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Acute Necrotizing Encephalopathy in Adult Patients With COVID-19: A Systematic Review of Case Reports and Case Series

Shaghayegh Karami|Fattaneh Khalaj|Houman Sotoudeh|Zohreh Tajabadi|Ramin Shahidi|Mohammad Amin Habibi|Mahsa Shirforoush Sattari|Amir Azimi|Seyed Ali Forouzannia|Romina Rafiei|Hamid Reihani|Reza Nemati|Soraya Teimori|Amirmohammad Khalaji|Vida Sarmadi|Ali Dadjou
대한신경과학회 (Korean Neurological Association)|2023.11|Journal of Clinical Neurology|제19권 제6호|pp. 597-611

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COVID-19SARS-CoV-2acute necrotizing encephalopathy

초록

Background and Purpose Acute necrotizing encephalopathy (ANE) is a rare neurological disorder that is often associated with viral infections. Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a few COVID-19-associated ANE cases have been reported. Since very little is known about ANE, the present study aimed to determine the clinical, biochemical, and radiological characteristics of affected patients. Methods A search was conducted on PubMed, Scopus, Embase, and Web of Science databases for articles published up to August 30, 2022 using relevant keywords. Case reports and series in the English language that reported ANE in adult patients with COVID-19 confirmed by reverse transcription polymerase chain reaction were included in this study. Data on the demographic, clinical, laboratory, and radiological characteristics of patients were extracted and analyzed using the SPSS software (version 26). Results The study included 30 patients (18 males) with COVID-19 and ANE who were aged 49.87±18.68 years (mean±standard deviation). Fever was the most-prevalent symptom at presentation (66.7%). Elevated C-reactive protein was observed in the laboratory assessments of 13 patients. Computed tomography and magnetic resonance imaging were the most-common radiological modalities used for brain assessments. The most commonly prescribed medications were methylprednisolone (30%) and remdesivir (26.7%). Sixteen patients died prior to discharge. Conclusions The diagnosis of COVID-19-associated ANE requires a thorough knowledge of the disease. Since the clinical presentations of ANE are neither sensitive nor specific, further laboratory and brain radiological evaluations will be needed to confirm the diagnosis. The suspicion of ANE should be raised among patients with COVID-19 who present with progressive neurological symptoms.

Abstract

Background and Purpose Acute necrotizing encephalopathy (ANE) is a rare neurological disorder that is often associated with viral infections. Since the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a few COVID-19-associated ANE cases have been reported. Since very little is known about ANE, the present study aimed to determine the clinical, biochemical, and radiological characteristics of affected patients. Methods A search was conducted on PubMed, Scopus, Embase, and Web of Science databases for articles published up to August 30, 2022 using relevant keywords. Case reports and series in the English language that reported ANE in adult patients with COVID-19 confirmed by reverse transcription polymerase chain reaction were included in this study. Data on the demographic, clinical, laboratory, and radiological characteristics of patients were extracted and analyzed using the SPSS software (version 26). Results The study included 30 patients (18 males) with COVID-19 and ANE who were aged 49.87±18.68 years (mean±standard deviation). Fever was the most-prevalent symptom at presentation (66.7%). Elevated C-reactive protein was observed in the laboratory assessments of 13 patients. Computed tomography and magnetic resonance imaging were the most-common radiological modalities used for brain assessments. The most commonly prescribed medications were methylprednisolone (30%) and remdesivir (26.7%). Sixteen patients died prior to discharge. Conclusions The diagnosis of COVID-19-associated ANE requires a thorough knowledge of the disease. Since the clinical presentations of ANE are neither sensitive nor specific, further laboratory and brain radiological evaluations will be needed to confirm the diagnosis. The suspicion of ANE should be raised among patients with COVID-19 who present with progressive neurological symptoms.

