Evidence map›Paper›PMID 40093251›Full record

ArticlemedRxiv : the preprint server for health sciences2025

Analysis of 977 Long COVID Patients Reveals Prevalent Neuropathy and Association with Anti-Ganglioside Antibodies.

Cole Maguire, Kristina Kashyap, Elizabeth Williams, Rija Aziz, Maisey Schuler, Cheyenne Ahamed, Chumeng Wang, Aurelia Mena, Jeffrey Saniuk, Johanna Busch and 4 more

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Cole MaguireDepartment of Neurology, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.ORCID 0000-0001-8986-9762
Kristina KashyapDepartment of Internal Medicine, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Elizabeth WilliamsDepartment of Neurology, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Rija AzizDepartment of Internal Medicine, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Maisey SchulerThe University of Michigan Medical School, Ann Arbor, MI, USA.
Cheyenne AhamedDepartment of Internal Medicine, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Chumeng WangDepartment of Neurology, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Aurelia MenaDepartment of Internal Medicine, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Jeffrey SaniukDepartment of Internal Medicine, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Johanna BuschDepartment of Internal Medicine, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Sara AustinAscension Seton Brain and Spine, Austin, TX, USA.
Mary KelleyDepartment of Neurology, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
W Michael BrodeDepartment of Internal Medicine, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.
Esther MelamedDepartment of Neurology, The University of Texas at Austin, Dell Medical School, Austin, TX, USA.ORCID 0000-0001-5571-3591

Funding

Alcohol's Impact on the Gut-Brain Axis in a Mouse Model of Multiple SclerosisK08AA027837 · NIAAA · UNIVERSITY OF TEXAS AT AUSTIN · PI MELAMED, ESTHER · 2020 to 2024
$971k
NIAAA NIH HHS K08 AA027837
6 · The paper itself

Abstract

Background: Long COVID (LC) is a novel condition that is characterized by persistent symptoms that last from months to years following a SARS-CoV-2 infection. While LC symptoms vary widely, neuropathy is one of the most prevalent symptoms and drastically affects patients' quality of life. However, the underlying pathophysiology of LC neuropathy remains poorly understood. Here, we investigated the prevalence and potential mechanisms of LC neuropathy in the largest LC neuropathy cohort to date. Methods: We conducted an observational study of 977 adults with LC at Dell Medical School. Participants underwent clinical assessments, skin punch biopsy, and comprehensive metabolic, endocrine and immunological profiling. A subset of patients received treatment with intravenous immunoglobulin (IVIG). Findings: Neuropathic symptoms were reported by 55% (534/977) participants, with skin biopsy confirming small fiber neuropathy in 56.5% (48/85) cases, affecting both epidermal and autonomic nerve fibers. Common risk factors for neuropathy, including metabolic and endocrine disorders, did not fully explain neuropathic symptoms. While general immunological markers (lymphocyte, T cell, and B cell count and C reactive protein were unremarkable, unexpectedly, we detected anti-ganglioside antibodies (AGAs) in 25% of patients with LC neuropathy, a comparable rate to other AGA-associated neuropathies. Longitudinal testing revealed persistent AGA positivity, and multiple elevated AGAs in a subset of patients. In a pilot treatment cohort of eight patients, IVIG treatment resulted in improvement of patient reported neuropathic symptoms. Interpretation: Our findings reveal a high prevalence of small fiber neuropathy in LC, with evidence suggesting an autoimmune mechanism involving AGAs in one in four LC neuropathy patients. The therapeutic response to IVIG further supports an autoimmune pathophysiology, suggesting potential benefits of immunomodulation in LC neuropathy patients.

Identifiers

PMID40093251
PMCPMC11908306

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