Background: Several preclinical and clinical investigations have argued for nervous system involvement in SARS-CoV-2 infection MESHD. Some sparse case reports have described various forms of encephalitis MESHD encephalitis HP in COVID-19 disease MESHD, but very few data have focused on clinical presentations, clinical course, response to treatment and outcomes yet. Objective: to describe the clinical phenotype, laboratory and neuroimaging findings of encephalitis MESHD encephalitis HP associated with SARS-CoV-2 infection MESHD, their relationship with respiratory function and inflammatory parameters and their clinical course and response to treatment. Design: The ENCOVID multicentre study was carried out in 13 centres in northern Italy between February 20th and May 31st, 2020. Only patients with altered mental status and at least two supportive criteria for encephalitis MESHD encephalitis HP with full infectious screening, CSF, EEG, MRI data and a confirmed diagnosis of SARS-CoV-2 infection MESHD were included. Clinical presentation and laboratory markers, severity of COVID-19 disease MESHD, response to treatment and outcomes were recorded. Results: Out of 45 cases screened, twenty-five cases of encephalitis MESHD encephalitis HP positive for SARS-CoV-2 infection MESHD with full available data were included. The most common symptoms at onset TRANS were delirium MESHD delirium HP (68%), aphasia MESHD aphasia HP/ dysarthria MESHD dysarthria HP (24%) and seizures MESHD seizures HP (24%). CSF showed hyperproteinorrachia and/or pleocytosis in 68% of cases whereas SARS-CoV-2 RNA by RT-PCR resulted negative. Based on MRI, cases were classified as ADEM (n=3), limbic encephalitis MESHD encephalitis HP (LE, n=2), encephalitis MESHD encephalitis HP with normal imaging (n=13) and encephalitis MESHD encephalitis HP with MRI alterations (n=7). ADEM and LE cases showed a delayed onset compared to the other encephalitis MESHD encephalitis HP (p=0.001) and were associated with previous more severe COVID-19 respiratory involvement. Patients with MRI alterations exhibited worse response to treatment and final outcomes compared to other encephalitis MESHD encephalitis HP. Conclusions and relevance: We found a wide clinical spectrum of encephalitis MESHD encephalitis HP associated with COVID19 infection MESHD, underlying different pathophysiological mechanisms. Response to treatment and final outcome strongly depended on specific CNS-manifestations.