Infectious Disease

Early analysis essential in treating encephalitis attributable to COVID-19, different causes

February 22, 2021

2 min read

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Siddiqi does not report any relevant information.

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February 22nd marks World Encephalitis Day, a day of global awareness started by the Encephalitis Society for people “directly or indirectly affected by encephalitis” and which now also includes patients with COVID-19 .

Healio Neurology spoke to Dr. med. Omar K. Siddiqi, MPH, Member of the Scientific Advisory Board of the Encephalitis Society, on the current state of encephalitis management. Siddiqi, assistant professor of neurology at Harvard Medical School, visiting professor at the University of Zambia Medical School, and director of the global neurology program at Beth Israel Deaconess Medical Center in Boston, said that while advances in the treatment of encephalitis have been made, needs remain unmet consist.

Healio-Neurology: How is COVID-19 Associated Encephalitis Different from Other Forms of the Disease?

Siddiqi: We are still learning about all of the neurological complications from COVID-19. Encephalitis seems to occur in a number of ways. There have been case reports of the detection of SARS-CoV-2 in spinal fluid and in patients with inflammatory brain syndrome. COVID-19 is linked to a high level of inflammation throughout the body. This also has a detrimental effect on the brain. There has been speculation that the blood vessels that supply blood to the brain become inflamed, leading to brain injury related to stroke and secondary tissue dysfunction. There can also be inflammation that causes secondary damage to the brain when the immune system is fighting the virus and there is cross-reactivity with the brain itself.

Healio-Neurology: Have There Recent Breakthroughs In The Treatment Of Encephalitis?

Siddiqi: The use of the technology known as Metagenomics Next-Generation Sequencing enabled the detection of infectious causes of encephalitis that were not previously considered. We are also recognizing a new form of autoimmune encephalitis that was not previously recognized. A decade ago, it was extremely difficult to reliably differentiate between infectious and autoimmune encephalitis. This is important because the treatment between the two is very different. One requires the use of antimicrobial drugs while the other relies on immunomodulatory drugs. With the ability to more accurately diagnose the cause of encephalitis, patients will receive appropriate treatment and have better chances of recovery.

Healio Neurology: Which Unmet Needs Remain?

Siddiqi: Some of the diagnostic tests can take some time to accurately diagnose encephalitis. There is a saying in the stroke world that time is the brain; I would say the same is true for encephalitis. The longer the diagnosis is delayed, the more susceptible the brain is to further injury. We want immediate point-of-care diagnostics that can quickly explain the cause of encephalitis to doctors and patients.

We can also always benefit from more targeted treatments. With some forms of viral encephalitis, we can only take supportive measures because we don’t have a drug that can actively reduce viral replication. There are still a number of unmet needs.

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