CSF immune cell alterations in women with neuropsychiatric Long COVID.

CSF immune cell alterations in women with neuropsychiatric Long COVID.

Publication date: Sep 08, 2025

Women are disproportionately affected by neuropsychiatric symptoms following recovery from acute COVID-19. However, whether there are central nervous system-specific changes in gene expression in women with neuropsychiatric Long COVID (NP-Long COVID) remains unknown. Twenty-two women with and ten women without NP-Long COVID were enrolled from New Haven, CT, and the surrounding region and consented to a blood draw and large volume lumbar puncture. Total RNA was extracted from cerebrospinal fluid (CSF) cells and peripheral blood mononuclear cells (PBMC). Polyadenylated RNA was sequenced, and differential expression analyses were performed. Both CSF and PBMC samples showed differential gene expression associated with Long COVID status. There were CSF-specific differentially expressed genes (DEGs) in people with Long COVID, including in genes related to oxidative stress, reactive oxygen species, and P53 response, indicating compartment-specific immune responses. Some pathways were dysregulated in both the CSF and PBMC of Long COVID compared to controls, including those related to androgen response, MTORC1 signaling, and lipid metabolism. Women with NP-long COVID show compartment-specific, transcriptional profiles in the CSF with evidence of enrichment in cellular stress pathways. These results underscore the importance of examining CSF-specific molecular profiles to better understand post-viral neurological syndromes.

Concepts Keywords
Ct Cerebrospinal fluid
Disproportionately Long COVID
Lipid Neuropsychiatric symptoms
Viral Post-viral syndrome
Women RNA sequencing

Semantics

Type Source Name
disease MESH syndromes
drug DRUGBANK Tropicamide
disease MESH oxidative stress
disease IDO blood
drug DRUGBANK Pentaerythritol tetranitrate
disease MESH COVID-19
disease MESH Long COVID
disease IDO cell

Original Article

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