Isolated Central Nervous System Vasculitides in COVID-19: A Systematic Review of Case Reports and Series

Cerebral vasculitides, both isolated or in systemic disorders, could be triggered by infections, and few cases have been associated to coronavirus disease 2019 (COVID-19). This study searched for publications Pubmed, EMBASE, Cochrane library databases case reports series of central nervous system (CNS) vasculitides severe acute respiratory syndrome coronavirus-2. We included 12 studies (published from June 2020 July 2022) collected 39 adult patients (5/39 pathologically radiologically proven, 34/39 suggestive primary CNS vasculitis PCNSV). All had a positive real-time polymerase chain reaction on nasopharyngeal swab tract specimen. About the 85% were males, onset occurred later than 50 years old all but three subjects. In total, 33/39 presented COVID-19 pneumonia, frequently requiring intensive care unit care. The most common neurological features headache, obnubilation, coma. PCNSV was suspected mainly radiological findings, whereas cerebrospinal fluid analysis minimally altered. Magnetic resonance imaging showed vessel wall enhancement 32/39 cases, generally with concomitant presence microbleeds, subarachnoid haemorrhages, and/or multiple ischemic lesions. Despite course, (93%) improved spontaneously after course high-dose intravenous steroids no need immunosuppression. conclusion, rarely relate independently pulmonary severity. Adults COVID-19-related favourable prognosis.