N2 in the time of COVID-19

Abstract

This issue of Neurology ® Neuroimmunology & Neuroinflammation reflects the impact of the COVID-19 pandemic with 15 studies related to inflammatory or autoimmune neurologic complications in patients with this disease, including Guillain-Barré syndrome, CNS inflammatory disorders, and several studies addressing the risk of COVID-19 in patients with neuromyelitis optica spectrum disorders (NMOSD) or multiple sclerosis (MS). Among the latter, a study conducted in New York by Parotta et al.1 included 72 patients with MS (55 relapsing and 17 progressive) or related disorders (4 patients) and confirmed (37 patients) or suspected COVID-19 illness. Most patients did not require hospitalization despite being on disease-modifying therapies; factors associated with critical illness were similar to those of the general at-risk patient population. On the other hand, most of the articles related to CNS disorders that occurred in association with COVID-19 are single cases describing acute necrotizing encephalitis or myelitis; acute disseminated encephalomyelitis; transient encephalitis with increased levels of interleukin 1 (IL1), IL6, and angiotensin-converting enzyme; and 2 cases of inflammatory vasculopathy (one of them with newly identified oligodendrocyte glycoprotein antibodies). Unrelated to the topic of the neurologic complications of COVID-19, the current issue of N2 contains multiple interesting studies, among which I selected 3 for additional comments.