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与 COVID-19 相关的自身免疫性脑炎:一项系统性综述。

Autoimmune encephalitis associated with COVID-19: A systematic review.

机构信息

Neuroscience Research Group (NRG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.

Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.

出版信息

Mult Scler Relat Disord. 2022 Jun;62:103795. doi: 10.1016/j.msard.2022.103795. Epub 2022 Apr 6.

Abstract

INTRODUCTION

There are increasing reports of COVID-19 related neurological complications which may be due to direct viral invasion, or immune mediated inflammatory diseases such as autoimmune encephalitis and ADEM (acute demyelinating encephalomyelitis). In this study, a systematic review is presented of the reported cases infected by the COVID-19 who were diagnosed with various forms of autoimmune encephalitis (AE).

METHODS

The authors searched three databases including PubMed, Scopus, and Web of science for extracting original articles on coronavirus/ COVID-19 and AE.

RESULTS

Eighteen articles were considered in this study, including 15 case reports, and three case series with a total of 81 patients. Among the studies, 19 cases were reported with AE including 7 (37%) cases of limbic encephalitis, 5 (26%) patients with anti-N-methyl-d-aspartate (NMDA) receptor encephalitis, 2 (11%) with AE presenting as new-onset refractory status epilepticus (NORSE), 1 (5%) case of steroid-responsive encephalitis, and 4 (21%) cases with an unknown type of AE.

CONCLUSION

Our systematic review revealed evidence on AE development in patients infected with the COVID-19. Clinicians should be aware of the possible diagnosis of AE when considering other neurological differential diagnosis in SARS-CoV-2 infected patients.

摘要

简介

越来越多的报告显示,COVID-19 可能与神经系统并发症有关,这些并发症可能是由病毒直接侵袭引起的,也可能是由自身免疫性脑炎和 ADEM(急性脱髓鞘性脑脊髓炎)等免疫介导的炎症性疾病引起的。在这项研究中,对已确诊为各种自身免疫性脑炎(AE)的 COVID-19 感染者病例进行了系统回顾。

方法

作者检索了包括 PubMed、Scopus 和 Web of Science 在内的三个数据库,以提取有关冠状病毒/COVID-19 和 AE 的原始文章。

结果

本研究共纳入 18 篇文章,包括 15 篇病例报告和 3 篇病例系列,共 81 例患者。在这些研究中,有 19 例报告了 AE,包括 7 例(37%)边缘性脑炎,5 例(26%)抗 N-甲基-D-天冬氨酸(NMDA)受体脑炎,2 例(11%)以新发性难治性癫痫持续状态(NORSE)为表现的 AE,1 例(5%)类固醇反应性脑炎和 4 例(21%)原因不明的 AE。

结论

我们的系统回顾显示了 COVID-19 感染患者中 AE 发展的证据。当考虑 SARS-CoV-2 感染患者的其他神经学鉴别诊断时,临床医生应该意识到可能的 AE 诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9941/8983076/a184f58ecaa5/gr1_lrg.jpg

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