COVID-19-associated autoimmune encephalitis: A case report and literature review

Medicine (Baltimore). 2024 Sep 20;103(38):e39533. doi: 10.1097/MD.0000000000039533.

Abstract

Rationale: This article reports a case of coronavirus disease (COVID-19)-associated autoimmune encephalitis (AE) and reviews the relevant literature to investigate the clinical manifestations, auxiliary inspection, diagnosis and treatment, and prognosis of AE associated with COVID-19.

Patient concerns: A 68-year-old female with fatigue developed altered consciousness after 2 days of fever, thereafter testing positive for COVID-19. The protein levels in the lumbar puncture cerebrospinal fluid were elevated, and cranial magnetic resonance imaging (MRI) scan indicated T2-weighted hyperintensity in the temporal lobe.

Diagnoses: The patient was diagnosed with COVID-19-associated AE.

Interventions: After admission, the patient received pulse steroid therapy with methylprednisolone. Additionally, gastric protection, blood glucose control, nutritional support, and other treatments were administered.

Outcomes: The symptoms were significantly relieved by steroid pulse therapy. At the 3-month follow-up, the patient had recovered completely without any obvious discomfort.

Lessons: The possibility of AE should be considered if neurological symptoms occur a few days after infection with COVID-19, with early diagnosis and immediate steroid pulse therapy resulting in better outcomes.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • COVID-19* / complications
  • COVID-19* / immunology
  • Encephalitis* / diagnosis
  • Encephalitis* / drug therapy
  • Encephalitis* / immunology
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Methylprednisolone* / administration & dosage
  • Methylprednisolone* / therapeutic use
  • SARS-CoV-2 / immunology

Substances

  • Glucocorticoids
  • Methylprednisolone