attack and stroke, after the COVID-19 vaccine (COVISHIELD) and moyamoya vasculopathy was observed. In addition, arterial stroke has been reported after COVID-19 vaccination. However, this is rare and, in the presence of vasculopathy, may not be so rare.
Vanderheiden and Klein (2022) [51], presented neuropathology in COVID-19 patients and its immunological causes. The function of the CNS and its impact on imbalanced peripheral immunity was studied. Then, the blood-brain barrier dysregulation during SARS-CoV-2 infection was examined. Then, the enhancement of COVID-19-associated neuropathology was studied through the possible role of myeloid cells. Finally, the focus was on COVID-19-associated neuroinflammation and the role of innate immunity in it.
Reis et al. (2022) [52], demonstrated that neuroscientists are interested in SARS-CoV-2 because the disease has a significant impact on the nervous system during infection and post-COVID. Some of the features that have supported the COVID-19 pandemic are defined from an environmental neuroscience perspective. They considered SARS-CoV-2 and its spread as influenced by environmental factors, its impact on the brain, and some brain health containment measures.
Wild et al. (2022) [53], studied 478 COVID-19 survivors and tested 30 days after infection, and it was found that cognition was affected in certain areas. Cognitive performance was found to be positively correlated with physical health and not mental health, suggesting that long COVID leads to physical and cognitive symptoms.
Sadeghizadeh et al. (2022) [54], studied two cases of children with COVID-19. Several symptoms such as headaches were seen in pediatric COVID-19 patients with multisystem inflammatory syndrome. However, reversible cerebral vasoconstriction syndrome should be considered as a differential diagnosis in cases of headache with neurological signs.
Aricò et al. (2022) [55], studied the COVID-19 outbreak, and the lessons learned that help to better identify strategies to combat future pandemics. Innate and innate immunity constitute the first line of defense against viruses. After a period of infection, antiviral molecules are produced. The progression of the disease in many patients is attributed to insufficient type I interferon activity.
Rastogi et al. (2022) [56], studied the first case after COVID-19 vaccine with untreated encephalitis, magnetic resonance imaging performed in conjunction with clinical improvement. Neurological deterioration was described 12 days after the second dose of COVID-19 vaccine. There was no evidence of edema on magnetic resonance imaging, but there was evidence of loss of blood-brain barrier.
Aubart et al. (2022) [57], studied 21 children with CNS inflammatory encephalopathy (CNS). A study of children with CNS inflammatory disease describes laboratory, neurological, and radiological features during SARS-CoV-2 infection. All 19 selected patients tested positive for circulating antibodies against SARS-CoV-2, meaning they had a history of exposure to SARS-CoV-2.
Monje and Iwasaki (2022) [58], developed a significant proportion of people with COVID-19 neuropsychiatric symptoms and they were a major component of post-acute COVID-19 syndrome. The neurobiological underpinnings affecting COVID-19 survivors were discussed and mechanisms that may contribute to this neurological health crisis are proposed.
Aschman et al. (2022) [59], studies several SARS-CoV-2 patients and have shown neurological symptoms, but the cause of these symptoms is unclear. They could be due to brain cell infection or immune response to the virus, in addition to common factors, since there is no significant evidence for the presence of SARS-CoV particles in the nervous system.
Koh et al. (2022) [60], demonstrated a case of a patient who received RNA vaccination for SARS-CoV.A 45-year-old man developed brain, nervous system and spinal cord dysfunction in which autoantibodies were detected. After injection of methylprednisolone and globulins, clinical improvement occurred.
Lambe et al. (2022) [61], guided nine cases of SARS-CoV-2 patients and subsequently diagnosed with myelin glial glycoprotein associated disorder. After infection with the coronavirus, some of the patients developed neurological symptoms, another developed myelitis, another developed optic neuritis, and encephalopathy was observed in several patients.
Jammoul et al. (2023) [62], controlled a long-term COVID patient experience a variety of neurological manifestations that persist for months after infection. One complication of long-term COVID is autonomic dystonia, which causes dizziness, fatigue, shortness of breath, fainting, and palpitations. The onset of autonomic dystonia after COVID is not definitively known. This study aims to focus on the potential mechanisms of autonomic dystonia after long-term COVID.
Ulucay et al. (2023) [63], studied that mRNA COVID-19 vaccines have been shown to be effective in reducing the severity of illness and complications of COVID-19 infection. The use of mRNA COVID-19 vaccines has also been associated with cardiovascular complications. In addition, COVID-19 infection has been associated with cardiovascular complications.
