A clinical case of post-covid syndrome in covid-associated limbic encephalitis

In contemporary medical practice, an increasing body of evidence highlights the consequences of infection with SARS-CoV-2, pointing to a wide range of extrapulmonary clinical and laboratory abnormalities, some of which are characteristic of autoimmune and autoinflammatory diseases. This article presents a clinical case of post-COVID syndrome in COVID-associated limbic encephalitis, in which the diagnosis of a post-infectious autoimmune encephalitis required a more detailed retrospective analysis of nonspecific clinical and dynamic data combined with a comparison of instrumental study results. Analysis of the presented clinical case indicates the need for long-term follow-up of patients with limbic encephalitis (for at least three years with electroencephalographic monitoring), along with appropriately adjusted retrospective therapy. Particular emphasis should also be placed, during medical history taking in patients with sequelae of SARS-CoV-2 infection, on identifying a history of limbic encephalitis when patients consult various medical specialists, especially when presenting with a set of nonspecific complaints associated with limbic system involvement that persistently reduce quality of life. By examining the cause-and-effect relationship, it can be concluded that a structural trace is formed within the functional immune system that was involved in adaptation to a specific environmental stressor – the SARS-CoV-2 pathogen – which subsequently led to pathological changes in other systems and, consequently, to dysregulation of vital processes. A stepwise selection of psychopharmacotherapy based on the pathophysiological mechanisms underlying the development of dysregulatory disorders is substantiated. The article presents the process of selecting optimal therapy taking into account the patient’s social status, justifies rehabilitation measures, and traces the clinical follow-up over a three-year period.

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