Autoimmune encephalitis associated with COVID-19: A systematic review

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• COVID-19 is associated with a rise in neurological complications.
• These complications may stem from direct viral effects or immune-mediated responses like autoimmune encephalitis (AE) and ADEM.
• This study systematically reviews AE cases in COVID-19 patients.

Purpose of the Study:

• To systematically review and synthesize evidence on autoimmune encephalitis (AE) in patients diagnosed with COVID-19.
• To inform clinicians about the potential link between SARS-CoV-2 infection and AE development.

Main Methods:

• A systematic literature search was conducted across PubMed, Scopus, and Web of Science.
• Original articles focusing on coronavirus/COVID-19 and AE were extracted.
• Data from case reports and case series were analyzed.

Main Results:

• Eighteen articles comprising 15 case reports and 3 case series were included, totaling 81 patients.
• Nineteen cases of AE were reported in COVID-19 patients.
• AE presentations included limbic encephalitis (37%), anti-NMDA receptor encephalitis (26%), new-onset refractory status epilepticus (NORSE) (11%), steroid-responsive encephalitis (5%), and unknown types (21%).

Conclusions:

• The systematic review confirms evidence of AE development in individuals infected with COVID-19.
• Autoimmune encephalitis should be considered in the differential diagnosis for neurological symptoms in SARS-CoV-2 infected patients.
• Increased clinical awareness is crucial for timely diagnosis and management of AE in the context of COVID-19.