Table 1.
Charcteristics and autoimmune encephaltis of included studies.
| Author | year | country | Study design | number of patients | age | gender | total number of encephalitis cases | SARS-CoV-2 laboratory results | Encephalitis laboratory results | type of autoimmune encephalitis | presenting signs |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Ayatollahi | 2020 | Iran, Canada | case report | 1 | 18 | Female | 1 | SARS-CoV-2 rRT-PCR: positive, SARS-CoV-2 CSF PCR: negative, Lung CT scan: normal | MRI: normal, EEG: showed moderate intermittent nonepileptiform abnormality over the frontocentrotemporal regions | NM | drowsiness, confusion, urinary retention,generalized tonic-clonic seizure |
| Zambreanu | 2020 | UK | case report | 1 | 66 | Female | 1 | SARS-CoV-2 rRT-PCR: positive, SARS-CoV-2 IgG: negative, SARS-CoV-2 CSF PCR: negative | MRI: symmetrical T2 and FLAIR hyperintensities, Diffusion MRI: punctate bright signal on the B1000 map in the medial temporal lobes, thalami and fornices, Autoantibody testing of immunemediated encephalitis: negative | Limbic encephalitis | confusion, amnestic |
| Grimaldi | 2020 | France | case report | 1 | 72 | Male | 1 | Lung CT scan: peripheral bilateral ground-glass lesions and consolidative opacities, SARS-CoV-2 rRT-PCR: positive first then turned to negative, SARS-CoV-2 IgG and IgM: negative | EEG: symmetric diffuse background, MRI: normal, F-FDG PET: putaminal and cerebellum hypermetabolism associated with diffuse cortical hypometabolism, serum IgG isotype autoantibodies: High | NM | action tremor, ataxia, dysarthria and upper limbs dysmetria |
| Manganotti | 2021 | Italy | case report | 2 | 54 | Male | 1 | SARS-CoV-2 rRT-PCR: positive | EEG: generalized epileptic discharges with bilateral frontal high amplitude delta waves, MRI: normal | autoimmune encephalitis presenting as new-onset refractory status epilepticus (NORSE) | convulsive status epilepticus, generalized myoclonic jerks of axial muscles and face |
| Pilotto | 2020 | Italy | case series | 25 | 65/9 | 15 Male/10 Female | 2 | RT PCR: positive | NM | Limbic encephalitis | altered mental status, aphasia, seizure, focal motor deficits |
| Khoo | 2020 | UK | case report | 1 | 65 | Female | 1 | SARS-CoV-2 rRT-PCR: positive, Chest X-ray: bilateral peripheral pulmonary infiltrates | MRI: normal, CSF white cell count: normal, Autoantibody testing of immunemediated encephalitis: negative, EEG: normal, | NM | involuntary movements, only speak in native language, speaking difficulties and increasing confusion. |
| Pilotto | 2020 | Italy, UK, sweden | case report | 1 | 60 | Male | 1 | SARS-CoV-2 rRT-PCR: positive, Chest X-ray: moderate bilateral interstitial pneumonia, SARS-CoV-2 CSF PCR: negative | CSF: mild lymphocytic pleocytosis and moderate increase of CSF protein, EEG: generalized slowing with decreased reactivity to acoustic stimuli, MRI: normal, Autoantibody testing of immunemediated encephalitis: negative | Steroid-responsive encephalitis | severe akinetic syndrome, unable to carry out simple orders, palmomental and glabella reflexes, nuchal rigidity, |
| Wang | 2020 | China | case report | 1 | 68 | Male | 1 | Lung CT scan: groundglass shadows in both lungs, PCR: negative, SARS-CoV-2 IgG and IgM: negative and positive, respectivly, SARS-CoV-2 CSF IgG and IgM: positive, | Brain CT scan: lacunar lesions in the left basal ganglia region | NM | unable to walk, uroclepsia, coprolalia, and persecution delusion. |
| Burr | 2020 | USA | case report | 1 | 2 | Female | 1 | SARS-CoV-2 PCR: positive, SARS-CoV-2 CSF PCR: negative, SARS-CoV-2 IgG: positive | MRI: normal, serum and CSF NMDA receptor autoantibody: positive | Anti-NMDA receptor encephalitis | fever, fussiness, poor sleep, constipation, decreased oral intake, fussy, not talking, constant kicking and thrashing movements of arms and legs. |
| Dhillon | 2021 | UK | cohort | 29 | 68/9 | 16 Male/13 Female | 1 | SARS-CoV-2 CSF PCR: negative | MRI; Lesions in the limbic system, predominantly in the left amygdala and hippocampus with partial restricted diffusion, Autoantibody testing of immunemediated encephalitis: negative | Limbic encephalitis | acute-onset delirium, altered mental status, status epilepticus, cognitive impairment |
