Acute necrotizing encephalopathy associated with COVID-19: case series and systematic review

Geng, Chang; Zhao, Weili; Wang, Zhijun; Wu, Jin; Jiang, Dongxiao; Jiang, Nan; Liu, Mange; Yao, Ming; Guan, Hongzhi

doi:10.1007/s00415-023-11915-8

Cited by 5 publications

(2 citation statements)

References 44 publications

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“…Additionally, serum IL-6 is a strong indicator of the clinical severity of influenza virusassociated encephalopathy [10]. In an adult case series of ANE associated with COVID-19, increased serum and CSF IL-6 were found in some cases, especially in a case with RNA binding protein 2 (RANBP2) mutation, and seems to be associated with worse outcome [11]. RANBP2 is one of the main components of the nuclear pore complex and has numerous roles throughout the cell cycle [12,13].…”

Section: Discussionmentioning

confidence: 99%

A Case of Acute Necrotizing Encephalopathy With Multiple Organ Failure Following COVID-19

Maejima,

Matsumoto,

Hayakawa

et al. 2024

Cureus

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Neurological complications are frequent non-respiratory complications associated with coronavirus disease 2019 , and acute encephalopathy (AE) has been reported to occur in 2.2% of patients. Among many phenotypes of AEs, acute necrotizing encephalopathy (ANE) is associated with multiple organ failure (MOF), leading to severe neurological morbidity and mortality. A previously healthy seven-year-old girl presented with a one-day history of fever followed by 12 hours of vomiting and altered consciousness. On arrival, the patient was in shock. Blood tests revealed severe acute liver failure and kidney injury, accompanied by coagulopathy. The serum interleukin-6 levels were also elevated. PCR testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive. A head CT scan showed heterogeneous low-density areas in the bilateral thalamus, without brainstem involvement. She was diagnosed as ANE complicated with MOF (ANE severity score = 6). Intravenous methylprednisolone and therapeutic plasma exchange (TPE) were initiated with neurocritical care. After the introduction of TPE, hemodynamics improved rapidly, followed by gradual improvement in neurological manifestations. Upon follow-up after two months, no neurological or systemic sequelae were noted. Although further studies are needed, our case suggests that early immunomodulatory therapy and TPE may have contributed to the improvement in ANE and MOF associated with COVID-19.

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Section: Discussionmentioning

confidence: 99%

A Case of Acute Necrotizing Encephalopathy With Multiple Organ Failure Following COVID-19

Maejima,

Matsumoto,

Hayakawa

et al. 2024

Cureus

View full text Add to dashboard Cite

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“…Several rare manifestations of COVID‐19 have been reported in the literature, with these manifestations including seizures and status epilepticus (Asadi‐Pooya et al, 2021), meningoencephalitis (Oosthuizen et al, 2021), Guillain–Barré syndrome (Toscano et al, 2020), acute necrotizing encephalopathy (Geng et al, 2023), and multisystem inflammatory syndrome in children (Whittaker et al, 2020). In addition, myositis (Saud et al, 2021), catatonia (Anvekar et al, 2022), vasculitis and arthritis (Batu et al, 2022), optic neuritis (Jossy et al, 2022), dermatological manifestations (Lipsker, 2020; Marraha et al, 2020), conjunctivitis (Danthuluri & Grant, 2020), and endocrine and metabolic complications (Esmaeilzadeh et al, 2022) have been observed.…”

Section: Brief Review Of Coronavirus 2019mentioning

confidence: 99%

Effect and mechanism of quercetin or quercetin‐containing formulas against COVID‐19: From bench to bedside

Chen,

Huang,

Hsu

et al. 2024

Phytotherapy Research

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Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has caused the global coronavirus disease 2019 (COVID‐19) pandemic since 2019. Immunopathogenesis and thromboembolic events are central to its pathogenesis. Quercetin exhibits several beneficial activities against COVID‐19, including antiviral, anti‐inflammatory, immunomodulatory, antioxidative, and antithrombotic effects. Although several reviews have been published, these reviews are incomplete from the viewpoint of translational medicine. The authors comprehensively evaluated the evidence of quercetin against COVID‐19, both basically and clinically, to apply quercetin and/or its derivatives in the future. The authors searched the PubMed, Embase, and the Cochrane Library databases without any restrictions. The search terms included COVID‐19, SARS‐CoV‐2, quercetin, antiviral, anti‐inflammatory, immunomodulatory, thrombosis, embolism, oxidative, and microbiota. The references of relevant articles were also reviewed. All authors independently screened and reviewed the quality of each included manuscript. The Cochrane Risk of Bias Tool, version 2 (RoB 2) was used to assess the quality of the included randomized controlled trials (RCTs). All selected studies were discussed monthly. The effectiveness of quercetin against COVID‐19 is not solid due to methodological flaws in the clinical trials. High‐quality studies are also required for quercetin‐containing traditional Chinese medicines. The low bioavailability and highly variable pharmacokinetics of quercetin hinder its clinical applications. Its positive impact on immunomodulation through reverting dysbiosis of gut microbiota still lacks robust evidence. Quercetin against COVID‐19 does not have tough clinical evidence. Strategies to improve its bioavailability and/or to develop its effective derivatives are needed. Well‐designed RCTs are also crucial to confirm their effectiveness in the future.

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COVID-19-Associated Cerebellar Ataxia: A Case Series

Liu,

Fan,

Geng

et al. 2024

Cerebellum

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Acute necrotizing encephalopathy associated with COVID-19: case series and systematic review

Cited by 5 publications

References 44 publications

A Case of Acute Necrotizing Encephalopathy With Multiple Organ Failure Following COVID-19

A Case of Acute Necrotizing Encephalopathy With Multiple Organ Failure Following COVID-19

Effect and mechanism of quercetin or quercetin‐containing formulas against COVID‐19: From bench to bedside

COVID-19-Associated Cerebellar Ataxia: A Case Series

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