Evidence map›Paper›PMID 34727881›Full record

ArticleBMC neurology2021

Persistent intrathecal interleukin-8 production in a patient with SARS-CoV-2-related encephalopathy presenting aphasia: a case report.

Takuya Kudo, Yuichi Hayashi, Kenjiro Kunieda, Nobuaki Yoshikura, Akio Kimura, Mika Otsuki, Takayoshi Shimohata

Abstract readCase Reports
In one paragraph

Article in BMC neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Takuya Kudo *Department of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu, Japan.
Yuichi Hayashi *Department of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu, Japan.
Kenjiro KuniedaDepartment of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu, Japan.
Nobuaki YoshikuraDepartment of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu, Japan.
Akio KimuraDepartment of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu, Japan.
Mika OtsukiFaculty of Health Sciences, Graduate School of Sciences, Hokkaido University, Kita 15, Nishi 7, Kitaku, 060-8638, Sapporo, Japan.
Takayoshi ShimohataDepartment of Neurology, Gifu University Graduate School of Medicine, 1-1 Yanagido, 501-1194, Gifu, Japan. shimohata@gmail.com.ORCID http://orcid.org/0000-0002-8788-9089

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeurological manifestations of coronavirus disease 2019 (COVID-19) are increasingly recognized and include encephalopathy, although direct infection of the brain by SARS-CoV-2 remains controversial. We herein report the clinical course and cytokine profiles of a patient with severe SARS-CoV-2-related encephalopathy presenting aphasia. CASE PRESENTATION: An 81-year-old man developed acute consciousness disturbance and status epileptics several days after SARS-CoV-2 infection. Following treatment with remdesivir and dexamethasone, his consciousness and epileptic seizures improved; however, amnestic aphasia and agraphia remained. Two months after methylprednisolone pulse and intravenous immunoglobulin, his neurological deficits improved. We found increased levels of interleukin (IL)-6, IL-8, and monocyte chemoattractant protein-1 (MCP-1), but not IL-2 and IL-10 in the serum and cerebrospinal fluid (CSF), and the levels of serum IL-6 and MCP-1 were much higher than those in the CSF. The level of IL-8 in the CSF after immunotherapy was four times higher than that before immunotherapy.

conclusionThe cytokine profile of our patient was similar to that seen in severe SARS-CoV-2-related encephalopathy. We demonstrated (i) that the characteristic aphasia can occur as a focal neurological deficit associated with SARS-CoV-2-related encephalopathy, and (ii) that IL8-mediated central nervous system inflammation follows systemic inflammation in SARS-CoV-2-related encephalopathy and can persist and worsen even after immunotherapy. Monitoring IL-8 in CSF, and long-term corticosteroids may be required for treating SARS-CoV-2-related encephalopathy.

Indexed as

AphasiaBrain DiseasesCOVID-19Aged, 80 and overHumansInterleukin-8MaleSARS-CoV-2Interleukin-8AphasiaCase reportEncephalopathyIL-8SARS-CoV-2

Identifiers

PMID34727881
PMCPMC8560881

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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.