COVID-19-Associated Encephalopathy: Systematic Review of Case Reports

Siahaan, Yusak Mangara Tua; Puspitasari, Vivien; Pangestu, Aristo

doi:10.3988/jcn.2022.18.2.194

Cited by 16 publications

(18 citation statements)

References 52 publications

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“…This is consistent with our case and other reports of cortical and subcortical white matter T2/FLAIR signal changes in SARS-CoV-2 encephalopathy patients. EEG evaluations are mostly indeterminate in these patients; however, it is sometimes necessary to exclude subclinical seizures if there is suspicion [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

The Rationale for Using Corticosteroids in COVID-19 Encephalopathy: Lessons From a Case Report With Evidence From Literature

Ameer¹,

Chaudhry²,

Babar³

et al. 2023

Cureus

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The coronavirus disease 2019 (COVID-19) virus primarily affects the pulmonary system, but neurological manifestations and complication of COVID-19 has been reported in abundance in the literature. We present a case of a middle-aged Caucasian male who was brought to the emergency department for altered mental status. His chief complaints were neurological rather than respiratory. A positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction (RT-PCR) nasal swab confirmed the diagnosis. Brain imaging showed mildly dilated ventricles with no other acute findings. As the patient did not require oxygen, he was treated with remdesivir alone without corticosteroids, which is also a precipitating factor of psychosis but, unfortunately, thickly used in practice. That led to remarkable results in full recovery without exposing the patient to steroid therapy. We strongly believe that remdesivir alone is sufficient in treating COVID-19-induced encephalopathy in a patient who does not require oxygen, and evidence supports this practice.

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Section: Discussionmentioning

confidence: 99%

The Rationale for Using Corticosteroids in COVID-19 Encephalopathy: Lessons From a Case Report With Evidence From Literature

Ameer¹,

Chaudhry²,

Babar³

et al. 2023

Cureus

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“…However, COVID-19-associated encephalopathy is novel, unexpectedly severe, and associated with prolonged conscious abnormalities following sedation withdrawal, which has prompted efforts into identifying potential disease-specific mechanisms. Several studies report MRI, EEG and CSF findings in COVID-19 encephalopathy 8 , 9 . Although some case reports have suggested SARS-CoV-2 may cause infectious and encephalitis 10 , 11 , the evidence for classical encephalitis mechanisms is limited.…”

Section: Neurological Complications Associated With Acute Sars-cov-2 ...mentioning

confidence: 99%

NeuroCOVID-19: a critical review

Guedes

2022

Arq. Neuro-Psiquiatr.

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Background: The COVID-19 pandemic has challenged neurologists since its early days. Neurology consultation services were then overloaded by emergency department and intensive-care patients with acute neurological syndromes. These complications are better explained today, but the growing number of patients with reported longstanding neurological symptoms constitute an emerging, complex, and still poorly understood phenomenon. Objective: This review summarizes data on relevant neurological manifestations of acute SARS-CoV-2 infection and lasting post-infectious disease, also known as Long COVID. The complex history of Long COVID is examined to illustrate the upsides and challenges imposed by the active participation of patient communities in the production of medical knowledge. Methods: Narrative review. Results: Infection with the severe acute respiratory syndrome coronavirus 2 is associated with encephalopathy/delirium, cerebrovascular disease, headache, and peripheral nervous system involvement. Long COVID is a living concept jointly defined by patient communities, physicians and scientists, including neurologists. Conclusion: Co-production of Long COVID knowledge between scientists and patients has initiated an era of patient-led research and evidence-based activism that acts as a two-edged sword - putting patient’s suffering in the spotlight, but with a tradeoff in methodological consistency.

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“…SARS-CoV-2 can invade the central nervous system through systemic circulation via angiotensin-converting enzyme 2 receptors and the cribriform plate. [5] Until now, only a few cases of anti-NMDAR encephalitis associated with COVID-19 have been reported. [6,7] Structural similarities between NMDAR and a subunit of SARS-CoV-2 may trigger anti-NMDAR encephalitis after COVID-19.…”

Section: Introductionmentioning

confidence: 99%

“…SARS-CoV-2 can invade the central nervous system through systemic circulation via angiotensin-converting enzyme 2 receptors and the cribriform plate. [ 5 ]…”

Section: Introductionmentioning

confidence: 99%

Anti-N-methyl-D-aspartate receptor encephalitis after coronavirus disease 2019: A case report and literature review

et al. 2022

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Rationale: Coronavirus disease 2019 (COVID-19) has become a global pandemic and COVID-19-associated anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis may occur through an immune-mediated pathomechanism. Patient concerns: A 21-year-old woman with a history of COVID-19 presented to our hospital with memory decline and psychiatric symptoms. Diagnosis: The patient was diagnosed with anti-NMDAR encephalitis. Intervention: Intravenous methylprednisolone (1 g/day over 5 days) followed by immunoglobulin (0.4 g/kg/day over 5 days) were administered. The patient underwent laparoscopic salpingo-oophorectomy to remove an ovarian teratoma. Outcomes: The patient was discharged with sequelae of short-term memory impairment, without other neuropsychiatric symptoms. Lessons: Cases of previously reported anti-NMDAR encephalitis with COVID-19 were reviewed and compared with the present case. Clinicians should be aware of the occurrence of anti-NMDAR encephalitis in patients who present with neuropsychiatric complaints during or after exposure to COVID-19. Further studies are required to determine the causal relationship between the 2 diseases and predict the prognosis of anti-NMDAR encephalitis after COVID-19 exposure.

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COVID-19-Associated Encephalopathy: Systematic Review of Case Reports

Cited by 16 publications

References 52 publications

The Rationale for Using Corticosteroids in COVID-19 Encephalopathy: Lessons From a Case Report With Evidence From Literature

The Rationale for Using Corticosteroids in COVID-19 Encephalopathy: Lessons From a Case Report With Evidence From Literature

NeuroCOVID-19: a critical review

Anti-N-methyl-D-aspartate receptor encephalitis after coronavirus disease 2019: A case report and literature review

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