Clinical analysis of patients with SARS-CoV-2 encephalitis confirmed by next-generation sequencing of cerebrospinal fluid
Journal Title: Chinese Journal of Nervous and Mental Diseases - Year 2024, Vol 50, Issue 9
Abstract
[Objective] To explore the clinical features, diagnostic methods, and treatment strategies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) encephalitis confirmed through cerebrospinal fluid (CSF) analysis. [Methods] The clinical data of patients diagnosed with SARS-CoV-2 encephalitis through CSF analysis in the Neurology Intensive Care Unit of the First Affiliated Hospital of Nanchang University from March 2022 to March 2023 were collected. Additionally, the relevant literature published in both domestic and international databases was analyzed and synthesized. [Results] The main neurological manifestations of five cases included decreased consciousness (5/5), psychiatric disorder (2/5), seizures (2/5), quadriplegia (1/5), and headaches (1/5). Two cases had abnormal brain magnetic resonance imaging (MRI) changes, involving the temporal lobe, insular lobe, thalamus, hippocampus, and pons. Additionally, CSF analysis showed mildly elevated protein levels in two cases. Next-generation sequencing (NGS) of the CSF identified SARS-CoV-2 in all five cases (sequence: 41-1620), and human herpesvirus 1 in one case (sequence: 21). The treatment regimen for all cases included antiviral therapy, three were additionally treated with glucocorticoids and one received immunoglobulin therapy. All cases achieved a favorable outcome (mRS: 0-2). [Conclusion] SARS-CoV-2 has the potential to induce encephalitis/meningitis due to its neurotropic nature. The consideration of this condition is warranted in patients with relevant epidemiological history and symptoms related to the central nervous system. CSF NGS serves as a valuable tool for early diagnosis, while active antiviral therapy and immunotherapy may improve patient outcomes.
Authors and Affiliations
Chong NIE, Zheng LUO, Shiding JIANG, Gangan LIU, Daojun HONG, Lianqun WANG, Yiyi. ZHOU
Keywords
Related Articles
- EP ID EP750549
- DOI 10.3969/j.issn.1002-0152.2024.09.002
- Views 47
- Downloads 0
An intervention study of Orff-music therapy for long-term hospitalized patients with schizophrenia
[Objective] This research aims to investigate the impact of Orff music therapy on long-term schizophrenic patients in hospitals. [Methods] The study was a randomized, single-blind controlled trial conducted from April,20...
Research progress on the application of light therapy in patients with bipolar depression
Existing antidepressant treatments are generally suboptimal for patients with bipolar disorder (BD). Several studies have explored the efficacy of light therapy (LT) in patients with bipolar depression, along with invest...
a case of paraneoplastic cerebellar ataxia syndrome associated with immunocheckpoint inhibitor treated with Ofatumumab
A case of paraneoplastic cerebellar ataxia syndrome caused by immune checkpoint inhibitors (ICI) was treated with ofatumumab (OFA). The patient is a 57-year-old male. He used “Camrelizumab” immunotherapy for his previous...
Advances on the mechanisms of metformin in improving cognitive impairment in schizophrenia
Schizophrenia is a common chronic mental disorder. Cognitive dysfunction is one of its core symptoms , which severely affects the social functioning of patients. Currently, antipsychotic medication treatments have poor e...
Advances in the management of patients with spontaneous subarachnoid hemorrhage with negative first angiography
Spontaneous subarachnoid hemorrhage (sSAH) is one of the common critical illnesses in neurosurgery, and still has a high rate of death and disability. For these patients, computed tomographic angiography (CTA) or digital...