Post-COVID-19 HSV encephalitis: a review

Gupta, S; Dutta, Ajitava; Chakraborty, Uddalak; Kumar, Reginald; Das, Diganta; Ray, B K

doi:10.1093/qjmed/hcac060

Cited by 13 publications

(10 citation statements)

References 26 publications

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“…Another observational study described 8 patients with laboratoryconfirmed herpes simplex encephalitis who had a history of COVID-19 within the previous 6 weeks and followed them for 3 months. In this report, all the patients received 14-day course of acyclovir and all but one with rhinocerebral mucormycosis survived Gupta et al (2022).…”

Section: Discussionmentioning

confidence: 73%

Central nervous system reactivation of herpesviridae family in patients with COVID-19

et al. 2023

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The objective of this study is to describe our COVID-19 patients with herpesviridae reactivation in the central nervous system (CNS). Four patients were described including two with acute encephalitis and two with acute encephalomyelitis. Three of four patients had abnormal findings on neuroimaging studies. One of four patients died, one survived with major neurological sequelae, and two others fully recovered. Herpesviridae reactivation in the CNS in patients with COVID-19 is a rare but serious coincidence. The optimal therapeutic management has not been investigated and until more information is available, it is prudent to treat these patients with appropriate antivirals with or without anti-inflammatory agents.

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Section: Discussionmentioning

confidence: 73%

Central nervous system reactivation of herpesviridae family in patients with COVID-19

et al. 2023

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“…Carneiro et al [45] reported a 40% incidence of neurological symptoms among patients with HSV reactivation. Four case reports of encephalitis [48][49][50][51] and one case of cerebellitis [47] have been found in the current literature review. The image patterns, sites of injury, signs and symptoms in neurological disorders seen in severe SARS-CoV-2 infection are highly heterogeneous [83], but HSV encephalitis presents well-known features, including an acute, necrotizing form that is almost always focal and often asymmetrical, located in the orbitofrontal and temporal lobes, with involvement of the cingulate and insular cortex [84][85][86].…”

Section: Detection Methods Clinical Presentationmentioning

confidence: 99%

Herpes Simplex Virus (HSV) Reactivation in COVID-19 Patients: A Mini Systematic Review

Norberg¹,

Norberg²,

Manhães

et al. 2023

JAMMR

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Background and Aim: Herpes simplex viruses (HSV) occur worldwide and have a high prevalence. In the context of COVID -19 there are several potential triggers for HSV reactivation, such as functional depletion or imbalance of the immune system, use of immunosuppressive drugs to control cytokine response, and physical or psychological stress in consequence of the disease. The aim of this research is to review, by analysing the current scientific literature, the context of the HSV reactivation or infection in the context of the COVID-19 pandemic. Methods: A systematic review of scientific manuscripts was performed using the PubMed, SciELO, and Google Scholar databases. The evaluated manuscripts were published between 2019 and January 2023. Systematic studies of groups of patients with COVID-19 that evaluated the incidence of HSV reactivations and infections, as well as case reports of HSV reactivation in patients with SARS-CoV-2 infection, were analyzed. Results: Analysis of systematic studies among patients with COVID-19 revealed incidence rates of HSV reactivation detected by PCR technique, which can range from 12% to 83%. The incidence of clinical manifestations was heterogeneous, and the occurence of atypical clinical forms was considered high. HSV reactivations without clinical symptoms were observed in all studies in patients hospitalized with COVID -19. Determining the severity of infection and distinguishing between benign reactivation and true HSV infection concomitant with COVID-19 is a diagnostic challenge. Currently available scientific investigations are controversial regarding the impact on the prognosis of patients with human herpesvirus reactivation and the possible association between HSV infection and mortality rates. The broad spectrum of atypical forms, as well as difficulties in accurately diagnosing real HSV infection, may lead to underestimating the true impact of concurrent reactivation in COVID-19 patients. Patients receiving invasive mechanical ventilation and corticosteroid therapy are the groups at highest risk for HSV reactivation. Further investigations are needed to clarify the interaction between these two viruses in the context of SARS-CoV-2 disease and treatment.

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“…(11) In fact, a recent study observed the occurrence of HSV encephalitis in post-coronavirus disease (COVID) syndrome patients, possibly caused by reactivation during immune dysregulation in SARS-CoV-2 infection. (12) Several studies have proposed an association between HSV-1 infection and neurodegenerative disease. (8,13) It is hypothesised that HSV-1 modulates neuronal 1920 (1) 1952 (17) 1964 (71) 1956 (26) 1986 (40) 1988 (41) 1990 (60) 1994 (80) Name Herpes simplex virus 1 Human betaherpesvirus 7…”

Section: Alphaherpesvirusmentioning

confidence: 99%

“…11 ) In fact, a recent study observed the occurrence of HSV encephalitis in post-coronavirus disease (COVID) syndrome patients, possibly caused by reactivation during immune dysregulation in SARS-CoV-2 infection. 12 …”

mentioning

confidence: 99%

Family Herpesviridae and neuroinfections: current status and research in progress

Carneiro

Pereira

Paula

2022

Mem. Inst. Oswaldo Cruz

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This article addresses the relationship between human herpesviruses (HHVs) and neuroinfections. Alphaherpesviruses, betaherpesviruses and gammaherpesviruses are neurotropic viruses that establish latency and exhibit reactivation capacity. Encephalitis and meningitis are common in cases of HHV. The condition promoted by HHV infection is a purported trigger for certain neurodegenerative diseases. Ongoing studies have identified an association between HSV-1 and the occurrence of Alzheimer's disease, multiple sclerosis and infections by HHV-6 and Epstein-Barr virus. In this review, we highlight the importance of research investigating the role of herpesviruses in the pathogenesis of diseases that affect the nervous system and describe other studies in progress.

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Post-COVID-19 HSV encephalitis: a review

Cited by 13 publications

References 26 publications

Central nervous system reactivation of herpesviridae family in patients with COVID-19

Central nervous system reactivation of herpesviridae family in patients with COVID-19

Herpes Simplex Virus (HSV) Reactivation in COVID-19 Patients: A Mini Systematic Review

Family Herpesviridae and neuroinfections: current status and research in progress

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