참고문헌 (73)

  1. "WHO coronavirus (COVID-19) dashboard" (2022)[URL]
  2. Mahboubi Mehrabani M, "Neurological complications associated with covid-19; molecular mechanisms and therapeutic approaches", Rev Med Virol, 32, pp.e2334~ (2022)
  3. Mullaguri N, "COVID-19 related acute hemorrhagic necrotizing encephalitis : a report of two cases and literature review", Cureus, 13, pp.e14236~ (2021)
  4. Misra S, "Frequency of neurologic manifestations in COVID-19 : a systematic review and meta-analysis", Neurology, 97, pp.e2269~e2281 (2021)
  5. Nepal G, "Neurological manifestations of COVID-19 : a systematic review", Crit Care, 24, pp.421~ (2020)
  6. Mahdizade Ari M, "Neurological manifestations in patients with COVID-19 : a systematic review and meta-analysis", J Clin Lab Anal, 36, pp.e24403~ (2022)
  7. Li Y, "Acute cerebrovascular disease following COVID-19 : a single center, retrospective, observational study", Stroke Vasc Neurol, 5, pp.279~284 (2020)
  8. Kumar N, "Acute necrotizing encephalitis as a probable association of COVID-19", Indian J Crit Care Med, 24, pp.991~994 (2020)
  9. Guerrero JI, "Central and peripheral nervous system involvement by COVID-19 : a systematic review of the pathophysiology, clinical manifestations, neuropathology, neuroimaging, electrophysiology, and cerebrospinal fluid findings", BMC Infect Dis, 21, pp.515~ (2021)
  10. Zhou Z, "Understanding the neurotropic characteristics of SARS-CoV-2 : from neurological manifestations of COVID-19 to potential neurotropic mechanisms", J Neurol, 267, pp.2179~2184 (2020)
  11. Wu Y, "Nervous system involvement after infection with COVID-19 and other coronaviruses", Brain Behav Immun, 87, pp.18~22 (2020)
  12. Hoffmann M, "SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2and is blocked by a clinically proven protease inhibitor", Cell, 181, pp.271~280 (2020)
  13. DosSantos MF, "Neuromechanisms of SARS-CoV-2 : a review", Front Neuroanat, 14, pp.37~ (2020)
  14. Collantes MEV, "Neurological manifestations in COVID-19 infection : a systematic review and meta-analysis", Can J Neurol Sci, 48, pp.66~76 (2021)
  15. Yang X, "Protective effect of oxytocin on ventilator-induced lung injury through NLRP3-mediated pathways", Front Pharmacol, 12, pp.722907~ (2021)
  16. Yassin A, "Neurological manifestations and complications of coronavirus disease 2019(COVID-19) : a systematic review and meta-analysis", BMC Neurol, 21, pp.138~ (2021)
  17. Nazari S, "Central nervous system manifestations in COVID-19patients : a systematic review and meta-analysis", Brain Behav, 11, pp.e02025~ (2021)
  18. Lazarte-Rantes C, "Acute necrotizing encephalopathy associated with SARS-CoV-2 exposure in a pediatric patient", Cureus, 13, pp.e15018~ (2021)
  19. Dixon L, "COVID-19-related acute necrotizing encephalopathy with brain stem involvement in a patient with aplastic anemia", Neurol Neuroimmunol Neuroinflamm, 7, pp.e789~ (2020)
  20. Wu X, "Acute necrotizing encephalopathy : an underrecognized clinicoradiologic disorder", Mediators Inflamm, 2015, pp.792578~ (2015)
  21. Poyiadji N, "COVID-19-associated acute hemorrhagic necrotizing encephalopathy : imaging features", Radiology, 296, pp.E119~E120 (2020)
  22. Shukla P, "Clinical manifestations and pathogenesis of acute necrotizing encephalopathy : the interface between systemic infection and neurologic injury", Front Neurol, 12, pp.628811~ (2021)
  23. Page MJ, "PRISMA 2020 explanation and elaboration : updated guidance and exemplars for reporting systematic reviews", BMJ, 372, pp.n160~ (2021)
  24. Moola S, "Joanna Briggs Institute Reviewer’s Manual" (2017), Joanna Briggs Institute
  25. Shankar P, "Organ involvement in COVID-19 : a molecular investigation of autopsied patients", Microorganisms, 10, pp.1333~ (2022)
