Observation on Efficacy and Safety of Intraveinous Bolus Artesunate Therapy among Clinically Proven Acute Covid-19 Induced Encepthalopathy

Abstract:  The spike glycoprotein of SARS-CoV-2 (COVID-19) helps the virus to bind the ACE2 receptor to enter the host cells. ACE2 receptors are present in lung, heart, kidney, liver and brain. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. COVID-19-induced  encephalopathy was defined as a rapidly developing (less than 4 weeks) pathophysiological process in the brain leading to decreased level of consciousness ranging from altered consciousness, mild confusion, delirium to deep coma  are hallmark clinical features. Clinical diagnosis of covid-19 induced encephalopathy was made  among hospitalized patients with negative oropharyngeal swab RT-PCR tests presented with clinical features of encephalitis by adopting a diagnostic criteria, if they met ≥ one of the following diagnostic criteria, such as elevated inflammatory markers i.e. serum LDH, CRP, Ferritin, D-dimer level and decreased lymphocyte, eosinophils and platelet counts, with associated  X-ray chest, HRCT  and MRI of brain findings suggestive of encephalitis, after exclusion of classical medical etiologies such as electrolyte disturbances, other infections, drug or alcohol toxicity or withdrawal, metabolic disorders, low perfusion state or acute central nervous system conditions, such as stroke or meningitis. Furthermore, confirmation of recent exposure to COVID-19 was made by testing of COVID-19 specific antibodies in selected cases. They were empirically treated with off label high dose Artesunate IV bolus Artesunate and it was observed that, Artesunate therapy appears to be very effective and safe decreases the morbidity and mortality among the clinically diagnosed COVID-19- induced encephalopathy.

Keywords: Central nervous system, Clinical COVID-19, SARS-CoV-2, COVID-19-induced Encephalopathy, Bolus Intravenous Artesunate.