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01-02-2021 | Coronavirus | Review

Meningoencephalitis associated with COVID-19: a systematic review

Authors: Ritwick Mondal, Upasana Ganguly, Shramana Deb, Gourav Shome, Subhasish Pramanik, Deebya Bandyopadhyay, Durjoy Lahiri

Published in: Journal of NeuroVirology | Issue 1/2021

Abstract

With the growing number of COVID-19 cases in recent times. significant set of patients with extra pulmonary symptoms has been reported worldwide. Here we venture out to summarize the clinical profile, investigations, and radiological findings among patients with SARS-CoV-2-associated meningoencephalitis in the form of a systemic review. This review was carried out based on the existing PRISMA (Preferred Report for Systematic Review and Meta analyses) consensus statement. The data for this review was collected from four databases: Pubmed/Medline, NIH Litcovid, Embase, and Cochrane library and Preprint servers up till 30 June 2020. Search strategy comprised of a range of keywords from relevant medical subject headings which includes “SARS-COV-2,” “COVID-19,” and “meningoencephalitis.” All peer reviewed, case–control, case report, pre print articles satisfying our inclusion criteria were involved in the study. Quantitative data was expressed in mean ± SD, while the qualitative date in percentages. Paired t test was used for analysing the data based on differences between mean and respective values with a p < 0.05 considered to be statistically significant. A total of 61 cases were included from 25 studies after screening from databases and preprint servers, out of which 54 of them had completed investigation profile and were included in the final analysis. Clinical, laboratory findings, neuroimaging abnormalities, and EEG findings were analyzed in detail. This present review summarizes the available evidences related to the occurrence of meningoencephalitis in COVID-19.

Afshar H, Yassin Z, Kalantari S et al (2020) Evolution and resolution of brain involvement associated with SARS-CoV2 infection: a close clinical–paraclinical follow up study of a case. Mult Scler Relat Disord. 43:102216CrossRefPubMedPubMedCentral

Al-olama M, Rashid A, Garozzo D et al (2020) COVID-19-associated meningoencephalitis complicated with intracranial hemorrhage: a case report. ActaNeurochir 162:1495–1499

Bernard-Valnet R, Pizzarotti B, Anichini A et al (2020) Two patients with acute meningoencephalitis concomitant with SARS-CoV-2 infection. Eur J Neurol. https://doi.org/10.1111/ene.14298CrossRefPubMedPubMedCentral

Bohmwald K, Gálvez NMS, Ríos M, Kalergis AM et al (2018) Neurologic alterations due to respiratory virus infections. Front Cell Neurosci 12:386CrossRefPubMedPubMedCentral

Chacón-Aguilar R, Osorio-Cámara JM, Sanjurjo-Jimenez I et al (2020) COVID-19: fever syndrome and neurological symptoms in a neonate. Anales de Pediatría 92:373–374CrossRefPubMedPubMedCentral

Chaumont H, Etienne P, Roze E et al (2020) Acute meningoencephalitis in a patient with COVID-19. Revue Neurologique 176:519–521CrossRefPubMedPubMedCentral

Ding Y, He L, Zhang Q et al (2004) Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J Pathol 203(2):622–630. https://doi.org/10.1002/path.1560CrossRefPubMedPubMedCentral

Dogan L, Kaya D, Sarikaya T et al (2020) Plasmapheresis treatment in COVID-19–related autoimmune meningoencephalitis: case series. Brain BehavImmun 87:155–158

Duong L, Xu P, Liu A et al (2020) Meningoencephalitis without respiratory failure in a young female patient with COVID-19 infection in Downtown Los Angeles, early April 2020. Brain Behav Immun 87:33CrossRefPubMedPubMedCentral

Efe IE, Aydin OU, Alabulut A, Celik O, Aydin K et al (2020) COVID-19−associated encephalitis mimicking glial tumor. World Neurosurg. 140:46–48CrossRefPubMedPubMedCentral

