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AI-CoV Study: Autoimmune Encephalitis Associated With COVID-19 and Its Vaccines—A Systematic Review

Samim, MM and Dhar, D and Goyal, S and Dey, T and Parvin, N and Shah, RD and Singh, V and Chowdhury, S and Lal, BM and Varghese, N and Gohel, A and Chowdhury, A and Chatterjee, A and Siddiqui, S (2022) AI-CoV Study: Autoimmune Encephalitis Associated With COVID-19 and Its Vaccines—A Systematic Review. In: Journal of Clinical Neurology (Korea), 18 (6). pp. 692-710.

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Official URL: https://doi.org/10.3988/jcn.2022.18.6.692


Background and Purpose Autoimmune encephalitis (AIE) following coronavirus disease 2019 (COVID-19) is an underexplored condition. This study aims to systematically review the clinico-investigational and pathophysiologic aspects of COVID-19 and its vaccines in association with AIE, and identify the factors predicting neurological severity and outcomes. Methods Relevant data sources were searched using appropriate search terms on January 15, 2022. Studies meeting the criteria for AIE having a temporal association with COVID-19 or its vaccines were included. Results Out of 1,894 citations, we included 61 articles comprising 88 cases: 71 of COVID-19-associated AIE, 3 of possible Bickerstaff encephalitis, and 14 of vaccine-associated AIE. There were 23 definite and 48 possible seronegative AIE cases. Anti-NMDAR (N-methyl-D-as-partate receptor; n=12, 16.9%) was the most common definite AIE. Males were more common-ly affected (sex ratio=1.63) in the AIE subgroup. The neurological symptoms included altered mental state (n=53, 74.6%), movement disorders (n=28, 39.4%), seizures (n=24, 33.8%), behav-ioural (n=25, 35.2%), and speech disturbances (n=17, 23.9%). The median latency to AIE diagnosis was 14 days (interquartile range=4–22 days). Female sex and ICU admission had higher risks of sequelae, with odds ratio (OR) of 2.925 (95% confidence interval [CI]=1.005–8.516) and 3.515 (95% CI=1.160–10.650), respectively. Good immunotherapy response was seen in 42/48 (87.5%) and 13/13 (100%) of COVID-19-associated and vaccine-associated AIE patients, respectively. Sequelae were reported in 22/60 (36.7%) COVID-19 associated and 10/13 (76.9%) vaccine-associated cases. Conclusions The study has revealed diagnostic, therapeutic, and pathophysiological aspects of AIE associated with COVID-19 and its vaccines, and its differences from postinfectious AIE. Systematic review registration PROSPERO registration number CRD42021299215.

Item Type: Journal Article
Publication: Journal of Clinical Neurology (Korea)
Publisher: Korean Neurological Association
Additional Information: The copyright for this article belongs to the Authors.
Keywords: autoimmune encephalitis; COVID-19; COVID-19 vaccine; postinfectious encephalitis
Department/Centre: Division of Interdisciplinary Sciences > Centre for Biosystems Science and Engineering
Date Deposited: 03 Jan 2023 04:58
Last Modified: 03 Jan 2023 04:58
URI: https://eprints.iisc.ac.in/id/eprint/78664

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