Que Xianting, Wu Yu, Liang Manli, Jiang Ailing, Shi Danli, Chen Yanlan, Lin Ziqun, Huang Yanzhen, Liu Chao, Wen Yishuang, Zhang Shuyi, Huang Wen
Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, No. 6 Shuangyong Road, Nanning, 530021, Guangxi, China.
Sci Rep. 2025 Jul 21;15(1):26400. doi: 10.1038/s41598-025-10750-3.
Autoimmune encephalitis (AE) has been described as a severe neurological complication of coronavirus disease 2019 (COVID-19). Following the adjustment of COVID-19 prevention strategies on December 7, 2022, the virus spread rapidly and extensively across China. This study aimed to explore the changing characteristics of AE pre- and post- COVID-19 epidemic in Guangxi, China. A total of 169 patients who were first diagnosed with AE and admitted to the First Affiliated Hospital of Guangxi Medical University from November 1, 2021 to December 31, 2023 were enrolled in this case-control study. Patients with the onset of AE before or after December 7, 2022, were respectively classified into the pre- and post- COVID-19 epidemic groups. There were 78 AE patients in the pre-COVID-19 epidemic group and 91 patients in the post-COVID-19 epidemic group. Compared to the AE patients pre-COVID-19 epidemic group, AE patients in the post-COVID-19 group had higher rates of abnormal movements (p = 0.013), autonomic dysfunction (p = 0.003), higher CASE scores (p = 0.041), and higher probabilities of complications such as pneumonia (p = 0.025) and other autoimmune diseases (p = 0.014). A higher proportion of AE patients in the post-COVID-19 pandemic period received rituximab treatment compared to those in the pre-COVID-19 (16.48% vs. 6.41%, p = 0.043). Among the AE patients infected with COVID-19, those who has a relapse of AE also had a higher risk of complications with tumors, autoimmune diseases, cranial magnetic resonance imaging (MRI) abnormalities, and higher baseline modified Rankin Scale (mRS) (median [IQR]:4[4,5] vs. 3[2.75,4.25], p = 0.029). AE patients in the post-COVID-19 epidemic group suffer from more severe clinical symptoms and higher rates of other immune diseases. Rituximab is commonly used in the post-COVID-19 epidemic period. Relapsed AE patients with COVID-19 had a higher risk of complications with tumors, autoimmune diseases, abnormal MRIs, and higher baseline mRS.
自身免疫性脑炎（AE）已被描述为2019冠状病毒病（COVID-19）的一种严重神经并发症。2022年12月7日COVID-19预防策略调整后，该病毒在中国迅速广泛传播。本研究旨在探讨中国广西COVID-19疫情前后AE的变化特征。本病例对照研究纳入了2021年11月1日至2023年12月31日首次诊断为AE并入住广西医科大学第一附属医院的169例患者。2022年12月7日之前或之后发病的AE患者分别分为COVID-19疫情前和疫情后组。COVID-19疫情前组有78例AE患者，COVID-19疫情后组有91例患者。与COVID-19疫情前组的AE患者相比，COVID-19疫情后组的AE患者异常运动发生率更高（p = 0.013）、自主神经功能障碍发生率更高（p = 0.003）、CASE评分更高（p = 0.041），以及肺炎（p = 0.025）和其他自身免疫性疾病（p = 0.014）等并发症的发生率更高。与COVID-19疫情前相比，COVID-19大流行期间更高比例的AE患者接受了利妥昔单抗治疗（16.48%对6.41%，p = 0.043）。在感染COVID-19的AE患者中，AE复发的患者发生肿瘤、自身免疫性疾病、头颅磁共振成像（MRI）异常以及改良Rankin量表（mRS）基线更高的并发症风险也更高（中位数[四分位间距]：4[4,5]对3[2.75,4.25]，p = 0.029）。COVID-19疫情后组的AE患者临床症状更严重，其他免疫性疾病的发生率更高。利妥昔单抗在COVID-19疫情后时期常用。COVID-19复发的AE患者发生肿瘤、自身免疫性疾病、MRI异常以及mRS基线更高的并发症风险更高。