Takenaka and Nakamori (2023) [64], reported various neurological complications after COVID-19 vaccination. The focus was on the case of a 25-year-old Japanese man who developed acute encephalopathy 2 days after the second dose of the COVID-19 vaccine. He was treated with nivolumab. The antibody test was positive, and he had a high fever and was confused on admission to the hospital. He was given intravenous methylprednisolone after being diagnosed with autoimmune encephalitis, after which the patient’s symptoms subsided rapidly.
Sarkanen et al. (2023) [65], explained that the COVID-19 pandemic has greatly affected our daily lives around the world. Its effects on fatigue and excessive sleepiness are still unclear. The COVID-19 International Sleep Study questionnaire, which included excessive sleep quantity and excessive daytime sleepiness, as well as socio-demographic factors, was distributed around the world from May to September in 2020.
Hira and Baker (2023) [66], studied patients after several months’ recovery from COVID-19, they developed severe post-operative complications. The prevalence of objective dynamic cardiovascular abnormalities was then determined, and gender differences were explored. They demonstrated that patients with severe complications after COVID-19 have evidence of autonomic cardiovascular abnormalities.
Chauvin et al. (2023) [67], showed that Tocilizumab treatment in severe COVID-19 patients has been to be effective, but there is little evidence to support the effect of short-term IL-6 receptor blocking therapy on B cell subsets. The study was conducted in 69 COVID-19 patients treated and untreated with tocilizumab. We observed that SARS-CoV-2-specific IgG1 titers were independent of tocilizumab administration but dependent on disease severity.
Seeck and Tankisi (2023) [68], studied the mutations of the original COVID virus that associated with less severe disease. The increase in long COVID cases suggests that the less severe disease is a result of vaccination and still has the potential to cause serious long-term disabilities. Because of respiratory distress, medicine focuses on intensive care, but it is becoming clear that the disease also affects both the central and peripheral systems, so it is preferable to examine it by neurophysiological methods.
Khoo et al. (2023) [69], demonstrated that children infected with COVID-19 are less severely affected than adults. They showed through longitudinal multimodal analysis that SARS-CoV-2 leaves a small COVID-19 signature in the T cell compartment of infected children but not in adults with the same disease. This was associated with the development of strong memory T cell responses in adults but not in children. It is the rapid viral clearance in children that restores their ability to resist reinfection.
Ebrahimi et al. (2023) [70], collected medical information for 12 patients who had attention-deficit/hyperactivity disorder (ADHD) or multiple sclerosis several weeks after receiving the Covid vaccine. Issues related to the administration of different SARS-CoV vaccines and their relationship with demyelinating disorders in the CNS were studied. Many vaccines have been used as triggers of CNS demyelination. Further investigations are needed to clarify the actual mechanisms and true associations in this field.
Chaumont et al. (2023) [71], studied Acute brain injury in COVID-19 patients, which is poorly understood. Preventing long-term neurological complications lies in better understanding these mechanisms. A panel of biomarkers of neuroinflammation in the cerebrospinal fluid of COVID-19 patients should be studied. They studied of 24 Neuro COVID patients, seven (29%) had meningoencephalitis and 17 (71%) had encephalopathy. Several of these patients also had stroke (21%) or new movement disorder (33%).
Bergantini et al. (2024) [72], monitoring patients admitted to hospital are most likely to have severe diseases. The etiology of post-COVID syndrome remains unknown. A panel of inflammatory and immune cytokines was evaluated in individuals without HRCT-variable features and in patients with High-resolution computed tomography variable features as part of long-COVID symptoms. A sample of 89 adult patients previously hospitalized for COVID, including patients with and without HRCT evidence.
5. CONCLUSION
We acquired a significant number of papers by conducting research using the keywords COVID-19, neuroscience, and autoantibodies. Two hundred and forty-three publications were found once the data were cleaned. Starting with reference 32 and continuing through reference 72, 243 articles undergo many steps of systematic review before arriving at the outcome of 41 publications. These sources are taken from research design, conclusion, and number of instances. An examination of this research revealed that the majority of them concentrate on the long-term, or post-COVID, impact of the condition. The most common of these symptoms, along with encephalitis and associated consequences, is nervous system inflammation. Furthermore, adverse consequences follow COVID immunization.
These three fields of study are still essential for developing public health plans, refining treatment modalities, and comprehending the wider ramifications of this worldwide outbreak. One of the important determinants of this research, especially since we are talking about the human health, is that there are some papers focusing on specific case with specific condition and cannot be generalized, in addition to the fact that there are various problems that were associated with each vaccine.
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