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Encephalitis in Patients with COVID-19: A Systematic Evidence-Based Analysis
Md Asiful Islam1,2, Cinzia Cavestro3, Sayeda Sadia Alam4
1Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia.
Cells
|August 26, 2022
Summary
COVID-19 can affect the central nervous system, causing encephalitis even without respiratory symptoms. This systematic review highlights clinical features, neurological manifestations, and outcomes in 91 COVID-19 patients with encephalitis.
Area of Science:
- Neurology
- Infectious Diseases
- Neuroscience
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily targets the respiratory system.
- However, emerging evidence indicates central nervous system (CNS) involvement in COVID-19, including encephalitis.
Purpose of the Study:
- To systematically review the clinical characteristics, neuro-radiological findings, laboratory features, and outcomes of encephalitis in patients with COVID-19.
Main Methods:
- A systematic review of case reports and case series published between December 2019 and July 2022.
- Searched PubMed, Scopus, and Google Scholar databases.
- Assessed study quality using Joanna Briggs Institute critical appraisal checklists.
Main Results:
- Included 91 COVID-19 patients (85.6% adults) with encephalitis; 92.2% confirmed by RT-PCR.
- Common neurological symptoms included seizures (29.5%), confusion (23.2%), and headache (20.5%).
- Abnormal MRI (77.6%), EEG (75.5%), and CSF (64.1%) findings were frequent. SARS-CoV-2-associated encephalitis was most common (59.3%).
- Outcomes: 66.7% discharged (37.8% improved, 28.9% fully recovered), 20.0% died.
Conclusions:
- Encephalitis is an uncommon but serious complication of COVID-19.
- SARS-CoV-2 may act as a neuropathogen, impacting the CNS independently of respiratory symptoms.
- COVID-19-associated encephalitis can lead to significant disability and mortality.
Keywords:
COVID-19SARS-CoV-2coronavirusencephalitisencephalopathymeningoencephalitissystematic reviewMore Related Videos
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