{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:28:19Z","timestamp":1786980499762,"version":"build-2736575974"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T00:00:00Z","timestamp":1716336000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,22]],"date-time":"2024-05-22T00:00:00Z","timestamp":1716336000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Neurol Sci"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Identifying coronavirus disease 2019 (COVID-19)-related encephalitis without clear etiological evidence is clinically challenging. The distinctions between this condition and other prevalent encephalitis types remain unknown. Therefore, we aimed to explore the similarities and differences in the clinical characteristics of COVID-19-related encephalitis and other encephalitis types.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Adult patients with encephalitis admitted to the neurology department at Xuanwu Hospital were enrolled and categorized into the following six groups based on the results of metagenomic next-generation sequencing and autoimmune antibody detection in cerebrospinal fluid (CSF): COVID-19-related encephalitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936), herpes simplex virus type 1 encephalitis (HSV-1 encephalitis;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200928), human herpesvirus 3 encephalitis (HHV-3 encephalitis;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910), NMDAR-antibody encephalitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918), LGI1-antibody encephalitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912), and GABAB-antibody encephalitis (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The predominant characteristics of COVID-19-related encephalitis include a low incidence of seizures (38.9%), cognitive defects (30.6%), and meningeal irritation signs (8.3%). Compared with HSV-1 and HHV-3 encephalitis, COVID-19-related encephalitis exhibited lower white blood cell count (2.5 count\/mm\n                      <jats:sup>3<\/jats:sup>\n                      ), protein (32.2\u00a0mg\/dL), and immunoglobulin M, G, and A levels (0.09, 3.2, and 0.46\u00a0mg\/dL, respectively) in the CSF tests. Abnormal imaging findings were present in only 36.1% of COVID-19-related encephalitis cases, mostly showing diffuse inflammation scattered in various parts, which differed from HSV-1 encephalitis. Additionally, COVID-19-related encephalitis exhibited significant differences in clinical symptoms and CSF white blood cell counts compared with NMDAR-antibody encephalitis; however, it showed limited differences compared with LGI1-antibody and GABAB-antibody encephalitis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>COVID-19-related encephalitis and herpes virus or autoimmune encephalitis differ clinically. Symptoms and auxiliary examinations can be used as distinguishing tools.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-024-07587-5","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T23:38:20Z","timestamp":1716334700000},"page":"3573-3582","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical features of COVID-19-related encephalitis: comparison with the features of herpes virus encephalitis and autoimmune encephalitis"],"prefix":"10.1007","volume":"45","author":[{"given":"Yue","family":"Cui","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongyun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingtao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiatang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0684-6248","authenticated-orcid":false,"given":"Liyong","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,22]]},"reference":[{"key":"7587_CR1","unstructured":"University JH (2020) Covid-19 dashboard. https:\/\/coronavirus.jhu.edu\/map.html.\u00a0Accessed 2\u00a0May\u00a0 2023"},{"key":"7587_CR2","doi-asserted-by":"publisher","first-page":"3086","DOI":"10.1007\/s00415-020-10380-x","volume":"268","author":"V Nersesjan","year":"2021","unstructured":"Nersesjan V, Amiri M, Lebech AM et al (2021) Central and peripheral nervous system complications of COVID-19: a prospective tertiary center cohort with 3-month follow-up. J Neurol 268:3086\u20133104. https:\/\/doi.org\/10.1007\/s00415-020-10380-x","journal-title":"J Neurol"},{"key":"7587_CR3","doi-asserted-by":"publisher","first-page":"3491","DOI":"10.1111\/ene.14913","volume":"28","author":"I Siow","year":"2021","unstructured":"Siow I, Lee KS, Zhang JJY et al (2021) Encephalitis as a neurological complication of COVID-19: a systematic review and meta-analysis of incidence, outcomes, and predictors. Eur J Neurol 28:3491\u20133502. https:\/\/doi.org\/10.1111\/ene.14913","journal-title":"Eur J Neurol"},{"key":"7587_CR4","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1212\/WNL.0b013e3182840b95","volume":"80","author":"E Marchioni","year":"2013","unstructured":"Marchioni E, Ravaglia S, Montomoli C et al (2013) Postinfectious