# Viral and immune-mediated CNS pathology during SARS-CoV-2 infection

> **NIH NIH R01** · YALE UNIVERSITY · 2022 · $1,235,421

## Abstract

Supplement Project Summary
Since its appearance in late 2019, SARS-CoV-2 has spread globally and resulted in 5.5 million deaths in 24
months. Our group’s published work has demonstrated that the pathogenesis of COVID-19 is characterized by
overlapping TH1, TH2, and TH17 responses and the presence of diverse, disease-modifying autoantibodies
(AAB). The extent of recovery following acute SARS-CoV-2 infection is varied, with 14-35% of patients reporting
persistent or new symptoms during convalescence, collectively termed as post-acute sequelae of COVID-19
(PASC or “Long COVID”). While PASC affects multiple organs, a prominent feature of PASC includes
neurological symptoms including unremitting fatigue, myalgia, insomnia, mental slowing, and confusion (‘Neuro-
PASC’). Although persistent symptoms are common following other severe viral infections, PASC patients
demonstrate significant and unique elevations in sequelae even when matched against comparator groups. In
the parent R01 proposal, we outlined our goals to investigate the encephalitic potential of SARS-CoV-2 (Aim 1),
to evaluate effects of CNS, respiratory and combination SARS-CoV-2 infection on disease outcomes in mouse
models (Aim 2), and to determine the CNS responses in COVID-19 patients with neurological symptoms (Aim
3). The supplement extends these studies to investigation of post-acute neurologic sequelae of COVID. To this
end, we have collated ~500 PASC patient plasma and sera samples from 4 separate, multisite cohorts to identify
AABs that correlate with neuro-PASC (Suppl. Aim 1.1), study longitudinal AAB responses in a well-defined cohort
of patients with or without neuro-PASC for which we have extensive data from their acute COVID infection
(Suppl. Aim 1.2) and to use machine learning approaches to identify biomarkers of neuro-PASC (Suppl. Aim
1.3). In addition, while the original grant proposal uses SARS-CoV-2 infection to model neurological diseases as
a result of direct virus infection in mice, this supplement takes an orthogonal approach to understand 1) how
AAB that correlate with neurological symptoms in patients contribute to neurological symptoms of PASC through
development of an AAB-transfer mouse model for neuro-PASC (Suppl. Aim 2.1), and 2) probe how SARS-CoV-
2 infection synergizes with host genetic predispositions towards autoimmunity to develop AAB that lead to neuro-
PASC (Suppl. Aim 2.2). The proposed research is hypothesis-driven, innovative, highly interdisciplinary, and has
a strong potential to inform the diagnosis, prevention, mitigation, and treatment of PASC through elucidating the
pathogenesis of post-acute sequelae and the identification of associated mechanistic pathways.

## Key facts

- **NIH application ID:** 10554829
- **Project number:** 3R01AI157488-03S1
- **Recipient organization:** YALE UNIVERSITY
- **Principal Investigator:** Charles S Dela Cruz
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,235,421
- **Award type:** 3
- **Project period:** 2020-07-24 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10554829

## Citation

> US National Institutes of Health, RePORTER application 10554829, Viral and immune-mediated CNS pathology during SARS-CoV-2 infection (3R01AI157488-03S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10554829. Licensed CC0.

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