ABSTRACT
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a clinical condition characterized by a myriad of psychiatric symptoms, abnormal movements, autonomic instability, seizures, and encephalopathy. Coronavirus disease-19 (COVID-19) infection is infrequently present with altered mental status. As the days of the COVID-19 pandemic pass, more and more awareness of its different types of immunological reactions are unveiled. A wide spectrum of clinical, pathological, and radiological manifestations has been reported. However, there have only been a few cases where anti-NMDAR antibodies have been found in people who have COVID-19. Herein, we reported two cases with simultaneous anti-NMDAR antibody and COVID-19 infection detection. Both cases clinically responded after treatment with an immunomodulator, showing significant improvement, and were discharged in a conscious and ambulatory state. Autoimmune encephalitis should be thought about if there are neurological symptoms associated with SARS-CoV-2 infection, and immunomodulators should be given to such patients. [ FROM AUTHOR] Copyright of Asian Journal of Medical Sciences is the property of Manipal Colleges of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Background: Though reports of neurological manifestations of COVID-19 have emerged from various parts of the world, the cohorts reported are from the West and mostly derived from electronic databases. Much remains unknown regarding neuro-COVID in developing countries. India is the second-worst affected country, and this study reports the neurological manifestations of COVID-19 in a comprehensively evaluated cohort. Objective: The aim of this study was to describe the range of neurological manifestations of COVID-19 in India with an emphasis on the risk factors, laboratory and imaging findings and short-term outcome. Methods: Retrospective review of hospital records of all confirmed COVID-19 patients with neurological manifestations, receiving inpatient care in two neurology referral hospitals were done. All demographic, clinical details, investigations, and treatment were analysed. Results: A total of 120 confirmed COVID-19 cases presenting with neurological symptoms were included. The mean age of illness and duration of illness was 48.03 ± 17.3 years and 10.9 ± 17.3 days respectively. New onset of neurological symptoms occurred in 100 cases while 20 patients had worsening of pre-existing neurological illness. Stroke was the commonest neurological disorder (43%), followed by encephalopathy (23%) and Guillain-Barre syndrome (10%). Other unusual neurological manifestations included new-onset headache (7%), seizures including denovo status epilepticus (5%) and meningo-encephalitis (5%). Nearly half of the patients had preceding COVID-19 symptoms. Poor outcome at discharge was seen in 40% and mortality occurred in 15%. Conclusion: Stroke and encephalopathy constitute the most common neurological manifestations. The absence of preceding COVID-19 symptoms in nearly half the cases is striking. Poor outcome was seen in nearly 50% despite early recognition and management.
ABSTRACT
The COVID-19 pandemic has disrupted all walks of life on an unprecedented scale. In the following report, we recount the experience of stroke and neurointerventional practitioners from different parts of India. It was written in September 2020 when the first wave of the pandemic was at its zenith in India and vaccines were not yet available.