Lv Pu, Peng Fen, Zhang Yeqiong, Zhang Linwei, Li Na, Sun Lili, Wang Yu, Hou Pihua, Huang Tiequn, Wang Xiaoping
Department of Healthcare, China-Japan Friendship Hospital, Ministry of Health, Beijing 100029, P.R. China.
Department of Cardiology, Renmin Hospital of Hubei Province, Wuhan, Hubei 430060, P.R. China.
Exp Ther Med. 2021 Apr;21(4):362. doi: 10.3892/etm.2021.9793. Epub 2021 Feb 14.
Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may target the central nervous system and several neurological symptoms have been reported in patients with coronavirus disease 2019 (COVID-19). In the present study, a case of a SARS-CoV-2 complicated with meningoencephalitis was reported. Cerebrospinal fluid (CSF) analyses indicated hyperproteinorrachia but the specimen was negative for SARS-CoV-2 RNA. Furthermore, 10 published articles reporting on patients with COVID-19-associated meningitis/encephalitis were reviewed. Patients diagnosed with COVID-19-associated meningitis/encephalitis had diverse clinical neurological manifestations, including consciousness disturbance, epileptic attacks, psychotic syndrome and meningeal irritation signs. CSF tests revealed elevated protein, lymphocytes and cytokines. SARS-CoV-2 may be detected in the CSF of certain cases. Neuroimaging findings included hyperintense signal changes in the white matter and enhancement of meninges on brain MRI. Certain patients responded well to corticosteroid therapy and had a favorable prognosis, while elderly patients tended to have poor outcomes due to multiple organ dysfunction.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染可能会侵袭中枢神经系统，2019冠状病毒病（COVID-19）患者中已报告出现多种神经症状。在本研究中，报告了1例SARS-CoV-2合并脑膜脑炎的病例。脑脊液（CSF）分析显示蛋白含量升高，但标本的SARS-CoV-2 RNA检测呈阴性。此外，还回顾了10篇关于COVID-19相关脑膜炎/脑炎患者的已发表文章。诊断为COVID-19相关脑膜炎/脑炎的患者有多种临床神经表现，包括意识障碍、癫痫发作、精神综合征和脑膜刺激征。脑脊液检查显示蛋白、淋巴细胞和细胞因子升高。在某些病例的脑脊液中可能检测到SARS-CoV-2。神经影像学检查结果包括脑MRI上白质高信号改变和脑膜强化。部分患者对皮质类固醇治疗反应良好，预后良好，而老年患者由于多器官功能障碍往往预后较差。
