Autoimmune Encephalitis in COVID-19 patients : a systematic review of case reports and case series (preprint)

ABSTRACT

Introduction: Growing evidence demonstrated the occurrence of neurological complications such as ischemic stroke, epilepsy, and autoimmune encephalitis ( AE ) associated with COVID − 19 infection. The purpose of this review was to summarize the clinical symptoms, treatment, and outcome of COVID-19-associated AE. Methods: We searched case reports and case series of AE associated with COVID-19 between January 1, 2020, and March 31, 2023, using Pubmed, Embase, and Web of Science databases. After screening and further evaluation, irrelevant articles were excluded. Information related to treatment, clinical manifestations, comorbidities, and outcomes was extracted and summarized. Results: 36 studies were included in this review, 34 of which were case reports and 2 were case series. A total of 39 patients with AE were included, including 18 (46%) cases of unknown type of AE, 10 (26%) cases of anti-N-methyl-D-aspartate (NMDA) encephalitis, 4 (10%) cases of limbic encephalitis, 3 (8%) cases of anti-myelin-oligodendrocyte-glycoprotein (MOG) encephalitis, and other type of AE. In addition, the clinical manifestations of AE are mainly disturbance of consciousness, seizure and psychiatric symptoms. Although the symptoms of AE are varied, most patients could recover completely, with a few having residual symptoms of neurological damage. Conclusions: In this systematic review, the characteristics of COVID-19-associated AE are summarized, including neurological manifestations, treatment, types, and outcomes. Although COVID−19-associated AE can sometimes be life-threatening, most AE is reversible if treated promptly.