COVID‑19‑associated meningoencephalitis: A care report and literature review

Lv,Pu; Peng,Fen; Zhang,Yeqiong; Zhang,Linwei; Li,Na; Sun,Lili; Wang,Yu; Hou,Pihua; Huang,Tiequn; Wang,Xiaoping

doi:10.3892/etm.2021.9793

COVID‑19‑associated meningoencephalitis: A care report and literature review

Authors:
- Pu Lv
- Fen Peng
- Yeqiong Zhang
- Linwei Zhang
- Na Li
- Lili Sun
- Yu Wang
- Pihua Hou
- Tiequn Huang
- Xiaoping Wang
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Affiliations: 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, Department of Neurology, China‑Japan Friendship Hospital, Ministry of Health, Beijing 100029, P.R. China
Published online on: February 14, 2021 https://doi.org/10.3892/etm.2021.9793
Article Number: 362

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Abstract

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.

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