Fulminant encephalitis as a sole manifestation of COVID-19

Etemadifar, Masoud; Salari, Mehri; Murgai, Aditya; Hajiahmadi, Somayeh

doi:10.1007/s10072-020-04712-y

Cited by 15 publications

(19 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…10 Reported neurologic and psychiatric symptoms in adult patients with COVID-19 include anosmia/ageusia, 11,12 headaches, 13 dizziness/ataxia, 10 psychosis, dementia, depression, anxiety, and mania. 14 Reported severe neurologic involvement in adult patients with COVID-19 includes acute encephalopathy or encephalitis, [15][16][17][18] acute necrotizing encephalopathy, 19,20 epilepsy/seizures, 21,22 acute transverse myelitis, [23][24][25] Guillain-Barré syndrome (GBS), 26,27 posterior reversible encephalopathy syndrome, 28 and acute ischemic or hemorrhagic stroke. 14,[29][30][31][32][33][34] Although most children and adolescents are spared from severe COVID-19, there have been reports of life-threatening neurologic involvement in patients developing multisystem inflammatory syndrome in children (MIS-C), a relatively rare, hyperinflammatory, severe illness temporally associated with SARS-CoV-2 infection, presumably postinfectious.…”

mentioning

confidence: 99%

Neurologic Involvement in Children and Adolescents Hospitalized in the United States for COVID-19 or Multisystem Inflammatory Syndrome

et al. 2021

View full text Add to dashboard Cite

IMPORTANCE Coronavirus disease 2019 (COVID-19) affects the nervous system in adult patients. The spectrum of neurologic involvement in children and adolescents is unclear. OBJECTIVE To understand the range and severity of neurologic involvement among children and adolescents associated with COVID-19. SETTING, DESIGN, AND PARTICIPANTS Case series of patients (age <21 years) hospitalized between March 15, 2020, and December 15, 2020, with positive severe acute respiratory syndrome coronavirus 2 test result (reverse transcriptase-polymerase chain reaction and/or antibody) at 61 US hospitals in the Overcoming COVID-19 public health registry, including 616 (36%) meeting criteria for multisystem inflammatory syndrome in children. Patients with neurologic involvement had acute neurologic signs, symptoms, or diseases on presentation or during hospitalization. Life-threatening involvement was adjudicated by experts based on clinical and/or neuroradiologic features. EXPOSURES Severe acute respiratory syndrome coronavirus 2. MAIN OUTCOMES AND MEASURES Type and severity of neurologic involvement, laboratory and imaging data, and outcomes (death or survival with new neurologic deficits) at hospital discharge. RESULTS Of 1695 patients (909 [54%] male; median [interquartile range] age, 9.1 [2.4-15.3] years), 365 (22%) from 52 sites had documented neurologic involvement. Patients with neurologic involvement were more likely to have underlying neurologic disorders (81 of 365 [22%]) compared with those without (113 of 1330 [8%]), but a similar number were previously healthy (195 [53%] vs 723 [54%]) and met criteria for multisystem inflammatory syndrome in children (126 [35%] vs 490 [37%]). Among those with neurologic involvement, 322 (88%) had transient symptoms and survived, and 43 (12%) developed life-threatening conditions clinically adjudicated to be associated with COVID-19, including severe encephalopathy (n = 15; 5 with splenial lesions), stroke (n = 12), central nervous system infection/demyelination (n = 8), Guillain-Barré syndrome/variants (n = 4), and acute fulminant cerebral edema (n = 4). Compared with those without life-threatening conditions (n = 322), those with life-threatening neurologic conditions had higher neutrophil-tolymphocyte ratios (median, 12.2 vs 4.4) and higher reported frequency of D-dimer greater than 3 μg/mL fibrinogen equivalent units (21 [49%] vs 72 [22%]). Of 43 patients who developed COVID-19-related life-threatening neurologic involvement, 17 survivors (40%) had new neurologic deficits at hospital discharge, and 11 patients (26%) died. CONCLUSIONS AND RELEVANCE In this study, many children and adolescents hospitalized for COVID-19 or multisystem inflammatory syndrome in children had neurologic involvement, mostly transient symptoms. A range of life-threatening and fatal neurologic conditions associated with COVID-19 infrequently occurred. Effects on long-term neurodevelopmental outcomes are unknown.