| Sánchez-Morales | 2021 | Mexico | case series | 10 | 11/8 | 5 Male/5 Female | 1 | SARS-CoV-2 CSF PCR: positive, Serum SARS-CoV-2 IgM and IgG: negative, CSF antibodies SARS-CoV-2 IgG: positive | NM | Anti-NMDA receptor encephalitis | Altered behavior and mental status, seizures, insomnia, orolingual dyskinesias |
| Dono | 2020 | Italy | case report | 1 | 81 | Male | 1 | Chest X-ray: normal, Lung CT scan: ground-glass pattern in both the inferior lobe segments, SARS-CoV-2 PCR: positive, SARS-CoV-2 CSF PCR: negative | EEG: normal, MRI: hyperintense lesions of the bilateral parietal cortex, left temporal cortex, and right cingulate cortex, Autoantibody testing of immunemediated encephalitis: negative | autoimmune encephalitis presenting as new-onset refractory status epilepticus (NORSE) | drowsy with Glasgow coma scale (GCS) of 5 (no eyes opening both to verbal and pain stimulation, no verbal response, and flexion of the upper limbs to pain), Contemporarily, frequent jerky myoclonic con- tractions of the abdomen and the right lower limb appeared. |
| Bhagat | 2020 | USA | case report | 1 | 54 | Male | 1 | SARS-CoV-2 rRT-PCR: positive, Chest X-ray: normal | MRI: hyperintensity on right posterior medial temporal lobe, Autoantibody testing of immunemediated encephalitis: negative, EEG: right posterior quadrant lateralized periodic discharges | Limbic encephalitis | nonradiating pressure type holocranial headache, diaphoresis, palpitation, nausea drowsy, oriented to time, place, and person with intact language, cranial nerves, motor, sensory, and cerebellar functions |
| Monti | 2020 | Italy | case report | 1 | 50 | Male | 1 | SARS-CoV-2 rRT-PCR: positive, Lung CT scan: normal | anti-NMDA receptors antibodies in CSF: positive, MRI: normal | Anti-NMDA receptor encephalitis | confabulations and delirious ideas, focal motor seizures with impaired awareness and oro-facial dyskinesia/automatisms, refractory status epilepticus |
| Hosseini | 2020 | UK | case report | 2 | 62/5 | Male | 1 | SARS-CoV-2 rRT-PCR: positive, SARS-CoV-2 CSF PCR: negative, Lung CT scan: bilateral pleural effusion | MRI: partial diffusion restriction in limbic system | Limbic encephalitis | dysphasia and impaired orientation, attention and memory. |
| Pizzanelli | 2021 | Italy | case report | 1 | 74 | Female | 1 | Lung CT scan: bilateral diffuse areas of ground-glass pattern with subpleural parenchymal consolidations, SARS-CoV-2 rRT-PCR: positive, SARS-CoV-2 CSF PCR: negative | Brain CT scan: normal, EEG: focal seizures with impaired awareness and oral automatisms, Autoantibody testing of immunemediated encephalitis in CSF and serum: negative, MRI: bilateral symmetric mesial temporal lobes hyperintensity and mild hippocampal thickness | Limbic encephalitis | mild confusion and a brief episode of non-responsivity with staring |
| Moideen | 2020 | India, UK | case report | 1 | 17 | Male | 1 | NM | MRI: normal, EEG: normal, anti-NMDA receptors antibodies in CSF: positive | Anti-NMDA receptor encephalitis | over-familiar attitude, increased psychomotor activity, and labile affect |
| Panariello | 2020 | Italy | case report | 1 | 23 | Male | 1 | Chest X-ray: bilateral ground glass opacities, Lung CT scan: patchy bi-basilar consolidations | Brain CT scan: normal, EEG: unstable non reactive to visual stimuli, anti-NMDA receptors antibodies in CSF: positive | Anti-NMDA receptor encephalitis | psychomotor agitation, anxiety, thought disorganization, persecutory delusions, auditory hallucinations, and global insomnia |
NM: Not Mentioned; NMDA: N-Methyl-D aspartate, SARS-CoV-2: severe acute respiratory syndrome coronavirus 2, rRT-PCR: Real-time reverse-transcription polymerase chain reaction analysis, CT scan: Computed tomography, MRI: Magnetic resonance imaging, PET: Positron emission tomography, F-FDG: Fludeoxyglucose, EEG: Electroencephalography.