Brain stem encephalitis is a rare complication of COVID-19

Marc C. Shamier; Yvette S. Crijnen; Susanne Bogers; Jeroen W. IJpelaar; Juna M. de Vries; Mathieu van der Jagt; Jochem K.H. Spoor; Jan H. von der Thüsen; Marco W.J. Schreurs; Corine H. GeurtsvanKessel; Maarten J. Titulaer

doi:10.1016/j.jneuroim.2022.578007

Brain stem encephalitis is a rare complication of COVID-19

Marc C. Shamier^*, Yvette S. Crijnen, Susanne Bogers, Jeroen W. IJpelaar, Juna M. de Vries, Mathieu van der Jagt, Jochem K.H. Spoor, Jan H. von der Thüsen, Marco W.J. Schreurs, Corine H. GeurtsvanKessel, Maarten J. Titulaer

^*Corresponding author for this work

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Abstract

Here, we describe the clinical phenotype of SARS-CoV-2-related CNS disease and evaluate the SARS-CoV-2 antibody index as a tool to differentiate between a direct (viral) and indirect etiology. Out of >4000 hospitalized patients with COVID-19, we included 13 patients with neurological symptoms with suspicion of neuroinflammation. On clinical grounds, eight were classified as having a possible/probable relationship between neurological symptoms and COVID-19. A clinically distinctive phenotype of brainstem and cerebellar symptoms was seen in 6/8 patients. As we found a positive SARS-CoV-2 antibody index in 3/5 patients, indicating specific intrathecal SARS-CoV-2 IgG production, a direct link with SARS-CoV-2 is likely.

Original language	English
Article number	578007
Journal	Journal of Neuroimmunology
Volume	374
DOIs	https://doi.org/10.1016/j.jneuroim.2022.578007
Publication status	Published - 15 Jan 2023

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title = "Brain stem encephalitis is a rare complication of COVID-19",

abstract = "Here, we describe the clinical phenotype of SARS-CoV-2-related CNS disease and evaluate the SARS-CoV-2 antibody index as a tool to differentiate between a direct (viral) and indirect etiology. Out of >4000 hospitalized patients with COVID-19, we included 13 patients with neurological symptoms with suspicion of neuroinflammation. On clinical grounds, eight were classified as having a possible/probable relationship between neurological symptoms and COVID-19. A clinically distinctive phenotype of brainstem and cerebellar symptoms was seen in 6/8 patients. As we found a positive SARS-CoV-2 antibody index in 3/5 patients, indicating specific intrathecal SARS-CoV-2 IgG production, a direct link with SARS-CoV-2 is likely.",

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AU - Bogers, Susanne

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AU - de Vries, Juna M.

AU - van der Jagt, Mathieu

AU - Spoor, Jochem K.H.

AU - von der Thüsen, Jan H.

AU - Schreurs, Marco W.J.

AU - GeurtsvanKessel, Corine H.

AU - Titulaer, Maarten J.

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AB - Here, we describe the clinical phenotype of SARS-CoV-2-related CNS disease and evaluate the SARS-CoV-2 antibody index as a tool to differentiate between a direct (viral) and indirect etiology. Out of >4000 hospitalized patients with COVID-19, we included 13 patients with neurological symptoms with suspicion of neuroinflammation. On clinical grounds, eight were classified as having a possible/probable relationship between neurological symptoms and COVID-19. A clinically distinctive phenotype of brainstem and cerebellar symptoms was seen in 6/8 patients. As we found a positive SARS-CoV-2 antibody index in 3/5 patients, indicating specific intrathecal SARS-CoV-2 IgG production, a direct link with SARS-CoV-2 is likely.

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Brain stem encephalitis is a rare complication of COVID-19

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