Gates B (2020) Responding to Covid-19—a Once-in-a-Century pandemic? N Engl J Med. https://doi.org/10.1056/NEJMp2003762CrossRefPubMed

Hayashi M, Sahashi Y, Baba Y, Okura H, Shimohata T et al (2020) COVID-19-associated mild encephalitis/encephalopathy with a reversible splenial lesion. J Neurol Sci. 415:116941CrossRefPubMedPubMedCentral

Karimi N, Razavi AS, Rouhani N et al (2020) Frequent convulsive seizures in an adult patient with COVID-19: a case report. Iran Red Crescent Med. 22:e102828

Kim J-E, Heo J-H, Kim H-o, Song S-H, Park S-S, Park T-H, Ahn J-Y, Kim M-K, Choi JP et al (2017) J Clin Neurol (13) 3:227-233. https://doi.org/10.3988/jcn.2017.13.3.227

Koralnik IJ, Tyle KL (2020) COVID-19: a global threat to the nervous system. https://doi.org/10.1002/ana.25807

Lahiri D, Ardila A (2020a) COVID-19 pandemic: a neurological perspective. Cureus. April 29 (12)4:e7889. https://doi.org/10.7759/cureus.788

Lahiri D, Mondal R, Deb S, Shome G, Ganguly U et al (2020) Incidence, clinical presentation, laboratory findings, imaging features and outcome of meningoencephalitis in COVID-19: a systematic review and meta-analysis. PROSPERO CRD42020185571

Lau KK, Yu WC, Chu CM, Lau ST, Sheng B, Yuen KY et al (2004) Possible central nervous system infection by SARS coronavirus. Emerg Infect Dis 10(2):342–344. https://doi.org/10.3201/eid1002.030638CrossRefPubMedPubMedCentral

Li Y, Li H, Fan R et al (2016) Coronavirus infections in the central nervous system and respiratory tract show distinct features in hospitalized children. Intervirology 59(3):163–169. https://doi.org/10.1159/000453066CrossRefPubMed

McAbee GN, Brosgol Y, Pavlakis S, Agha R, Gaffoor M et al (2020) Encephalitis associated with COVID-19 infection in an 11-year-old child. Pediatr Neurol. https://doi.org/10.1016%2Fj.pediatrneurol.2020.04.013

Morassi M, Bagatto D, Cobelli M et al (2020) Stroke in patients with SARS-CoV-2 infection: case series. J Neurol. https://doi.org/10.1007/s00415-020-09885-2CrossRefPubMedPubMedCentral

Morfopoulou S, Brown JR, Davies EG et al (2016) Human coronavirus OC43 associated with fatal encephalitis. N Engl J Med. 375:497–498. https://doi.org/10.1056/NEJMc1509458

Moriguchi T, Harii N, Goto J et al (2020) A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 94:55–58CrossRefPubMedPubMedCentral

Mukherjee D, Sarkar P, Dubey S et al (2020) Ataxia as a presenting manifestation of COVID-19: report of a single case. medRxiv.https://doi.org/10.1101/2020.05.24.20103648

Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S et al (2008) Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2 Journal of Virology Jul, 82 (15) 72647275. https://doi.org/10.1128/JVI.00737-08

Packwood R, Galletta G, Tennyson J et al (2020) An unusual case report of COVID-19 presenting with meningitis symptoms and shingles. Clinical Practice and Cases in Emergency Medicine. https://doi.org/10.5811/cpcem.2020.4.47557CrossRefPubMedPubMedCentral

Panariello A, Bassetti R, Radice A et al (2020) Anti-NMDA receptor encephalitis in a psychiatric Covid-19 patient: a case report. Brain, Behaviour, and Immunity 87:179–181CrossRef

Pierre SZYBA, Toko YRL, Klopfenstein TVGT et al (2020) Encephalopathy in patients with COVID‐19: ‘Causality or coincidence?’ J Med Virol. https://doi.org/10.1002/jmv.26027