neurologic syndromes: a prospective cohort study. Neurology 80:882\u2013889. https:\/\/doi.org\/10.1212\/WNL.0b013e3182840b95","journal-title":"Neurology"},{"key":"7587_CR5","doi-asserted-by":"publisher","unstructured":"Poloni TE, Moretti M, Medici V et al (2022) COVID-19 pathology in the lung, kidney, heart and brain: the different roles of t-cells, macrophages, and microthrombosis. Cells 11. https:\/\/doi.org\/10.3390\/cells11193124","DOI":"10.3390\/cells11193124"},{"key":"7587_CR6","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1159\/000530536","volume":"57","author":"JM Park","year":"2023","unstructured":"Park JM, Woo W, Lee SC et al (2023) Prevalence and mortality risk of neurological disorders during the COVID-19 pandemic: an umbrella review of the current evidence. Neuroepidemiology 57:129\u2013147. https:\/\/doi.org\/10.1159\/000530536","journal-title":"Neuroepidemiology"},{"key":"7587_CR7","doi-asserted-by":"publisher","first-page":"e1060","DOI":"10.1212\/wnl.0000000000009937","volume":"95","author":"CM Romero-S\u00e1nchez","year":"2020","unstructured":"Romero-S\u00e1nchez CM, D\u00edaz-Maroto I, Fern\u00e1ndez-D\u00edaz E et al (2020) Neurologic manifestations in hospitalized patients with COVID-19: the ALBACOVID registry. Neurology 95:e1060\u2013e1070. https:\/\/doi.org\/10.1212\/wnl.0000000000009937","journal-title":"Neurology"},{"key":"7587_CR8","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1515\/revneuro-2021-0082","volume":"33","author":"R Zamani","year":"2022","unstructured":"Zamani R, Pouremamali R, Rezaei N (2022) Central neuroinflammation in Covid-19: a systematic review of 182 cases with encephalitis, acute disseminated encephalomyelitis, and necrotizing encephalopathies. Rev Neurosci 33:397\u2013412. https:\/\/doi.org\/10.1515\/revneuro-2021-0082","journal-title":"Rev Neurosci"},{"key":"7587_CR9","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.24426","volume":"36","author":"M Koupaei","year":"2022","unstructured":"Koupaei M, ShadabMehr N, Mohamadi MH et al (2022) Clinical symptoms, diagnosis, treatment, and outcome of COVID-19-associated encephalitis: a systematic review of case reports and case series. J Clin Lab Anal 36:e24426. https:\/\/doi.org\/10.1002\/jcla.24426","journal-title":"J Clin Lab Anal"},{"key":"7587_CR10","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1093\/infdis\/jiaa609","volume":"223","author":"A Pilotto","year":"2021","unstructured":"Pilotto A, Masciocchi S, Volonghi I et al (2021) Clinical presentation and outcomes of severe acute respiratory syndrome coronavirus 2-related encephalitis: the ENCOVID multicenter study. J Infect Dis 223:28\u201337. https:\/\/doi.org\/10.1093\/infdis\/jiaa609","journal-title":"J Infect Dis"},{"key":"7587_CR11","doi-asserted-by":"publisher","first-page":"1114","DOI":"10.1093\/cid\/cit458","volume":"57","author":"A Venkatesan","year":"2013","unstructured":"Venkatesan A, Tunkel AR, Bloch KC et al (2013) Case definitions, diagnostic algorithms, and priorities in encephalitis: consensus statement of the international encephalitis consortium. Clin Infect Dis 57:1114\u20131128. https:\/\/doi.org\/10.1093\/cid\/cit458","journal-title":"Clin Infect Dis"},{"key":"7587_CR12","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/s1474-4422(15)00401-9","volume":"15","author":"F Graus","year":"2016","unstructured":"Graus F, Titulaer MJ, Balu R et al (2016) A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol 15:391\u2013404. https:\/\/doi.org\/10.1016\/s1474-4422(15)00401-9","journal-title":"Lancet Neurol"},{"key":"7587_CR13","doi-asserted-by":"publisher","first-page":"2243","DOI":"10.1161\/01.str.0000027437.22450.bd","volume":"33","author":"JT Wilson","year":"2002","unstructured":"Wilson JT, Hareendran A, Grant M et al (2002) Improving the assessment of outcomes in stroke: use of a structured interview to assign grades on the modified Rankin Scale. Stroke 33:2243\u20132246. https:\/\/doi.org\/10.1161\/01.str.0000027437.22450.bd","journal-title":"Stroke"},{"key":"7587_CR14","doi-asserted-by":"publisher","unstructured":"Teasdale G, Jennett B (1974) Assessment of coma and impaired consciousness. A practical scale. Lancet 2:81\u201384. https:\/\/doi.org\/10.1016\/s0140-6736(74)91639-0","DOI":"10.1016\/s0140-6736(74)91639-0"},{"key":"7587_CR15","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1097\/nhh.0000000000000331","volume":"34","author":"D Fritz","year":"2016","unstructured":"Fritz D, Musial MK (2016) Neurological assessment. Home Healthc Now 34:16\u201322. https:\/\/doi.org\/10.1097\/nhh.0000000000000331","journal-title":"Home Healthc Now"},{"key":"7587_CR16","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s12974-021-02339-0","volume":"19","author":"S Jarius","year":"2022","unstructured":"Jarius S, Pache F, K\u00f6rtvelyessy P et al (2022) Cerebrospinal fluid findings in COVID-19: a multicenter study of 150 lumbar punctures in 127 patients. J Neuroinflammation 19:19. https:\/\/doi.org\/10.1186\/s12974-021-02339-0","journal-title":"J