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Hemorrhagic encephalopathy associated with COVID-19
Jonathan D Krett1, Gordon A E Jewett1, Charissa Elton-Lacasse2
1Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
Journal of Neuroimmunology
|July 20, 2020
Summary
COVID-19 can cause hemorrhagic encephalopathy, a brain condition. While SARS-CoV-2 was not found in the patient's CSF or blood, inflammation indicated a cytokine release syndrome, suggesting a treatable cause of neurological symptoms.
Area of Science:
- Neurology
- Infectious Diseases
- Critical Care Medicine
Background:
- Neurological complications of COVID-19 remain poorly understood.
- Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can lead to diverse neurological manifestations.
Purpose of the Study:
- To describe a case of COVID-19-associated hemorrhagic encephalopathy.
- To investigate the potential mechanisms underlying neurological dysfunction in severe COVID-19.
Main Methods:
- Case report of a critically ill patient with COVID-19.
- Cerebrospinal fluid (CSF) and blood analysis for SARS-CoV-2 RNA.
- CSF cytokine profiling to assess inflammatory pathways.
Main Results:
- SARS-CoV-2 RNA was undetectable in CSF and blood.
- CSF analysis revealed dysregulation of pro-inflammatory cytokines, including tumor necrosis factor-α and interleukin-6.
- Findings were consistent with a cytokine release syndrome.
Conclusions:
- COVID-19-associated hemorrhagic encephalopathy is a potential neurological complication.
- Inflammation, possibly via cytokine release syndrome, may underlie this condition.
- Early identification of such inflammatory processes could lead to improved patient outcomes.
