Autoimmune encephalitis associated with COVID-19: A systematic review

Mult Scler Relat Disord. 2022 Jun:62:103795. doi: 10.1016/j.msard.2022.103795. Epub 2022 Apr 6.


Introduction: There are increasing reports of COVID-19 related neurological complications which may be due to direct viral invasion, or immune mediated inflammatory diseases such as autoimmune encephalitis and ADEM (acute demyelinating encephalomyelitis). In this study, a systematic review is presented of the reported cases infected by the COVID-19 who were diagnosed with various forms of autoimmune encephalitis (AE).

Methods: The authors searched three databases including PubMed, Scopus, and Web of science for extracting original articles on coronavirus/ COVID-19 and AE.

Results: Eighteen articles were considered in this study, including 15 case reports, and three case series with a total of 81 patients. Among the studies, 19 cases were reported with AE including 7 (37%) cases of limbic encephalitis, 5 (26%) patients with anti-N-methyl-d-aspartate (NMDA) receptor encephalitis, 2 (11%) with AE presenting as new-onset refractory status epilepticus (NORSE), 1 (5%) case of steroid-responsive encephalitis, and 4 (21%) cases with an unknown type of AE.

Conclusion: Our systematic review revealed evidence on AE development in patients infected with the COVID-19. Clinicians should be aware of the possible diagnosis of AE when considering other neurological differential diagnosis in SARS-CoV-2 infected patients.

Keywords: Autoimmune encephalitis; COVID-19; Systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anti-N-Methyl-D-Aspartate Receptor Encephalitis* / diagnosis
  • COVID-19* / complications
  • Encephalitis
  • Hashimoto Disease* / complications
  • Hashimoto Disease* / diagnosis
  • Humans
  • SARS-CoV-2

Supplementary concepts

  • Hashimoto's encephalitis