Batna Journal of Medical Sciences
Volume 11, Numéro 1, Pages 90-96
2026-03-02
Before The Covid-19 Era, Were Coronaviruses Involved In Cases Of Encephalitis And Meningoencephalitis? A Cohort Study
Authors : Righi Nora . Debbabi Meriem . Fellah Rihab . Rahmoune Loubna . Doumandji Melissa . Slimani Samy . Mekki Yahia Abdelmoumene . Lina Bruno .
Abstract
Over the past three decades, a clear neuroinvasive and neurotropic potential has been demonstrated for human coronaviruses (HCoVs), involving both primary and secondary central nervous system (CNS) involvement. The classical coronaviruses (229E, OC43, and NL63) are primarily responsible for upper and lower respiratory tract infections but have also been implicated in gastrointestinal and neurological diseases. Objective: To demonstrate the involvement of coronaviruses in encephalitis and meningoencephalitis before the SARS-CoV-2 pandemic and to compare these findings with the neurological manifestations observed during COVID-19. Materials and Methods: To determine the etiological spectrum of encephalitis in Batna, Algeria, we conducted a prospective study using a broad testing approach from April 2012 to August 2015. We adopted a case definition consistent with previous studies, including acute cerebral dysfunction and signs of inflammation, as well as patients presenting with meningeal inflammation and an associated encephalitic component (meningoencephalitis). Patients were recruited from three departments (intensive care, infectious diseases, pediatrics), and data were collected using a standardized case report form. We aimed to identify the etiological agents through a standardized diagnostic procedure and to describe the epidemiological, clinical, biological characteristics and outcomes associated with the different causes. Risk factors associated with in-hospital mortality were statistically evaluated using the chi-squared test. Results: Using a comprehensive diagnostic approach, over 30 pathogens were tested in blood and cerebrospinal fluid (CSF). Among the 141 patients with acute infectious encephalitis, a viral etiology was established in 73 (51.8%), including 18 cases involving coronaviruses. Among these, 4 were not coinfected. The median age was 20 years (range: 0–45), with immunosuppression present in 16.7% of cases. Sudden onset was observed in 38.9%, neck stiffness in 38.9%, and a Glasgow Coma Score <8 in 22.2%. Respiratory involvement and hepatic involvement were each observed in 27.8% of patients. Pleocytosis was noted in 77.8% of cases, with hyperalbuminorachia in 55.6%. Respiratory viral coinfection was detected in 11.1%. The median duration of hospitalization was 19.5 days (range: 1–874), with a mortality rate of 5.6%. Conclusion: The neurological involvement of coronaviruses remains to be fully elucidated. Nonetheless, coronaviriform particles have been observed in brain tissue sections, and coronaviruses have been isolated from patients with multiple sclerosis (MS). Moreover, anti-coronavirus antibodies have frequently been detected at high titers in the CSF of MS patients.
Keywords
Encephalitis ; Meningoencephalitis ; Respiratory involvement ; Coinfections
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