Table 2.
Study origin, demographics, CSF, MRI findings, severity and outcomes in COVID-19 and MOG-associated disease
| Author/country | Patient age/gender | Time duration from COVID-19 to neurological symptom onset | Time duration from COVID-19 to MOG AB positive | Co-morbidity | Neurological presentation | CSF findings | Serum/CSF AQP4, and ANTI-MOG Ab | MRI findings | Diagnosis | Management | Outcomes | Severity based on IDSA/ATSa |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sawalha et al./USA | 44/M | 2 weeks | 3 weeks | None | Bilateral eye pain and vision loss |
CSF WBC 3/mm3, protein 50 mg/dL, glucose 88 mg/dLb OCB negative |
Serum AQP4 negative, CSF AQP4 NA, serum MOG Ab positive, CSF MOG Ab NA | Brain MRI showed enhancement in the right more than the left optic nerve suggestive of optic neuritis although no other abnormalities were noted in brain, cervical, or thoracic spine | MOG antibody-associated optic neuritis |
IVMP * 5 days Tapering Prednisolone |
Not fatal | Not sever |
| Zhou et al./USA | 26/M | < 1 week | 1 day | None | Sequential vision loss first affecting the left eye, then the right eye 3 days later |
CSF WBC 55/mm3, protein 31 mg/dL, glucose-57 mg/dLb OCB mirror |
Serum AQP4 negative, CSF AQP4 NA, serum, MOG Ab positive, CSF MOG Ab NA | MRI of the brain and orbits uniform enhancement and thickening of both optic nerves with non-specific focal lesion in left occipital area. MRI spine focal patchy lesion in C and T spine with enhancement | MOG associated optic neuritis and myelitis |
IVMP * 5 days Tapering Prednisolone |
Not fatal | Not sever |
| Khan et al./India | 11/M | < 1 week | 2 weeks | None | Rapidly progressive loss of vision |
CSF WBC 55/mm3, protein normal, glucose normalb OCB negative |
Serum AQP4 negative, CSF AQP4 NA Serum MOG Ab positive, CSF MOG Ab negative |
MRI orbit bilateral asymmetrical optic neuritis, with enhancement of the optic nerve sheath in the right orbit MRI brain and spine normal |
MOG associated optic neuritis |
IVMP * 5 days Tapering Prednisolone |
Not fatal | Not sever |
| Sardar et al./Qatar | 38/F | 2 weeks | NA |
Diabetes Migraine Obesity Obstructive sleep apnea Gastritis |
Headache Diminution of vision With painful eye movement |
CSF WBC normal, protein normal, glucose-normalb OCB-NA |
Serum AQP4 NA, CSF AQP4 NA, Serum MOG Ab NA, CSF MOG Ab NA | MRI orbit T2 signal bilateral optic nerve and enhancement | Seronegative NMOSD and IIH |
IVMP for 5 d, IVIG * 5 days PLEX Acetazolamide |
Not fatal | Not sever |
| Zorić et al./Serbia | 63/M | 4 weeks | 11 weeks | Diabetes |
Headache Left eye visual loss |
CSF NA | Serum AQP4 positive, CSF AQP4 NA, serum MOG Ab positive, CSF MOG Ab NA | MRI brain microangiopathic and a neuroglial cyst on the right temporal side, and normal appearing orbits and optic nerves. MRI C and T spine no abnormal cord signal | MOG associated optic neuritis |
IVMP * 5 days Tapering Prednisolone |
Not fatal | Not sever |
| Pinto et al./UK | 44/F | 1 week | 30 days | None | Mild expressive and receptive dysphasia, visual and sensory inattention |
CSF WBC 13/mm3, protein 507 mg/dL, glucose-52 mg/dLb OCB negative |
