Journal of Neurology and Psychology

Case Report

Aquaporin-4 Protein Antibody Seropositivity after Acute SARS-CoV-2 Infection

Tan Y1*, Zuberi HZ2, Hernandez RM1 and Avila M1

1Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, Texas
2Texas Tech University Health Sciences Center School of Medicine, Lubbock, Texas
*Address for Correspondence: Tan Y, Department of Neurology, Texas Tech University Health Sciences Center, Lubbock 79430, Texas; Telephone: 806.743.2391; E-mail: Yuanyuan.Tan@ttuhsc.edu
Submission: August 16, 2022
Accepted: September 09, 2022
Published: September 12, 2022
Copyright: © 2022 Tan Y, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Development of autoimmune neurological disorders after Coronavirus Disease 2019 (COVID-19) has been reported. Though many cases of multiple sclerosis developing after COVID-19 are present in current literature, Neuromyelitis Optica Spectrum Disorder (NMOSD) is much rarer sequela of the disease.
Methods: Two cases that meet the international consensus diagnostic criteria for NMOSD were encountered at a regional hospital in West Texas in the same month. Both were preceded by acute SARS-CoV-2 infection and developed newly diagnosed NMOSD with Aquaporin-4 Protein Antibody seropositivity.
Results: Case 1 was a 28-year-old Hispanic female who presented with opsoclonus and ophthalmoplegia; Case 2 was a 20-year-old African American female who presented with transverse myelitis. Both patients had no neurological co morbidities or symptoms prior to SARSCoV- 2 infection. Neither of them was vaccinated for COVID-19, and both were of non-Caucasian ethnicity. They presented with a typical features including younger onset, ocular presentation of opsoclonus, negative neuroimaging, no response to steroids, and relapse after a short interval.
Conclusion: New developments of NMOSD in previously healthy individuals can be a neurological sequela of COVID-19, especially among unvaccinated individuals. The correlation and pathophysiology of NMOSD after COVID-19 are not fully understood, but molecular mimicry of the virus and cytokine storm are postulated mechanisms. Additional observational studies are needed to further explore the correlation between acute COVID-19 infection and NMOSD.