Neuroinflammation"},{"key":"7587_CR17","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1212\/wnl.0000000000012051","volume":"97","author":"K Oosthuizen","year":"2021","unstructured":"Oosthuizen K, Steyn EC, Tucker L et al (2021) SARS-CoV-2 Encephalitis presenting as a clinical cerebellar syndrome: a case report. Neurology 97:27\u201329. https:\/\/doi.org\/10.1212\/wnl.0000000000012051","journal-title":"Neurology"},{"key":"7587_CR18","doi-asserted-by":"publisher","first-page":"2314","DOI":"10.1002\/acn3.51479","volume":"8","author":"S Beretta","year":"2021","unstructured":"Beretta S, Stabile A, Balducci C et al (2021) COVID-19-associated immune-mediated encephalitis mimicking acute-onset Creutzfeldt-Jakob disease. Ann Clin Transl Neurol 8:2314\u20132318. https:\/\/doi.org\/10.1002\/acn3.51479","journal-title":"Ann Clin Transl Neurol"},{"key":"7587_CR19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.117316","volume":"421","author":"A Lewis","year":"2021","unstructured":"Lewis A, Frontera J, Placantonakis DG et al (2021) Cerebrospinal fluid in COVID-19: a systematic review of the literature. J Neurol Sci 421:117316. https:\/\/doi.org\/10.1016\/j.jns.2021.117316","journal-title":"J Neurol Sci"},{"key":"7587_CR20","doi-asserted-by":"publisher","first-page":"3856","DOI":"10.1111\/ene.15045","volume":"28","author":"G Cosentino","year":"2021","unstructured":"Cosentino G, Todisco M, Hota N et al (2021) Neuropathological findings from COVID-19 patients with neurological symptoms argue against a direct brain invasion of SARS-CoV-2: a critical systematic review. Eur J Neurol 28:3856\u20133865. https:\/\/doi.org\/10.1111\/ene.15045","journal-title":"Eur J Neurol"},{"key":"7587_CR21","doi-asserted-by":"publisher","unstructured":"Huo L, Xu KL, Wang H (2021) Clinical features of SARS-CoV-2-associated encephalitis and meningitis amid COVID-19 pandemic. World J Clin Cases 9:1058\u20131078. https:\/\/doi.org\/10.12998\/wjcc.v9.i5.1058","DOI":"10.12998\/wjcc.v9.i5.1058"},{"key":"7587_CR22","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1002\/ana.25131","volume":"83","author":"D Dubey","year":"2018","unstructured":"Dubey D, Pittock SJ, Kelly CR et al (2018) Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis. Ann Neurol 83:166\u2013177. https:\/\/doi.org\/10.1002\/ana.25131","journal-title":"Ann Neurol"},{"key":"7587_CR23","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.jcv.2014.03.010","volume":"60","author":"U Sili","year":"2014","unstructured":"Sili U, Kaya A, Mert A (2014) Herpes simplex virus encephalitis: clinical manifestations, diagnosis and outcome in 106 adult patients. J Clin Virol 60:112\u2013118. https:\/\/doi.org\/10.1016\/j.jcv.2014.03.010","journal-title":"J Clin Virol"},{"key":"7587_CR24","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1007\/s12185-020-02930-w","volume":"112","author":"X Yuan","year":"2020","unstructured":"Yuan X, Huang W, Ye B et al (2020) (2020) Changes of hematological and immunological parameters in COVID-19 patients. Int J Hematol 112:553\u2013559","journal-title":"Int J Hematol"},{"key":"7587_CR25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0238160","volume":"15","author":"RM Elshazli","year":"2020","unstructured":"Elshazli RM, Toraih EA, Elgaml A et al (2020) Diagnostic and prognostic value of hematological and immunological markers in COVID-19 infection: a meta-analysis of 6320 patients. PLoS ONE 15:e0238160. https:\/\/doi.org\/10.1371\/journal.pone.0238160","journal-title":"PLoS ONE"},{"key":"7587_CR26","doi-asserted-by":"publisher","unstructured":"Ghahramani S, Tabrizi R, Lankarani KB et al (2020) Laboratory features of severe vs. non-severe COVID-19 patients in Asian populations: a systematic review and meta-analysis. Eur J Med Res 25:30. https:\/\/doi.org\/10.1186\/s40001-020-00432-3","DOI":"10.1186\/s40001-020-00432-3"}],"container-title":["Neurological Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-024-07587-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10072-024-07587-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10072-024-07587-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:14:59Z","timestamp":1721175299000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10072-024-07587-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,22]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["7587"],"URL":"https:\/\/doi.org\/10.1007\/s10072-024-07587-5","relation":{},"ISSN":["1590-1874","1590-3478"],"issn-type":[{"value":"1590-1874","type":"print"},{"value":"1590-3478","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,22]]},"assertion":[{"value":"16 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Ethical Standards Committee of Xuanwu Hospital.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Institutional review board"}},{"value":"Written consent for studies was obtained from families and patients\u2019 representatives.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}