Possible temporal relationship between SARS-CoV-2 infection and anti-NMDA receptor encephalitis: a meta-analysis
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Possible temporal relationship between SARS-CoV-2 infection and anti-NMDA receptor encephalitis : a meta-analysis. / Vasilevska, Veronika; Guest, Paul C; Szardenings, Michael; Benros, Michael E; Steiner, Johann.
In: Translational Psychiatry, Vol. 14, No. 1, 08.03.2024, p. 139.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Possible temporal relationship between SARS-CoV-2 infection and anti-NMDA receptor encephalitis
T2 - a meta-analysis
AU - Vasilevska, Veronika
AU - Guest, Paul C
AU - Szardenings, Michael
AU - Benros, Michael E
AU - Steiner, Johann
N1 - © 2024. The Author(s).
PY - 2024/3/8
Y1 - 2024/3/8
N2 - The global impact of SARS-CoV-2 infection has raised concerns about secondary diseases beyond acute illness. This review explores the significance and potential underlying mechanisms of how SARS-CoV-2 infection might elicit an immune response targeting N-methyl-D-aspartate (NMDA) receptors, and its implications for autoimmune-driven neuropsychiatric manifestations. We identified 19 published case reports of NMDA receptor encephalitis associated with SARS-CoV-2 infection or vaccination by a systematic literature search. The significance of these reports was limited since it is not clear if a coincidental or causal relationship exists between SARS-CoV-2 infection or vaccination and manifestation of NMDA receptor encephalitis. The included studies were hampered by difficulties in establishing if these patients had pre-existing NMDA receptor antibodies which entered the brain by infection- or vaccination-associated transient blood-brain barrier leakage. In addition, four cases had comorbid ovarian teratoma, which is a known trigger for development of NMDA receptor encephalitis. Considering that billions of people have contracted COVID-19 or have been vaccinated against this virus, the publication of only 19 case reports with a possible link to NMDA receptor encephalitis, indicates that it is rare. In conclusion, these findings do not support the case that SARS-CoV-2 infection or vaccination led to an increase of existing or de novo encephalitis mediated by an autoimmune response targeting NMDA receptor function. Nevertheless, this work underscores the importance of ongoing vigilance in monitoring viral outbreaks and their potential impact on the central nervous system through basic, epidemiological and translational research.
AB - The global impact of SARS-CoV-2 infection has raised concerns about secondary diseases beyond acute illness. This review explores the significance and potential underlying mechanisms of how SARS-CoV-2 infection might elicit an immune response targeting N-methyl-D-aspartate (NMDA) receptors, and its implications for autoimmune-driven neuropsychiatric manifestations. We identified 19 published case reports of NMDA receptor encephalitis associated with SARS-CoV-2 infection or vaccination by a systematic literature search. The significance of these reports was limited since it is not clear if a coincidental or causal relationship exists between SARS-CoV-2 infection or vaccination and manifestation of NMDA receptor encephalitis. The included studies were hampered by difficulties in establishing if these patients had pre-existing NMDA receptor antibodies which entered the brain by infection- or vaccination-associated transient blood-brain barrier leakage. In addition, four cases had comorbid ovarian teratoma, which is a known trigger for development of NMDA receptor encephalitis. Considering that billions of people have contracted COVID-19 or have been vaccinated against this virus, the publication of only 19 case reports with a possible link to NMDA receptor encephalitis, indicates that it is rare. In conclusion, these findings do not support the case that SARS-CoV-2 infection or vaccination led to an increase of existing or de novo encephalitis mediated by an autoimmune response targeting NMDA receptor function. Nevertheless, this work underscores the importance of ongoing vigilance in monitoring viral outbreaks and their potential impact on the central nervous system through basic, epidemiological and translational research.
KW - Humans
KW - Anti-N-Methyl-D-Aspartate Receptor Encephalitis/complications
KW - Antibodies
KW - COVID-19/complications
KW - Receptors, N-Methyl-D-Aspartate
KW - SARS-CoV-2
U2 - 10.1038/s41398-024-02831-0
DO - 10.1038/s41398-024-02831-0
M3 - Journal article
C2 - 38459000
VL - 14
SP - 139
JO - Translational Psychiatry
JF - Translational Psychiatry
SN - 2158-3188
IS - 1
ER -
ID: 389988387