Posterior Reversible Leukoencephalopathy Syndrome in a Patient after Acute COVID-19 Infection

Area of Science:

• Neurology
• Infectious Diseases
• Neuroscience

Background:

• SARS-CoV-2 infection can impact the central nervous system, potentially causing neuroinflammation and neurological disorders.
• Posterior Reversible Encephalopathy Syndrome (PRES) is a recognized neurological complication associated with COVID-19, typically observed during acute hospitalization.

Observation:

• A case report of a 90-year-old female with severe COVID-19 who developed PRES and seizures one week after hospital discharge.
• The patient presented with new-onset generalized tonic-clonic seizures, and subsequent brain imaging confirmed PRES.
• Clinical recovery was achieved with supportive care and anticonvulsant therapy, with MRI showing resolution of abnormalities four months later.

Findings:

• This case represents the first documented instance of PRES manifesting after clinical recovery from severe acute COVID-19.
• The findings suggest that cerebrovascular endothelial cell damage from SARS-CoV-2 may persist post-infection, leading to delayed neurological complications like PRES.
• The temporal relationship indicates a potential delayed effect of the virus on the vasculature, even after initial recovery.

Implications:

• This case underscores the importance of monitoring for delayed neurological complications in patients recovering from severe COVID-19.
• It suggests that SARS-CoV-2 may have long-term effects on cerebrovascular health, contributing to conditions like PRES.
• Further research is warranted to understand the mechanisms and long-term neurological sequelae of SARS-CoV-2 infection.