Steroid-Responsive Encephalitis in Coronavirus Disease 2019.
Identifieur interne : 001673 ( Main/Corpus ); précédent : 001672; suivant : 001674Steroid-Responsive Encephalitis in Coronavirus Disease 2019.
Auteurs : Andrea Pilotto ; Silvia Odolini ; Stefano Masciocchi ; Agnese Comelli ; Irene Volonghi ; Stefano Gazzina ; Sara Nocivelli ; Alessandro Pezzini ; Emanuele Focà ; Arnaldo Caruso ; Matilde Leonardi ; Maria P. Pasolini ; Roberto Gasparotti ; Francesco Castelli ; Nicholas J. Ashton ; Kaj Blennow ; Henrik Zetterberg ; Alessandro PadovaniSource :
- Annals of neurology [ 1531-8249 ] ; 2020.
English descriptors
- KwdEn :
- Akinetic Mutism (physiopathology), Antiviral Agents (therapeutic use), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (cerebrospinal fluid), Coronavirus Infections (complications), Coronavirus Infections (drug therapy), Coronavirus Infections (physiopathology), Drug Combinations (MeSH), Electroencephalography (MeSH), Encephalitis (cerebrospinal fluid), Encephalitis (complications), Encephalitis (drug therapy), Encephalitis (physiopathology), Glucocorticoids (therapeutic use), Humans (MeSH), Hydroxychloroquine (therapeutic use), Interleukin-6 (cerebrospinal fluid), Interleukin-8 (cerebrospinal fluid), Lopinavir (therapeutic use), Magnetic Resonance Imaging (MeSH), Male (MeSH), Methylprednisolone (therapeutic use), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (cerebrospinal fluid), Pneumonia, Viral (complications), Pneumonia, Viral (drug therapy), Pneumonia, Viral (physiopathology), Ritonavir (therapeutic use), SARS-CoV-2 (MeSH), Treatment Outcome (MeSH), Tumor Necrosis Factor-alpha (cerebrospinal fluid), beta 2-Microglobulin (cerebrospinal fluid).
- MESH :
- chemical , cerebrospinal fluid : Interleukin-6, Interleukin-8, Tumor Necrosis Factor-alpha, beta 2-Microglobulin.
- chemical , therapeutic use : Antiviral Agents, Glucocorticoids, Hydroxychloroquine, Lopinavir, Methylprednisolone, Ritonavir.
- cerebrospinal fluid : Coronavirus Infections, Encephalitis, Pneumonia, Viral.
- complications : Coronavirus Infections, Encephalitis, Pneumonia, Viral.
- drug therapy : Coronavirus Infections, Encephalitis, Pneumonia, Viral.
- physiopathology : Akinetic Mutism, Coronavirus Infections, Encephalitis, Pneumonia, Viral.
- Betacoronavirus, COVID-19, Drug Combinations, Electroencephalography, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pandemics, SARS-CoV-2, Treatment Outcome.
Abstract
Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been described in patients with severe respiratory distress. Here, we described the case of a 60-year-old patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but only mild respiratory abnormalities who developed an akinetic mutism attributable to encephalitis. Magnetic resonance imaging was negative, whereas electroencephalography showed generalized theta slowing. Cerebrospinal fluid analyses during the acute stage were negative for SARS-CoV-2, positive for pleocytosis and hyperproteinorrachia, and showed increased interleukin-8 and tumor necrosis factor-α concentrations. Other infectious or autoimmune disorders were excluded. A progressive clinical improvement along with a reduction of cerebrospinal fluid parameters was observed after high-dose steroid treatment, thus arguing for an inflammatory-mediated brain involvement related to COVID-19. ANN NEUROL 2020;88:423-427.
