COVID-19-associated leukoencephalopathy in the absence of severe hypoxia with subsequent improvement: a case report View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2022-05-10

AUTHORS

Hiroki Kojima, Naoya Sakamoto, Atsushi Kosaka, Masayoshi Kobayashi, Mitsuo Amemiya, Takuya Washino, Yusuke Kuwahara, Takuto Ishida, Mayu Hikone, Satoshi Miike, Tatsunori Oyabu, Sentaro Iwabuchi, Fukumi Nakamura-Uchiyama

ABSTRACT

BackgroundSeveral cases of coronavirus disease 2019 (COVID-19)-associated leukoencephalopathy have been reported. Although most cases involve hypoxia, the pathophysiological mechanism and neurologic outcomes of COVID-19-associated leukoencephalopathy remain unclear.Case presentationWe report a case of COVID-19-associated leukoencephalopathy without severe hypoxia in a 65-year-old woman diagnosed with pyelonephritis. After the initiation of intravenous ceftriaxone, her fever resolved, but she developed an altered state of consciousness with abnormal behavior and, subsequently, a relapse fever. She was diagnosed with COVID-19 pneumonia and was intubated. Lung-protective ventilation with deep sedation and neuromuscular blockade were used for treatment. After cessation of sedative administration, her mental status remained at a Glasgow Coma Scale score of 3. COVID-19 was assumed to have caused leukoencephalopathy due to the absence of severe hypoxia or other potential causes. She subsequently showed gradual neurologic improvement. Three months after the COVID-19 diagnosis, she regained alertness, with a Glasgow Coma Scale score of 15.ConclusionClinicians should consider leukoencephalopathy in the differential diagnosis of consciousness disorders in patients with severe COVID-19, even in the absence of severe hypoxia. Gradual neurologic improvement can be expected in such cases. More... »

PAGES

444

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12879-022-07426-y

DOI

http://dx.doi.org/10.1186/s12879-022-07426-y

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1147759098

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/35538434


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