Infectious disease-associated encephalopathies

Crit Care. 2021 Jul 6;25(1):236. doi: 10.1186/s13054-021-03659-6.

Abstract

Infectious diseases may affect brain function and cause encephalopathy even when the pathogen does not directly infect the central nervous system, known as infectious disease-associated encephalopathy. The systemic inflammatory process may result in neuroinflammation, with glial cell activation and increased levels of cytokines, reduced neurotrophic factors, blood-brain barrier dysfunction, neurotransmitter metabolism imbalances, and neurotoxicity, and behavioral and cognitive impairments often occur in the late course. Even though infectious disease-associated encephalopathies may cause devastating neurologic and cognitive deficits, the concept of infectious disease-associated encephalopathies is still under-investigated; knowledge of the underlying mechanisms, which may be distinct from those of encephalopathies of non-infectious cause, is still limited. In this review, we focus on the pathophysiology of encephalopathies associated with peripheral (sepsis, malaria, influenza, and COVID-19), emerging therapeutic strategies, and the role of neuroinflammation.

Keywords: COVID-19; Cognition; Encephalopathy; Infection; Influenza; Malaria; Microglial priming; Neuroinflammation; SARS-CoV-2; Sepsis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Blood-Brain Barrier / immunology
  • Brain Diseases / immunology*
  • Brain Diseases / prevention & control
  • COVID-19 / complications*
  • COVID-19 / immunology
  • Cytokines / immunology*
  • Humans
  • Influenza, Human / complications*
  • Influenza, Human / immunology
  • Malaria / complications*
  • Malaria / immunology
  • Sepsis / complications*
  • Sepsis / immunology

Substances

  • Cytokines