DOI: 10.1002/ana.25783
PubMed: 32418288
PubMed Central: PMC7276848
Links to Exploration step
pubmed:32418288Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Steroid-Responsive Encephalitis in Coronavirus Disease 2019.</title><author><name sortKey="Pilotto, Andrea" sort="Pilotto, Andrea" uniqKey="Pilotto A" first="Andrea" last="Pilotto">Andrea Pilotto</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Parkinson's Disease Rehabilitation Centre, FERB ONLUS - S. Isidoro Hospital, Trescore Balneario (BG), Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Odolini, Silvia" sort="Odolini, Silvia" uniqKey="Odolini S" first="Silvia" last="Odolini">Silvia Odolini</name><affiliation><nlm:affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Masciocchi, Stefano" sort="Masciocchi, Stefano" uniqKey="Masciocchi S" first="Stefano" last="Masciocchi">Stefano Masciocchi</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Comelli, Agnese" sort="Comelli, Agnese" uniqKey="Comelli A" first="Agnese" last="Comelli">Agnese Comelli</name><affiliation><nlm:affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Volonghi, Irene" sort="Volonghi, Irene" uniqKey="Volonghi I" first="Irene" last="Volonghi">Irene Volonghi</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Gazzina, Stefano" sort="Gazzina, Stefano" uniqKey="Gazzina S" first="Stefano" last="Gazzina">Stefano Gazzina</name><affiliation><nlm:affiliation>Neurophysiology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Nocivelli, Sara" sort="Nocivelli, Sara" uniqKey="Nocivelli S" first="Sara" last="Nocivelli">Sara Nocivelli</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pezzini, Alessandro" sort="Pezzini, Alessandro" uniqKey="Pezzini A" first="Alessandro" last="Pezzini">Alessandro Pezzini</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Foca, Emanuele" sort="Foca, Emanuele" uniqKey="Foca E" first="Emanuele" last="Focà">Emanuele Focà</name><affiliation><nlm:affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Caruso, Arnaldo" sort="Caruso, Arnaldo" uniqKey="Caruso A" first="Arnaldo" last="Caruso">Arnaldo Caruso</name><affiliation><nlm:affiliation>Microbiology Unit, Department of Molecular and Translational Medicine, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Leonardi, Matilde" sort="Leonardi, Matilde" uniqKey="Leonardi M" first="Matilde" last="Leonardi">Matilde Leonardi</name><affiliation><nlm:affiliation>Neurology, Public Health, Disability Unit - IRCCS Neurology Institute Besta, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pasolini, Maria P" sort="Pasolini, Maria P" uniqKey="Pasolini M" first="Maria P" last="Pasolini">Maria P. Pasolini</name><affiliation><nlm:affiliation>Neurophysiology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Gasparotti, Roberto" sort="Gasparotti, Roberto" uniqKey="Gasparotti R" first="Roberto" last="Gasparotti">Roberto Gasparotti</name><affiliation><nlm:affiliation>Neuroradiology Unit, Department of Molecular and Translational Medicine, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Castelli, Francesco" sort="Castelli, Francesco" uniqKey="Castelli F" first="Francesco" last="Castelli">Francesco Castelli</name><affiliation><nlm:affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ashton, Nicholas J" sort="Ashton, Nicholas J" uniqKey="Ashton N" first="Nicholas J" last="Ashton">Nicholas J. Ashton</name><affiliation><nlm:affiliation>Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Blennow, Kaj" sort="Blennow, Kaj" uniqKey="Blennow K" first="Kaj" last="Blennow">Kaj Blennow</name><affiliation><nlm:affiliation>Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Zetterberg, Henrik" sort="Zetterberg, Henrik" uniqKey="Zetterberg H" first="Henrik" last="Zetterberg">Henrik Zetterberg</name><affiliation><nlm:affiliation>Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>UK Dementia Research Institute at UCL, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Padovani, Alessandro" sort="Padovani, Alessandro" uniqKey="Padovani A" first="Alessandro" last="Padovani">Alessandro Padovani</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32418288</idno><idno type="pmid">32418288</idno><idno type="doi">10.1002/ana.25783</idno><idno type="pmc">PMC7276848</idno><idno type="wicri:Area/Main/Corpus">001673</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001673</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Steroid-Responsive Encephalitis in Coronavirus Disease 2019.</title><author><name sortKey="Pilotto, Andrea" sort="Pilotto, Andrea" uniqKey="Pilotto A" first="Andrea" last="Pilotto">Andrea Pilotto</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Parkinson's Disease Rehabilitation Centre, FERB ONLUS - S. Isidoro Hospital, Trescore Balneario (BG), Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Odolini, Silvia" sort="Odolini, Silvia" uniqKey="Odolini S" first="Silvia" last="Odolini">Silvia Odolini</name><affiliation><nlm:affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Masciocchi, Stefano" sort="Masciocchi, Stefano" uniqKey="Masciocchi S" first="Stefano" last="Masciocchi">Stefano Masciocchi</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Comelli, Agnese" sort="Comelli, Agnese" uniqKey="Comelli A" first="Agnese" last="Comelli">Agnese Comelli</name><affiliation><nlm:affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Volonghi, Irene" sort="Volonghi, Irene" uniqKey="Volonghi I" first="Irene" last="Volonghi">Irene Volonghi</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Gazzina, Stefano" sort="Gazzina, Stefano" uniqKey="Gazzina S" first="Stefano" last="Gazzina">Stefano