show abstract

mentioning

confidence: 99%

Neurologic Involvement in Children and Adolescents Hospitalized in the United States for COVID-19 or Multisystem Inflammatory Syndrome

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Central nervous system 1. Infective • Acute encephalitis [ 13 , 14 ] • Acute encephalitis [ 1 ] • Bickerstaff encephalitiswith GBS [ 15 ] • Acute necrotizing hemorrhagicencephalitis [ 16 , 17 ] • Viral encephalitis [ 18 – 20 ] • Meningoencephalitis [ 21 ] • Rhombencephalitis [ 22 ] 2. Vascular • Ischemic stroke [ 23 ] • Ischemic stroke[ 1 ] • Ischemic stroke with large vesselocclusion [ 11 , 24 ] • Intracerebral hemorrhage,subarachnoidhemorrhage [ 25 , 26 ] • CVST [ 27 – 29 ] • PRES [ 30 – 33 ] • Microvascular occlusivedisorder [ 34 ] 3.…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Three case reports described more fulminant course of COVID-19-associated encephalitis in patients of acute hemorrhagic necrotizing encephalopathy and rhombencephalitis [ 18 , 20 , 21 ]. Meningeal signs (including nuchal rigidity, Kerning, and Brudzinski signs) along with extensor plantar response were present among all.…”

Section: Clinical Featuresmentioning

confidence: 99%

See 1 more Smart Citation

Neurological manifestations of coronavirus disease 2019: exploring past to understand present

et al. 2021

View full text Add to dashboard Cite

“…The symptoms consist of a combination of acute fever, seizures, neurologic deficits, cerebrospinal fluid (CSF) pleocytosis, and neuroimaging and electroencephalographic (EEG) abnormalities. Clinical cases of VE in COVID-19 patients have been reported (Etemadifar et al, 2020 ; Moriguchi et al, 2020 ; Paniz-Mondolfi et al, 2020 ; Ye et al, 2020 ; Zhou F. et al, 2020 ), suggesting a potential invasion capacity of this virus into the Central Nervous System (CNS), as shown by other members of the Coronaviridae family (Xu et al, 2005 ; Morfopoulou et al, 2016 ; Nilsson et al, 2020 ). Neurological complications induced by respiratory viruses from the Coronaviridae family, such as HCoV-OC43, HCoV-229E, and SARS-CoV-1, have been already reported (Sharifian-Dorche et al, 2020 ).…”

Section: Nervous System Diseases Related To Sars-cov-2 Infectionmentioning

confidence: 99%

The Other Side of SARS-CoV-2 Infection: Neurological Sequelae in Patients

Alonso-Bellido

Bachiller

Vázquez

et al. 2021

Front. Aging Neurosci.

View full text Add to dashboard Cite

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread around the globe causing coronavirus disease 2019 (COVID-19). Because it affects the respiratory system, common symptoms are cough and breathing difficulties with fever and fatigue. Also, some cases progress to acute respiratory distress syndrome (ARDS). The acute phase of COVID-19 has been also related to nervous system symptoms, including loss of taste and smell as well as encephalitis and cerebrovascular disorders. However, it remains unclear if neurological complications are due to the direct viral infection of the nervous system, or they appear as a consequence of the immune reaction against the virus in patients who presented pre-existing deficits or had a certain detrimental immune response. Importantly, the medium and long-term consequences of the infection by SARS-CoV-2 in the nervous system remain at present unknown. This review article aims to give an overview of the current neurological symptoms associated with COVID-19, as well as attempting to provide an insight beyond the acute affectation.

show abstract

Fulminant encephalitis as a sole manifestation of COVID-19

Cited by 15 publications

References 6 publications

Neurologic Involvement in Children and Adolescents Hospitalized in the United States for COVID-19 or Multisystem Inflammatory Syndrome

Neurologic Involvement in Children and Adolescents Hospitalized in the United States for COVID-19 or Multisystem Inflammatory Syndrome

Neurological manifestations of coronavirus disease 2019: exploring past to understand present

The Other Side of SARS-CoV-2 Infection: Neurological Sequelae in Patients

Contact Info

Product

Resources

About