  26. Garg R, "Neurological symptoms as initial manifestation of covid-19 – An observational study", Ann Indian Acad Neurol, 23, pp.482~486 (2020)
  27. Guedes BF, "NeuroCOVID-19 : a critical review", Arq Neuropsiquiatr, 80(5 Suppl 1), pp.281~289 (2022)
  28. Orrù G, "Neurological complications of COVID-19 and possible neuroinvasion pathways : a systematic review", Int J Environ Res Public Health, 17, pp.6688~ (2020)
  29. Whittaker A, "Neurological manifestations of COVID-19 : a systematic review and current update", Acta Neurol Scand, 142, pp.14~22 (2020)
  30. Yusak Mangara Tua Siahaan, "COVID-19-Associated Encephalopathy: Systematic Review of Case Reports", Journal of Clinical Neurology, 18(2), pp.194~206 (2022), 대한신경과학회
  31. Stoian A, "Autoimmune encephalitis in COVID-19 infection : our experience and systematic review of the literature", Biomedicines, 10, pp.774~ (2022)
  32. Carmo RLD, "Neuroimaging of emergent and reemergent infections", Radiographics, 39, pp.1649~1671 (2019)
  33. Zamani R, "Central neuroinflammation in covid-19 : a systematic review of 182 cases with encephalitis, acute disseminated encephalomyelitis, and necrotizing encephalopathies", Rev Neurosci, 33, pp.397~412 (2021)
  34. Yoo-Na Kim, "A case of acute necrotizing encephalopathy associated with parainfluenza virus infection", Clinical and Experimental Pediatrics, 55(4), pp.147~150 (2012), 대한소아청소년과학회[DOI]
  35. Mahapure KS, "COVID-19-associated acute disseminated encephalomyelitis : a systematic review", Asian J Neurosurg, 16, pp.457~469 (2021)
  36. Novi G, "Acute disseminated encephalomyelitis after SARS-CoV-2 infection", Neurol Neuroimmunol Neuroinflamm, 7, pp.e797~ (2020)
  37. Sklinda K, "Radiological manifestation of neurological complications in the course of SARS-CoV-2 infection", Front Neurol, 12, pp.711026~ (2021)
  38. Sudulagunta SR, "Posterior reversible encephalopathy syndrome(PRES)", Oxf Med Case Reports, 2017, pp.omx011~ (2017)
  39. Mondal R, "Meningoencephalitis associated with COVID-19 : a systematic review", J Neurovirol, 27, pp.12~25 (2021)
  40. Khoo A, "Postinfectious brainstem encephalitis associated with SARS-CoV-2", J Neurol Neurosurg Psychiatry, 91, pp.1013~1014 (2020)
  41. Rodriguez-Morales AJ, "Clinical, laboratory and imaging features of COVID-19 : a systematic review and meta-analysis", Travel Med Infect Dis, 34, pp.101623~ (2020)
  42. Chow CK, "Presentation and outcome of acute necrotizing encephalopathy of childhood : a 10-year single-center retrospective study from Hong Kong", J Child Neurol, 35, pp.674~680 (2020)
  43. Bashiri FA, "Acute necrotizing encephalopathy of childhood : a multicenter experience in Saudi Arabia", Front Pediatr, 8, pp.526~ (2020)
  44. Okumura A, "Outcome of acute necrotizing encephalopathy in relation to treatment with corticosteroids and gammaglobulin", Brain Dev, 31, pp.221~227 (2009)
  45. Wang ML, "Clinical experience in the diagnosis and treatment of adult acute necrotizing encephalopathy", Neuroimmunomodulation, 29, pp.468~475 (2022)
  46. Monedero P, "Early corticosteroids are associated with lower mortality in critically ill patients with COVID-19 : a cohort study", Crit Care, 25, pp.2~ (2021)
  47. Mongardon N, "Impact of late administration of corticosteroids in COVID-19 ARDS", Intensive Care Med, 47, pp.110~112 (2021)
  48. Li Q, "Efficacy evaluation of early, low-dose, short-term corticosteroids in adults hospitalized with non-severe COVID-19 pneumonia : a retrospective cohort study", Infect Dis Ther, 9, pp.823~836 (2020)
  49. Ma S, "Efficacy and safety of systematic corticosteroids among severe COVID-19 patients : a systematic review and meta-analysis of randomized controlled trials", Signal Transduct Target Ther, 6, pp.83~ (2021)
  50. Li H, "Effectiveness of corticosteroids to treat severe COVID-19 : a systematic review and meta-analysis of prospective studies", Int Immunopharmacol, 100, pp.108121~ (2021)
