ArticleeNeurologicalSci2020
Encephalopathy in COVID-19 patients; viral, parainfectious, or both?
Article in eNeurologicalSci, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 29 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 6 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Pooled it
- A Systematic Review on Neurological Aspects of COVID-19: Exploring the Relationship Between COVID-19-Related Olfactory Dysfunction and Neuroinvasion.Frontiers in neurology · 2022Pooled it
- Acute disseminated encephalomyelitis and COVID-19: A systematic synthesis of worldwide cases.Journal of neuroimmunology · 2021Pooled it
- Encephalitis as a neurological complication of COVID-19: A systematic review and meta-analysis of incidence, outcomes, and predictors.European journal of neurology · 2021Pooled it
- COVID-19 associated brain/spinal cord lesions and leptomeningeal enhancement: A meta-analysis of the relationship to CSF SARS-CoV-2.Journal of neuroimaging : official journal of the American Society of Neuroimaging · 2021Pooled it
- Cerebrospinal fluid in COVID-19: A systematic review of the literature.Journal of the neurological sciences · 2021Pooled it
- COVID-19 vaccine-induced parkinsonism due to LGI1 antibody encephalitis: case report and brief literature review.Oxford medical case reports · 2025Article
- Severe central nervous system injury in 9 children with COVID-19.BMC pediatrics · 2025Article
- COVID-19-associated encephalopathy: connection between neuroinflammation and microbiota-gut-brain axis.Frontiers in microbiology · 2024Review
- Review
- Acute COVID-19 Presenting as Neurological Disease in a Pediatric Patient.Clinical pediatrics · 2023Article
- Article
- Pathological Features and Neuroinflammatory Mechanisms of SARS-CoV-2 in the Brain and Potential Therapeutic Approaches.Biomolecules · 2022Review
- Encephalopathy as a prognostic factor in adults with acute disseminated encephalomyelitis following COVID-19.Journal of neurology · 2022Article
- Immunopathological changes, complications, sequelae and immunological memory in COVID-19 patients.Heliyon · 2022Review
- COVID-19-Associated Encephalopathy-Case Series and Clinical Considerations.Journal of clinical medicine · 2022Article
- Neuropsychiatric symptoms associated with the COVID-19 and its potential nervous system infection mechanism: the role of imaging in the study.Psychoradiology · 2021Article
- Hospital-based observational study of neurological disorders in patients recently vaccinated with COVID-19 mRNA vaccines.Journal of the neurological sciences · 2021Observational
- Altered mental status predicts length of stay but not death in a community-based cohort of hospitalized COVID-19 patients.Clinical neurology and neurosurgery · 2021Article
- Post-COVID-19 vaccine acute hyperactive encephalopathy with dramatic response to methylprednisolone: A case report.Annals of medicine and surgery (2012) · 2021Article
Corrections and comments
- Erratum issued
- Erratum issued
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We describe the clinical, laboratory and radiological features of 3 critically ill patients with COVID-19 who developed severe encephalopathy. The first patient did not regain consciousness when sedation was removed at the end of 2 weeks of intensive care. He had received treatment with convalescent plasma. His clinical examination was remarkable for intact brainstem reflexes, roving eye movements, later transient ocular flutter; and then what appeared to be slow ocular dipping. He had no coherent volitional response to the environment. The second patient recovered with measurable cognitive deficits after a prolonged period of encephalopathy. He had received combination treatment with interferon beta 1b and lopinavir/ritonavir. The third patient remained in persistent, severe agitated delirium and died 3 months into his illness. The MRI of the 3 patients showed multifocal abnormalities predominantly in the cerebral white matter, with varying involvement of the grey matter, brainstem and spinal cord. Case 1's MRI changes were consistent with acute disseminated encephalomyelitis. The patients also displayed blood markers, to varying degree, of autoimmunity and hypercoagulability. We were not able to convincingly show, from microbiological as well as immunological evaluation, if the effects of COVID-19 on these patients' nervous system were a direct consequence of the virus, proinflammatory-thrombotic state or a combination. Patient 1 responded partially to empirical, albeit delayed, therapy with intravenous immunoglobulins. Patient 2 recovered with no specific treatment. These cases illustrate the need to understand the full spectrum of encephalopathy associated with COVID-19 so as to better guide its management.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.