Doctors From Slovakia Warn That Even Mild COVID-19 Can Trigger Rare Autoimmune Brain Disorder
Nikhil Prasad Fact checked by:Thailand Medical News Team May 08, 2025 6 hours, 17 minutes ago
Medical News: A new medical case from Slovakia has uncovered a rare but dangerous complication of COVID-19 involving autoimmune encephalitis (AIE), a serious brain inflammation triggered by the immune system attacking the brain. Even more alarmingly, the cause was linked to anti-SOX1 autoantibodies—antibodies normally associated with cancer-related neurological disorders, but in this case, appearing in a previously healthy 28-year-old woman during acute COVID-19 infection.
Doctors From Slovakia Warn That Even Mild COVID-19 Can Trigger Rare Autoimmune Brain Disorder
The study was conducted by researchers from the Department of Infectology and Geographical Medicine and the 2nd Department of Neurology, Faculty of Medicine, Comenius University in Bratislava, Slovakia. This
Medical News report explores the case and its wider implications.
Sudden Seizures and Neurological Collapse After Mild COVID Symptoms
The young woman had initially experienced only mild flu-like symptoms—low fever, fatigue, and nasal congestion. But just two days later, she began showing signs of confusion and suffered a sudden onset of multiple tonic-clonic seizures. She was rushed to the emergency department and treated for status epilepticus, a life-threatening condition where seizures do not stop on their own. Initial brain scans and lab results were inconclusive, but cerebrospinal fluid (CSF) analysis showed inflammation and elevated protein and antibody levels—clues pointing toward autoimmune encephalitis.
Despite aggressive antiseizure medications including high doses of levetiracetam and lacosamide, the seizures continued unabated. Her condition worsened with intense psychiatric symptoms such as agitation, stereotypical behavior, and complete lack of speech.
Rare Autoimmune Clue Uncovered
Doctors suspected AIE and ordered a specialized antibody panel. Electroencephalography (EEG) revealed a rare brainwave pattern known as "extreme delta brush," commonly seen in anti-NMDA receptor encephalitis. But this time, blood and CSF tests identified anti-SOX1 autoantibodies—a surprising discovery since these antibodies are usually linked to paraneoplastic syndromes, which are neurological complications of cancer.
To rule out cancer, a full-body scan using fluorodeoxyglucose PET imaging and a battery of oncological tests were performed. All results came back negative. The only identifiable trigger was the confirmed SARS-CoV-2 infection. This strongly pointed to COVID-19 as the cause of the autoimmune reaction.
Treatment Brings Swift Recovery
Doctors began immediate immunosuppressive therapy with intravenous immunoglobulin (IVIG) and high-dose methylprednisolone. Within days, the patient’s seizures reduced, her psychiatric symptoms faded, and she gradually returned to normal. By day 20, she was discharged from the hospital, seizure-free and fully coherent. At her four-month follow-up, she had no remaining symptoms and a comple
tely normal EEG.
Scientific Insights and Broader Impact
Autoimmune encephalitis is already rare, but cases linked to COVID-19 are even more uncommon—affecting roughly 0.1% to 0.2% of infected individuals. Even among those, the presence of anti-SOX1 antibodies is nearly unheard of. This case is believed to be the first of its kind ever documented in medical literature.
Researchers believe COVID-19 may trigger autoimmune disorders through several pathways: antigen mimicry (where the virus resembles the body’s own cells), bystander immune activation, or release of self-antigens due to tissue damage. All of these mechanisms can provoke the immune system into mistakenly attacking healthy tissue, including brain cells.
This case illustrates that COVID-19 is not just a respiratory illness—it can cause serious neurological complications through immune dysfunction. Early recognition and testing for autoimmune markers are critical, as swift treatment with immunotherapy can prevent permanent brain damage or death.
Conclusions
This unprecedented case adds to the growing body of evidence that COVID-19 is capable of triggering severe and unexpected autoimmune responses in previously healthy individuals. The rapid progression from mild respiratory symptoms to brain inflammation and seizures underscores the unpredictable nature of the virus. While autoimmune encephalitis is treatable, early diagnosis is essential. Clinicians must remain vigilant for signs of neurological involvement in COVID-19 patients, even in the absence of prior autoimmune or oncological history. The presence of rare autoantibodies such as anti-SOX1 must be considered when seizures and behavioral changes arise, as missing the diagnosis could cost lives. Timely immunotherapy can make the difference between recovery and irreversible brain injury.
The study findings were published in the peer reviewed journal: IDCases
https://www.sciencedirect.com/science/article/pii/S2214250925000757
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