Post Covid-19 Neuropsychiatric Complications and Therapeutic Role for Tnf-Α Inhibitors: A Case Series Study Publisher



Shafiee G¹ ; Arastou T² ; Heshmat R¹ ; Jamshidi AR³ ; Larijani B⁴ ; Arzaghi SM^{2, 5}
Source: Journal of Diabetes and Metabolic Disorders Published:2022

Abstract

Background: The post-COVID syndrome is the various physical and neuropsychiatric symptoms after the acute phase of COVID-19. The understanding of pathophysiology of this syndrome and its treatment need to further studies. This study aimed to present three cases of neuropsychiatric symptoms after COVID-19 and effective treatments in these patients. Case presentation: Three patients with new or progressively neuropsychiatric symptoms such as seizures, attention difficulties, insomnia, confusion and etc., were referred to our clinic about 8 months after severe COVID-19 infection. The patients were assessed with extensive workup includes a neurological exam, brain MRI, LORETA scan, and biochemical and levels of inflammatory serum markers. All patients had elevated levels of TNF-α, poor neurological exam, and abnormal reports of MRI or LORETA scan. Diagnosis of post- COVID neuropsychiatric complications was made for the patients.TNF inhibition with Adalimumab (40 mg/weekly for a month) was initiated for the patients and led to a dramatic improvement of all symptoms. Conclusions: To our knowledge, this report is the first case series study that suggests TNF inhibitors in the treatment of post-COVID-19 syndrome, especially neuropsychological complications. However, future studies should evaluate the best therapeutic options for this syndrome. © 2022, The Author(s), under exclusive licence to Tehran University of Medical Sciences.