Serum AQP4 negative, CSF AQP4 NA, serum MOG Ab positive, CSF MOG Ab NA | MRI brain hyperintensity within bilateral periventricular area extending left temporal and occipital horns and into the subcortical deep white matter bilateral. There was perivascular enhancement within the lesions, and MRA was normal. MRI the spine normal. MRI orbit not reported | CNS inflammatory vasculopathy with anti-MOG |
IVMP * 5 days Tapering Prednisolone PLEX * 5 Sessions |
Not fatal | Not sever |
| Vraka et al./UK | 13m/F | 1 week | 4 days | None | Altered consciousness, seizures |
CSF WBC 10/mm3, protein 31 mg/dL, glucose-84 mg/dLb OCB negative |
Serum AQP4 negative, CSF AQP4 NA, serum MOG Ab positive, CSF MOG Ab NA |
MRI brain hyperintensity in the splenium of the corpus callosum with associated diffusion restriction and high signal in the thalami and pons MRI spine normal |
ADEM with anti-MOG | IVMP, acyclovir, levetiracetam | Not fatal | Severe |
| Kogure et al./Japan | 47/M | NA | 2 days |
Recurrent Paranasal sinusitis Adrenal resection |
Left eye pain Visual loss |
CSF WBC normal, protein normal, glucose normalb OCB-NA |
Serum AQP4 negative, CSF AQP4 NA, serum MOG Ab positive, CSF MOG Ab negative | MRI orbit revealed the bilateral uniform enhancement along with optic nerve sheaths | MOG associated optic neuritis |
IVMP * 3 days Tapering Prednisolone |
Not fatal | Not sever |
| Jumah et al./USA | 61/M | 1 week | 1 day | None |
Retention sensory Level at T7, paraplegia |
CSF WBC 279/mm3, protein 106 mg/dL, glucose NAb OCB negative |
Serum AQP4 negative, CSF AQP4 NA, serum MOG Ab positive, CSF MOG Ab NA | MRI showed T2 hyperintense lesions of variable length in the mid-thoracic spinal cord, while brain MRI was unremarkable | MOG-antibody myelitis/HHV myelitis | IVMP, PLEX, ganciclovir | Not fatal | Not sever |
| de Ruijter et al./Netherland | 15/M | > 1 week | NA | None | Subacute bilateral visual loss over the course of 7 day |
CSF WBC normal, protein normal, glucose normalb OCB-NA |
Serum AQP4 negative, CSF AQP4 NA, Serum MOG Ab positive, CSF MOG Ab NA | MRI orbit revealed a bilateral edematous optic nerve lesion | MOG associated optic neuritis | IVMP * 3 days | Not fatal | Not sever |
| Woodhall et al./UK | 39/F | < 1 week | 6 days | MOGAD | Painful progressive right visual loss consistent with optic neuritis | CSF NA | Serum AQP4 negative, CSF AQP4 NA, serum MOG Ab positive, CSF MOG Ab NA | MRI progression of right optic nerve atrophy and subtle T2 signal hyperintensity | MOG associated relapse optic neuritis |
IVMP * 5 days Mycopheno-late, PLEX * 5 Sessions |
Not fatal | Not sever |
| Peters et al./USA | 23/M | 2 weeks | 2 weeks | Childhood non-febrile seizures |
Generalized tonic Clonic seizure, slowing Fever |
CSF WBC 57/mm3, protein 40 mg/dL, glucose-60 mg/dLb OCB negative |
Serum AQP4 negative, CSF AQP4 NA, serum MOG Ab positive, CSF MOG Ab NA |
MRI brain diffuse left-hemispheric cortical hyperintensity, most pronounced in the left occipital and posterior temporal lobe with leptomeningeal enhancement Spine MRI not reported |
MOG-associated encephalitis | IVMP * 5 days | Not fatal | Not sever |
MOGAD myelin oligodendrocytes glycoprotein antibody disease, AQP4 aquaporin antibody, IVIG intravenous immunoglobulin, PLEX plasmapheresis, IVMP intravenous methylprednisolone, MRI magnetic resonance imaging, CSF cerebrospinal fluid, OCB oligoclonal bands
aSeverity based on the Infectious Diseases Society of America IDSA and American Thoracic Society ATS guidelines
bSerum glucose not reported or available