Encephalitis' clinical and laboratory characteristics during a triple epidemic of Dengue, Zika and Chikungunya 

Project Lead - Aline de Moura Brasil Matos, Instituto de Medicina Tropical, Medicine School, University of São Paulo, Brazil

Awarded: 2019

Our pilot study aims to investigate clinical and laboratory aspects of 18 patients who developed encephalitis during a triple epidemics of Dengue, Zika and Chikungunya in Brazilian northeast from June 2015 to December 2017. Those people were assisted in a single tertiary center.

By that time, we asked the patients to donate blood and cerebral spinal fluid (CSF) for further virological study. As we had no funding to laboratory tests by that time, the samples were stored in an adequate facility and the patients’ clinical history was carefully noted in medical records. This initiative was approved by local ethical committee.

With funding available, we will first conduct a search for viral genetic material in those samples, though a technique called real-time polymerase chain reaction (RT-PCR).

We are also going to look into the samples for antibodies against Dengue, Zika and Chikungunya. Antibodies are specific structures from the human defense system that show us if defense was activated against an invader. They usually last from weeks to months in the host blood and CSF.

Later, we are going to measure a CSF biomarker to measure degeneration of brain cells.

Finally, we are going to compare clinical and laboratory data, to find out which virus was able to cause a larger damage and if the encephalitis was more severe when vestiges of more than one virus are present in the same patient.

If our biomarkers prove to be useful we will pursue a larger project during the patients’ one-year follow-up to evaluate if the damage caused by the viruses is only punctual or if they are able to generate a chronic and sustained brain damage.

Lead project-Aline de Moura Brasil Matos, Instituto de Medicina Tropical, Medicine School, University of São Paulo, Brazil

This seed funding has been completed.

"First of all, it was a great honour to be selected for the 2019 Encephalitis Society Seed Funding. At that time, I was starting my PhD thesis and my research had no specific funding. In my country resources are basically limited to governmental grants. In order to have one of those grants, you have to have things like published articles, international experience, a topic of public interest and supervisors recognized by their previous work.

The seed funding was essential to start my career as a young scientist and made me able to dedicate myself to my main topic of interest – neurological manifestations of emergent and re-emergent viruses in encephalitis. We started with Chikungunya virus encephalitis and our preliminary data was presented at the annual Encephalitis Society Conference.

There, I got in touch with many researchers and built relationships with them. Also, we presented this same data in several meetings in Brazil and organized a research group to gather more data about encephalitis. All of a sudden, the COVID-19 pandemic emerged, and since we were already organizing our network for neurology and viruses, we were able to direct our efforts to COVID-19. Based on this background and built network we were selected for a great national full grant to work with COVID-19 and neurology.

From June 2020 until now we followed more than 160 COVID-19 patients with neurological conditions, most of them with encephalopathy or encephalitis and hope we can soon shed some light on these manifestations.

Please go to www.neurocovbr.combr  for more information" 

Dr Aline Matos, May 2021