COVID-19 Presenting as Encephalopathy in the Emergency Department: A Case Report

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the etiology of the coronavirus disease 2019 (COVID-19) pandemic, has proven to be an era-defining illness with profound impact on patients and healthcare providers alike. By nearly all measures, daily cases and deaths are growing on a global scale despite conscious infection control efforts. As the medical community strives to better understand the pathogenesis of COVID-19, it has become increasingly appreciated that this "respiratory virus" can present clinically with a wide range of signs and symptoms not necessarily confined to the respiratory system.

Specifically, the central nervous system has been described as the presenting complaint of COVID-19, including anosmia and headaches and, more rarely, meningitis. This clinical case highlights the presentation of a 52-year-old male who presented to the emergency department with altered mental status and fever, ultimately attributed to COVID-19 infection.

This case serves to add to the growing body of evidence surrounding the potentially severe neuropathologic capabilities of the novel SARS-CoV-2 virus.