  51. Li K, "Plasma exchange therapy for acute necrotizing encephalopathy of childhood", Pediatr Investig, 5, pp.99~105 (2021)
  52. Dangi S, "A case of deep cerebral venous thrombosis presenting like acute necrotizing encephalopathy", J Pediatr Neurosci, 15, pp.54~56 (2020)
  53. Taniguchi D, "Deep cerebral venous thrombosis mimicking influenza-associated acute necrotizing encephalopathy : a case report", J Med Case Rep, 11, pp.281~ (2017)
  54. Garg RK, "Encephalopathy in patients with COVID-19 : a review", J Med Virol, 93, pp.206~222 (2021)
  55. Agha T, "Acute necrotizing encephalopathy secondary to COVID-19", Proc(Bayl Univ Med Cent), 35, pp.512~513 (2022)
  56. Breit H, "Acute necrotizing encephalopathy due to SARS-CoV-2 in a pregnant female", Neurol Sci, 42, pp.3991~3994 (2021)
  57. Ciolac D, "Extensive cerebellar involvement and cognitive impairment in COVID-19-associated acute necrotizing encephalopathy", Ther Adv Neurol Disord, 14, pp.1756286420985175~ (2021)
  58. Delamarre L, "COVID-19-associated acute necrotising encephalopathy successfully treated with steroids and polyvalent immunoglobulin with unusual IgG targeting the cerebral fibre network", J Neurol Neurosurg Psychiatry, 91, pp.1004~1006 (2020)
  59. Diallo A, "A fatal case coronavirus disease 2019 – Associated acute hemorrhagic necrotizing encephalopathy", J Glob Infect Dis, 14, pp.84~86 (2022)
  60. Ermilov VV, "Clinical and morphological features of SARS-COV-2 associated acute hemorrhagic necrotizing encephalopathy : case report", Egypt J Neurol Psychiatr Neurosurg, 57, pp.158~ (2021)
  61. Elkady A, "Acute necrotizing encephalopathy and myocarditis in a young patient with COVID-19", Neurol: Neuroimmunol NeuroInflammation, 7, pp.e801~ (2020)
  62. Ghosh R, "SARS-CoV-2-associated acute hemorrhagic, necrotizing encephalitis(AHNE)presenting with cognitive impairment in a 44-year-old woman without comorbidities : a case report", Am J Case Rep, 21, pp.e925641~ (2020)
  63. Hemachudha P, "A case of successive development of possible acute necrotizing encephalopathy after COVID-19pneumonia", SAGE Open Med Case Rep, 10, pp.2050313~ (2022)
  64. Holmes BB, "Hyper-acute necrotizing encephalopathy-like syndrome in early pregnancy", Neurohospitalist, 12, pp.90~95 (2022)
  65. Jomaa N, "COVID-19-associated acute asymmetric hemorrhagic necrotizing encephalopathy : a case report", Neurohospitalist, 12, pp.371~376 (2022)
  66. Tien Lee Ong, "COVID-19 Associated Acute Necrotizing Encephalopathy Presenting as Parkinsonism and Myorhythmia", Journal Of Movement Disorders, 15(1), pp.89~92 (2022), 대한파킨슨병및이상운동질환학회[DOI]
  67. Raschke R, "Rapidly fatal COVID-19-associated acute necrotizing encephalopathy in a previously healthy 26-year-old man", Southwest J Pulm Crit Care, 23, pp.138~143 (2021)
  68. Rettenmaier LA, "COVID-19-associated necrotizing encephalopathy presenting without active respiratory symptoms : a case report with histopathology", J Neurovirol, 28, pp.172~176 (2022)
  69. Sharma R, "Spectrum of hemorrhagic encephalitis in COVID-19 patients: a case series and review", Diagnostics(Basel), 12, pp.924~ (2022)
  70. Vanni H, "COVID-19 associated acute necrotizing encephalopathy in a hospitalized cohort in oregon", Research Square (2020)[DOI]
  71. Virhammar J, "Acute necrotizing encephalopathy with SARS-CoV-2 RNA confirmed in cerebrospinal fluid", Neurology, 95, pp.445~449 (2020)
  72. Woldie IL, "Autoimmune hemolytic anemia in a 24-year-old patient with COVID-19 complicated by secondary cryptococcemia and acute necrotizing encephalitis : a case report and review of literature", J Med Cases, 11, pp.362~365 (2020)
  73. Ziemele D, "A fatal case of COVID-19-associated acute necrotizing encephalopathy", Eur J Neurol, 28, pp.3870~3872 (2021)

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