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J Hum Immun . Acute necrotizing encephalopathy associated with COVID-19 in a pediatric patient and a systematic review

tetano

Editor, Senior Moderator
J Hum Immun


. 2026 Feb 4;2(2):e20250101.
doi: 10.70962/jhi.20250101. eCollection 2026 Mar 2.
Acute necrotizing encephalopathy associated with COVID-19 in a pediatric patient and a systematic review

Kanako Takeuchi[SUP] 1 [/SUP], Yuichi Tateishi[SUP] 1 [/SUP], Kosuke Ashihara[SUP] 1 [/SUP], Takanori Utsumi[SUP] 1 [/SUP], Yoshiyuki Kobayashi[SUP] 1 [/SUP], Takaki Asano[SUP] 1 [/SUP], Satoshi Okada[SUP] 1 [/SUP]


Affiliations
Abstract

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, can lead to neurological complications such as acute necrotizing encephalopathy (ANE). However, the pathogenesis of ANE associated with COVID-19 remains unclear. We report a case of ANE associated with COVID-19 and then conducted a literature review using PubMed for cases reported up to June 30, 2024. Clinical data from 74 patients were analyzed. Among those with severe sequelae (n = 28), 39.2% (n = 11) had hemorrhagic findings on CT or MRI, significantly more than in the mild sequelae group (10.8% [n = 5], P = 0.04). 16 patients underwent genetic testing for RANBP2 mutations, of whom four (25%, n = 16) tested positive. These findings suggest that imaging evidence of hemorrhage may be a poor prognostic factor and that RANBP2 mutations could contribute to disease susceptibility. Further genetic studies involving larger cohorts are needed to better understand the mechanisms of ANE associated with COVID-19 and improve outcomes for affected patients.


 
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