Gazzina</name><affiliation><nlm:affiliation>Neurophysiology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Nocivelli, Sara" sort="Nocivelli, Sara" uniqKey="Nocivelli S" first="Sara" last="Nocivelli">Sara Nocivelli</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pezzini, Alessandro" sort="Pezzini, Alessandro" uniqKey="Pezzini A" first="Alessandro" last="Pezzini">Alessandro Pezzini</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Foca, Emanuele" sort="Foca, Emanuele" uniqKey="Foca E" first="Emanuele" last="Focà">Emanuele Focà</name><affiliation><nlm:affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Caruso, Arnaldo" sort="Caruso, Arnaldo" uniqKey="Caruso A" first="Arnaldo" last="Caruso">Arnaldo Caruso</name><affiliation><nlm:affiliation>Microbiology Unit, Department of Molecular and Translational Medicine, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Leonardi, Matilde" sort="Leonardi, Matilde" uniqKey="Leonardi M" first="Matilde" last="Leonardi">Matilde Leonardi</name><affiliation><nlm:affiliation>Neurology, Public Health, Disability Unit - IRCCS Neurology Institute Besta, Milan, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Pasolini, Maria P" sort="Pasolini, Maria P" uniqKey="Pasolini M" first="Maria P" last="Pasolini">Maria P. Pasolini</name><affiliation><nlm:affiliation>Neurophysiology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Gasparotti, Roberto" sort="Gasparotti, Roberto" uniqKey="Gasparotti R" first="Roberto" last="Gasparotti">Roberto Gasparotti</name><affiliation><nlm:affiliation>Neuroradiology Unit, Department of Molecular and Translational Medicine, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Castelli, Francesco" sort="Castelli, Francesco" uniqKey="Castelli F" first="Francesco" last="Castelli">Francesco Castelli</name><affiliation><nlm:affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</nlm:affiliation></affiliation></author><author><name sortKey="Ashton, Nicholas J" sort="Ashton, Nicholas J" uniqKey="Ashton N" first="Nicholas J" last="Ashton">Nicholas J. Ashton</name><affiliation><nlm:affiliation>Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Blennow, Kaj" sort="Blennow, Kaj" uniqKey="Blennow K" first="Kaj" last="Blennow">Kaj Blennow</name><affiliation><nlm:affiliation>Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.</nlm:affiliation></affiliation></author><author><name sortKey="Zetterberg, Henrik" sort="Zetterberg, Henrik" uniqKey="Zetterberg H" first="Henrik" last="Zetterberg">Henrik Zetterberg</name><affiliation><nlm:affiliation>Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>UK Dementia Research Institute at UCL, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Padovani, Alessandro" sort="Padovani, Alessandro" uniqKey="Padovani A" first="Alessandro" last="Padovani">Alessandro Padovani</name><affiliation><nlm:affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Annals of neurology</title><idno type="eISSN">1531-8249</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Akinetic Mutism (physiopathology)</term><term>Antiviral Agents (therapeutic use)</term><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Coronavirus Infections (cerebrospinal fluid)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (drug therapy)</term><term>Coronavirus Infections (physiopathology)</term><term>Drug Combinations (MeSH)</term><term>Electroencephalography (MeSH)</term><term>Encephalitis (cerebrospinal fluid)</term><term>Encephalitis (complications)</term><term>Encephalitis (drug therapy)</term><term>Encephalitis (physiopathology)</term><term>Glucocorticoids (therapeutic use)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Interleukin-6 (cerebrospinal fluid)</term><term>Interleukin-8 (cerebrospinal fluid)</term><term>Lopinavir (therapeutic use)</term><term>Magnetic Resonance Imaging (MeSH)</term><term>Male (MeSH)</term><term>Methylprednisolone (therapeutic use)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (cerebrospinal fluid)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (drug therapy)</term><term>Pneumonia, Viral (physiopathology)</term><term>Ritonavir (therapeutic use)</term><term>SARS-CoV-2 (MeSH)</term><term>Treatment Outcome (MeSH)</term><term>Tumor Necrosis Factor-alpha (cerebrospinal fluid)</term><term>beta 2-Microglobulin (cerebrospinal fluid)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="cerebrospinal fluid" xml:lang="en"><term>Interleukin-6</term><term>Interleukin-8</term><term>Tumor Necrosis Factor-alpha</term><term>beta 2-Microglobulin</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiviral Agents</term><term>Glucocorticoids</term><term>Hydroxychloroquine</term><term>Lopinavir</term><term>Methylprednisolone</term><term>Ritonavir</term></keywords><keywords scheme="MESH" qualifier="cerebrospinal fluid" xml:lang="en"><term>Coronavirus Infections</term><term>Encephalitis</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Encephalitis</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Encephalitis</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Akinetic Mutism</term><term>Coronavirus Infections</term><term>Encephalitis</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Betacoronavirus</term><term>COVID-19</term><term>Drug Combinations</term><term>Electroencephalography</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>SARS-CoV-2</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been described in patients with severe respiratory distress. Here, we described the case of a 60-year-old patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but only mild respiratory abnormalities who developed an akinetic mutism attributable to encephalitis. Magnetic resonance imaging was negative, whereas electroencephalography showed generalized theta slowing. Cerebrospinal fluid analyses during the acute stage were negative for SARS-CoV-2, positive for pleocytosis and hyperproteinorrachia, and showed increased interleukin-8 and tumor necrosis factor-α concentrations. Other infectious or autoimmune disorders were excluded. A progressive clinical improvement along with a reduction of cerebrospinal fluid parameters was observed after high-dose steroid treatment, thus arguing for an inflammatory-mediated brain involvement related to COVID-19. ANN NEUROL 2020;88:423-427.