Clinical characteristics of SARS-CoV-2 infection-related encephalitis
10.12138/j.issn.1671-9638.20256672
- VernacularTitle:SARS-CoV-2感染相关脑炎的临床特点
- Author:
Min GAO
1
;
Hui YUAN
1
Author Information
1. 山东第一医科大学第二附属医院神经内科,山东泰安 271000
- Publication Type:Journal Article
- Keywords:
SARS-CoV-2;
encephalitis;
electroencephalogram;
magnetic resonance imaging;
tocilizumab
- From:
Chinese Journal of Infection Control
2025;24(3):388-395
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical characteristics and pathogenesis of severe acute respiratory syn-drome coronavirus 2(SARS-CoV-2)infection-related encephalitis,aiming to provide new theoretical basis for clini-cal diagnosis and treatment.Methods Clinical characteristics as well as diagnosis and treatment process of 25 pa-tients with SARS-CoV-2 infection-related encephalitis in the Second Affiliated Hospital of Shandong First Medical University were analyzed,and the pathogenesis was evaluated.Results The main prodromal symptoms were fever(80.0％),the initial symptoms were consciousness disturbance(56.0％),epileptic seizures(52.0％),and mental symptoms(36.0％).The subsequent symptoms were mainly autonomic nerve dysfunction(88.0％),epileptic sei-zures(68.0％),cognitive dysfunction(68.0％),motor impairment(64.0％),and language dysfunction(52.0％).The auxiliary examination results were mainly increase of content of cerebrospinal fluid(CSF)protein and increase ofC-reactive protein(CRP);electroencephalogram(EEG)showed slowing down of a non-specific background rhythm,followed by abnormal discharges;the most common manifestation of magnetic resonance imaging(MRI)was abnormal high signal in the insular cortex and medial temporal lobe,followed by diffuse or focal microbleeds.The first-line treatment agents were glucocorticoid combined with immunotherapy,and the second-line treatment agent was monoclonal antibody.The prognosis was poor.Conclusion Patients with a history of exposure to SARS-CoV-2 infection,consciousness disturbance,epileptic seizures and mental symptoms should be vigilant to the possi-bility of encephalitis.CSF,EEG,and MRI auxiliary examination should be given.Once diagnosed,early interven-tion is necessary.The main pathogenesis include direct invasion,cytokine storm,excessive immune inflammation,specific lymphocyte response,etc.
