The case of encephalitis in a COVID-19 pediatric patient

Urso, Lidia; Distefano, Mariagrazia; Cambula, Gaetano; Colomba, A; Nuzzo, Domenico; Picone, Pasquale Massimo; Giacomazza, Daniela; Sicurella, Luigi

doi:10.1007/s10072-021-05670-9

Cited by 18 publications

(12 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This girl was treated with only AED; her seizures diminished, and behavior disorders disappeared over the next two months. Finally, a five-year-old girl manifested with respiratory symptoms, low-grade fever, and neck edema with lymphadenopathy [ 87 ]. In a few days, she became lethargic; her EEG was characterized by slow-wave rhythm, and brain oedema with altered signal of splenium of corpus callosum and subcortical parietal lobes was detected in brain MR. She improved and was discharged after two weeks, after having been treated with antibiotics, antivirals, and steroids.…”

Section: Resultsmentioning

confidence: 99%

Encephalitis in Patients with COVID-19: A Systematic Evidence-Based Analysis

Islam

Cavestro

Alam

et al. 2022

Cells

View full text Add to dashboard Cite

Although severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) predominantly infects the respiratory system, several investigations have shown the involvement of the central nervous system (CNS) along the course of the illness, with encephalitis being one of the symptoms. The objective of this systematic review was to evaluate the characteristics (clinical, neuro-radiological aspects, and laboratory features) and outcomes of encephalitis in COVID-19 patients. PubMed, Scopus, and Google Scholar databases were searched from 1 December 2019 until 21 July 2022 to identify case reports and case series published on COVID-19 associated with encephalitis. The quality of the included studies was assessed by the Joanna Briggs Institute critical appraisal checklists. This systematic review included 79 studies, including 91 COVID-19 patients (52.7% male) experiencing encephalitis, where 85.6% were adults (49.3 ± 20.2 years), and 14.4% were children (11.2 ± 7.6 years). RT-PCR was used to confirm 92.2% of the COVID-19 patients. Encephalitis-related symptoms were present in 78.0% of COVID-19 patients at the time of diagnosis. In these encephalitis patients, seizure (29.5%), confusion (23.2%), headache (20.5%), disorientation (15.2%), and altered mental status (11.6%) were the most frequently reported neurologic manifestations. Looking at the MRI, EEG, and CSF findings, 77.6%, 75.5%, and 64.1% of the patients represented abnormal results. SARS-CoV-2-associated or -mediated encephalitis were the most common type observed (59.3%), followed by autoimmune encephalitis (18.7%). Among the included patients, 66.7% were discharged (37.8% improved and 28.9% fully recovered), whereas 20.0% of the reported COVID-19-positive encephalitis patients died. Based on the quality assessment, 87.4% of the studies were of high quality. Although in COVID-19, encephalitis is not a typical phenomenon, SARS-CoV-2 seems like a neuropathogen affecting the brain even when there are no signs of respiratory illness, causing a high rate of disability and fatality.

show abstract

Section: Resultsmentioning

confidence: 99%

Encephalitis in Patients with COVID-19: A Systematic Evidence-Based Analysis

Islam

Cavestro

Alam

et al. 2022

Cells

View full text Add to dashboard Cite

show abstract

“…In children, a few neurological complications were reported including mainly headache and loss of smell [3] . However, a few cases of more serious complications such as seizures and encephalitis were reported with a wide variation in presentation and outcome [1] [4] [5] [6] [7] [8] [9] . The pathophysiology of encephalitis with Covid-19 is not clear with a possibility of direct viral invasion, autoimmune or vascular process [8] .…”

mentioning

confidence: 99%

Encephalitis and transverse myelitis associated with Covid-19 infection, a case report

et al. 2022

View full text Add to dashboard Cite

“…Despite the absence of significant respiratory symptoms, neurological manifestations of COVID-19 infection are possible. Abnormal signals in the vast areas of the corpus callosum on MRI images have been reported in the case of a 5-year-old girl positive for COVID-19 [ 100 ]. Atypical manifestations in children, such as altered mental status and seizures as well as a hyperinflammatory shock with multiorgan dysfunction, should be noted by pediatricians.…”

Section: Acute Encephalopathy In the Covid-19 Eramentioning

confidence: 99%

A Comprehensive Review of Pediatric Acute Encephalopathy

Imataka

Kuwashima

Yoshihara

2022

JCM

View full text Add to dashboard Cite

Acute encephalopathy typically affects previously healthy children and often results in death or severe neurological sequelae. Acute encephalopathy is a group of multiple syndromes characterized by various clinical symptoms, such as loss of consciousness, motor and sensory impairments, and status convulsions. However, there is not only localized encephalopathy but also progression from localized to secondary extensive encephalopathy and to encephalopathy, resulting in a heterogeneous clinical picture. Acute encephalopathy diagnosis has advanced over the years as a result of various causes such as infections, epilepsy, cerebrovascular disorders, electrolyte abnormalities, and medication use, and new types of acute encephalopathies have been identified. In recent years, various tools, including neuroradiological diagnosis, have been developed as methods for analyzing heterogeneous acute encephalopathy. Encephalopathy caused by genetic abnormalities such as CPT2 and SCN1A is also being studied. Researchers were able not only to classify acute encephalopathy from image diagnosis to typology by adjusting the diffusion-weighted imaging/ADC value in magnetic resonance imaging diffusion-weighted images but also fully comprehend the pathogenesis of vascular and cellular edema. Acute encephalopathy is known as a very devastating disease both medically and socially because there are many cases where lifesaving is sometimes difficult. The overall picture of childhood acute encephalopathy is becoming clearer with the emergence of the new acute encephalopathies. Treatment methods such as steroid pulse therapy, immunotherapy, brain hypothermia, and temperature control therapy have also advanced. Acute encephalopathy in children is the result of our predecessor’s zealous pursuit of knowledge. It is reasonable to say that it is a field that has advanced dramatically over the years. We would like to provide a comprehensive review of a pediatric acute encephalopathy, highlighting advancements in diagnosis and treatment based on changing disease classification scenarios from the most recent clinical data.

show abstract

The case of encephalitis in a COVID-19 pediatric patient

Cited by 18 publications

References 42 publications

Encephalitis in Patients with COVID-19: A Systematic Evidence-Based Analysis

Encephalitis in Patients with COVID-19: A Systematic Evidence-Based Analysis

Encephalitis and transverse myelitis associated with Covid-19 infection, a case report

A Comprehensive Review of Pediatric Acute Encephalopathy

Contact Info

Product

Resources

About