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32418288</PMID><DateCompleted><Year>2020</Year><Month>11</Month><Day>26</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1531-8249</ISSN><JournalIssue CitedMedium="Internet"><Volume>88</Volume><Issue>2</Issue><PubDate><Year>2020</Year><Month>08</Month></PubDate></JournalIssue><Title>Annals of neurology</Title><ISOAbbreviation>Ann Neurol</ISOAbbreviation></Journal><ArticleTitle>Steroid-Responsive Encephalitis in Coronavirus Disease 2019.</ArticleTitle><Pagination><MedlinePgn>423-427</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/ana.25783</ELocationID><Abstract><AbstractText>Coronavirus disease 2019 (COVID-19) infection has the potential for targeting the central nervous system, and several neurological symptoms have been described in patients with severe respiratory distress. Here, we described the case of a 60-year-old patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection but only mild respiratory abnormalities who developed an akinetic mutism attributable to encephalitis. Magnetic resonance imaging was negative, whereas electroencephalography showed generalized theta slowing. Cerebrospinal fluid analyses during the acute stage were negative for SARS-CoV-2, positive for pleocytosis and hyperproteinorrachia, and showed increased interleukin-8 and tumor necrosis factor-α concentrations. Other infectious or autoimmune disorders were excluded. A progressive clinical improvement along with a reduction of cerebrospinal fluid parameters was observed after high-dose steroid treatment, thus arguing for an inflammatory-mediated brain involvement related to COVID-19. ANN NEUROL 2020;88:423-427.</AbstractText><CopyrightInformation>© 2020 American Neurological Association.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Pilotto</LastName><ForeName>Andrea</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0003-2029-6606</Identifier><AffiliationInfo><Affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Parkinson's Disease Rehabilitation Centre, FERB ONLUS - S. Isidoro Hospital, Trescore Balneario (BG), Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Odolini</LastName><ForeName>Silvia</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Masciocchi</LastName><ForeName>Stefano</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Comelli</LastName><ForeName>Agnese</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Volonghi</LastName><ForeName>Irene</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gazzina</LastName><ForeName>Stefano</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Neurophysiology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nocivelli</LastName><ForeName>Sara</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pezzini</LastName><ForeName>Alessandro</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Focà</LastName><ForeName>Emanuele</ForeName><Initials>E</Initials><Identifier Source="ORCID">0000-0003-4395-5379</Identifier><AffiliationInfo><Affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Caruso</LastName><ForeName>Arnaldo</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Microbiology Unit, Department of Molecular and Translational Medicine, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Leonardi</LastName><ForeName>Matilde</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Neurology, Public Health, Disability Unit - IRCCS Neurology Institute Besta, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pasolini</LastName><ForeName>Maria P</ForeName><Initials>MP</Initials><AffiliationInfo><Affiliation>Neurophysiology Unit, ASST Spedali Civili of Brescia, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gasparotti</LastName><ForeName>Roberto</ForeName><Initials>R</Initials><Identifier Source="ORCID">0000-0002-2591-2415</Identifier><AffiliationInfo><Affiliation>Neuroradiology Unit, Department of Molecular and Translational Medicine, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Castelli</LastName><ForeName>Francesco</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>University Division of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Hospital, Brescia, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ashton</LastName><ForeName>Nicholas J</ForeName><Initials>NJ</Initials><AffiliationInfo><Affiliation>Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Blennow</LastName><ForeName>Kaj</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zetterberg</LastName><ForeName>Henrik</ForeName><Initials>H</Initials><Identifier Source="ORCID">0000-0003-3930-4354</Identifier><AffiliationInfo><Affiliation>Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>UK Dementia Research Institute at UCL, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Padovani</LastName><ForeName>Alessandro</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0002-0119-3639</Identifier><AffiliationInfo><Affiliation>Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>09</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Ann 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