Severe COVID-19-related encephalitis can respond to immunotherapy

This article provides major categories of COVID-19-related neurological syndromes, including patients with encephalitis, and reports corticosteroids and intravenous immunoglobulin response in some patients. Indeed, various COVID-19-related neurological syndromes have been reported since December 2019 (Filatovet al., 2020;Helmset al., 2020;Khooet al., 2020;Maoet al., 2020;Moriguchiet al., 2020;Oxleyet al., 2020;Poyiadjiet al., 2020). However, encephalitis has seldom been reported and the potential benefit of immunotherapy remains unclear (one of two patients improved inPatersonet al., 2020). Herein, we report a case series of five patients (from an observational cohort: the CoCo Neurosciences Study) with severe COVID-19-related encephalitis (impaired consciousness/unresponsive and mechanically ventilated) treated by therapeutic plasma exchanges (TPE) and corticosteroids. The dramatic improvement in three of five patients reinforces the hypothesis of an immune-related mechanism, as evoked by Paterson and colleagues. Neurologists and intensivists should be aware that this life-threatening COVID-19 neurological syndrome has a potentially favourable outcome after immunotherapy, and should not motivate systematic limitation in active patient care.
Source: Brain - Category: Neurology Source Type: research