SARS-CoV-2 Encephalitis versus Influenza Encephalitis: More Similarities than Differences

Area of Science:

• Pediatric Neurology
• Infectious Diseases
• Virology

Background:

• Acute management of viral encephalitis in children presents diagnostic and therapeutic challenges.
• Distinguishing between SARS-CoV-2 and influenza encephalitis is crucial for effective clinical care.

Purpose of the Study:

• To provide an updated narrative review comparing SARS-CoV-2 and influenza encephalitis in pediatric patients.
• To highlight similarities and differences in clinical presentation, outcomes, and management.

Main Methods:

• A systematic PubMed search was conducted using "SARS-CoV-2" OR "Influenza" AND "Encephalitis" keywords.
• Included studies encompassed metaanalyses, clinical trials, reviews, and observational studies in the English literature, focusing on pediatric populations.

Main Results:

• Encephalitis is an uncommon manifestation for both SARS-CoV-2 and influenza, though it can lead to significant morbidity and mortality.
• SARS-CoV-2 can present with mild or asymptomatic cases, aiding silent spread, while influenza often causes more severe symptoms and is seasonal.
• Long-term sequelae (long COVID-19) are noted with SARS-CoV-2 but not influenza; mortality appears higher with influenza-associated encephalitis.

Conclusions:

• Encephalitis is a rare but serious complication of both SARS-CoV-2 and influenza infections in children.
• Both viral infections offer available prophylaxis via immunization and effective antiviral treatments.
• While both conditions carry risks, SARS-CoV-2 encephalitis may have a lower mortality rate compared to influenza encephalitis.