Pilotto A et al (2020) The clinical spectrum of encephalitis in COVID-19 disease: the ENCOVID multicentre study. medRxiv. 06.19.20133991

Pilotto A, Odolini S, Masciocchi S et al (2020) Steroid-responsive encephalitis in coronavirus disease 2019 [published online ahead of print, 2020 May 17]. Ann Neurol. https://doi.org/10.1002/ana.25783

Prasad R (1982) Immunoglobulin levels in serum and cerebrospinal fluid in certain viral infections of the central nervous system The Journal of Infectious Diseases, September, 148(3):607. https://doi.org/10.1093/infdis/148.3.607

Romero-Sánchez CM, Díaz-Maroto I, Fernández-Díaz E et al (2020) Neurologic manifestations in hospitalized patients with COVID-19: the ALBACOVID Registry. Neurology. https://doi.org/10.1212/WNL.0000000000009937CrossRefPubMedPubMedCentral

Schattner A, Hadar S, Dubin I et al (2018) Human coronavirus NL63 and acute encephalitis. Ann Infect Dis Epidemiol. 3(2): 1032. ISSN: 2475–5664

Sureka J, Jakkani RK (2012) Clinico-radiological spectrum of bilateral temporal lobe hyperintensity: a retrospective review Br J Radiol. 85(1017):e782-e792. https://doi.org/10.1259/bjr/30039090

Sohal S, Mossammat M (2020) COVID-19 Presenting with seizures. IDCases 20:e00782CrossRefPubMedPubMedCentral

Talmor G, Grube JG, Eloy JA, Liu JK, Hsueh WD et al (2020) Nasoseptal flap necrosis after endoscopic skull base surgery in the setting of severe acute respiratory syndrome coronavirus 2/coronavirus 2019. World Neurosurg. https://doi.org/10.1016/j.wneu.2020.05.237

Varatharaj A, Thomas N, Ellul MA et al (2020) Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry. S2215–0366(20)30287-X. https://doi.org/10.1016/S2215-0366(20)30287-X

Wong PF, Craig S, Newman P et al (2020) A case of rhombencephalitis as a rare complication of acute COVID-19 infection. Clin Med 20:293–294CrossRef

Ye M, Ren Y, Lv T et al (2020) Encephalitis as a clinical manifestation of COVID-19. Brain Behav Immun 1591:30465–30467

Yeh EA, Collins A, Cohen ME, Duffner PK, Faden H (2004) Detection of coronavirus in the central nervous system of a child with acute disseminated encephalomyelitis. Pediatrics 113(1 Pt 1):e73–e76. https://doi.org/10.1542/peds.113.1.e73CrossRefPubMed

Yin R, Feng W, Wang T et al (2020) Concomitant neurological symptoms observed in a patient diagnosed with coronavirus disease 2019. J Med Virol. https://doi.org/10.1002/jmv.25888

Zubair AS, McAlpine LS, Gardin T, MPP; Farhadian S, Kuruvilla DE, Spudich S et al (2019) Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease. JAMA Neurol. https://doi.org/10.1001/jamaneurol.2020.2065

Title: Meningoencephalitis associated with COVID-19: a systematic review
Authors: Ritwick Mondal
Upasana Ganguly
Shramana Deb
Gourav Shome
Subhasish Pramanik
Deebya Bandyopadhyay
Durjoy Lahiri
Publication date: 01-02-2021
Publisher: Springer International Publishing
Keywords: Coronavirus
Meningoencephalitis
SARS-CoV-2
Electroencephalography
COVID-19
Encephalitis
Published in: Journal of NeuroVirology / Issue 1/2021
Print ISSN: 1355-0284
Electronic ISSN: 1538-2443
DOI: https://doi.org/10.1007/s13365-020-00923-3

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Meningoencephalitis associated with COVID-19: a systematic review

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