Background: Since the advent of global COVID-19 vaccination, several studies reported cases of encephalitis with its various subtypes following COVID-19 vaccinations. In this regard, we conducted a systematic review to investigate and characterize the clinical settings of these reported cases to aid in physician awareness and proper care provision. Methods: We systematically searched PubMed, Web of Science, and Scopus and manually searched Google Scholar. Studies published until October 2022 were included. Demographic data, clinical features, vaccine data, treatment lines, and outcomes were extracted. Results: A total of 65 patients from 52 studies were included. The mean age of patients was 46.82 ± 19.25 years, 36 cases (55.4%) were males. AstraZeneca was the most-reported vaccine associated with encephalitis (38.5%) followed by Pfizer (33.8%), Moderna (16.9%), and others. Moat encephalitis cases occurred after the first dose of vaccination in 41/65 (66.1%). The mean time between vaccination and symptom onset was 9.97 ± 7.16 days. Corticosteroids (86.2 %) and immunosuppressants (81.5 %) were the most used lines of treatment. The majority of affected individuals experienced a full recovery. Conclusion: Our study summarizes the current evidence of reported post-vaccination encephalitis, regarding clinical presentation, symptoms onset, management, outcomes, and comorbid conditions; however, it fails to either acknowledge the incidence of occurrence or establish a causal relationship between various COVID-19 vaccines and encephalitis.

Introduction: Stroke is a leading cause of morbidity and mortality worldwide, with limited effective treatment options. Fingolimod has been shown to have neuroprotective effects in previous studies and has been approved for use in multiple sclerosis. This systematic review aims to evaluate the current evidence regarding the efficacy of Fingolimod in cerebrovascular stroke. Methods: A comprehensive literature search was conducted using electronic databases (PubMed, Scopus, Cochrane Library, and Web of Science) for studies published up to January 2023. Studies were included if they evaluated the efficacy of Fingolimod in subjects with cerebrovascular stroke and reported outcomes. Results: This meta-analysis included six studies with a total of 251 patients, 124 in the fingolimod group and 127 in the control group. Fingolimod was associated with significant improvements in NIHSS scores on days 7, 14, 30, and 90 post-stroke, with the greatest improvement seen after one month (MD = -7.1, 95% CI [-9.73, -4.65], P < 0. 00001). Additionally, fingolimod was associated with significant reductions in mRS scores after three months (MD = 7.3, 95% CI [3.06, 17.40], P < 0. 00001) and significant improvements in Modified Barthel Index scores on days 7, 14, 30, and 90 post-stroke. After three months, the mean difference in Modified Barthel Index scores was 14.6 (95% CI [5.80, 23.36], P = 0.0005). Fingolimod was also associated with significant reductions in microvascular permeability ratio (rT%) and infarct volume (MD = -15.2, 95% CI [-23.33, -7.15], P < 0. 00001). Conclusion: The current evidence suggests that Fingolimod may have potential as a neuroprotective agent in cerebrovascular stroke. However, more high-quality clinical trials are warranted.

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