Acute hemorrhagic leukoencephalitis in a COVID-19 patient—a case report with literature review

Varadan, Baskaran; Shankar, Abhinaya; Rajakumar, Akila; Subramanian, Shubha; Sathya, Anvitha; Hakeem, Abdul; Kalyanasundaram, S.

doi:10.1007/s00234-021-02667-1

Cited by 44 publications

(39 citation statements)

References 32 publications

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“…Outcome and severity of COVID-19 were not reported in one case [ 52 ] but the other 5 cases had severe COVID-19 based on IDSA/ATS guidelines [ 53 – 57 ]. There was two fatal outcome as reported by Dixon et al [ 53 , 56 ].…”

Section: Discussionsupporting

confidence: 51%

COVID-19 and neuroinflammation: a literature review of relevant neuroimaging and CSF markers in central nervous system inflammatory disorders from SARS-COV2

Sriwastava

Tandon

Podury³

et al. 2021

J Neurol

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Background The literature on neurological manifestations in COVID-19 patients has been rapidly increasing with the pandemic. However, data on CNS inflammatory disorders in COVID-19 are still evolving. We performed a literature review of CNS inflammatory disorders associated with coronavirus disease-2019 . Methods We screened all articles resulting from a search of PubMed, Google Scholar and Scopus, using the keywords; "SARS-CoV-2 and neurological complication", "SARS-CoV-2 and CNS Complication" looking for reports of transverse myelitis, longitudinally extensive transverse myelitis, neuromyelitis optica, myelitis, Myelin Oligodendrocyte Glycoprotein Antibody Disorder (MOGAD), Acute Disseminated Encephalomyelitis (ADEM), Acute Hemorrhagic Necrotizing Encephalitis/Acute Hemorrhagic Leukoencephalitis (AHNE/AHLE), Cytotoxic lesion of the Corpus Callosum/Mild Encephalopathy Reversible Splenium Lesion(CLOCC/MERS) and Optic neuritis published between December 01, 2019 and March 15, 2021. Results Our literature search revealed 43 patients meeting the diagnosis of myelitis, including Transverse Myelitis, ADEM, AHNE/AHLE or CLOCC/MERS and Optic neuritis. Acute myelitis was most commonly associated with non-severe COVID-19 and all reported cases of AHNE/AHLE had severe COVID-19 infection. Based on IDSA/ATS criteria of either requiring vasopressor for septic shock or mechanical ventilation, 49% (n = 18) patients were considered to have a severe COVID infection. There were 7 (n = 19%) fatalities. Conclusion To our knowledge, this is among the first reviews that includes the clinical features, neuroimaging, CSF findings and outcomes in COVID-19-associated CNS inflammatory disorders. Our observational review study reveals that although rare, myelitis, ADEM, AHNE and CLOCC can be associated with COVID-19 infection. Further studies using MRI imaging and CSF analysis in early diagnosis and intervention of these disorders are warranted.

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Section: Discussionsupporting

confidence: 51%

COVID-19 and neuroinflammation: a literature review of relevant neuroimaging and CSF markers in central nervous system inflammatory disorders from SARS-COV2

Sriwastava

Tandon

Podury³

et al. 2021

J Neurol

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“… 26. , 27. Distinction between PRES, COVID-19 related leukoencephalopathy, and acute hemorrhagic leukoencephalitis may be relevant clinically as it may alter clinical management.…”

Section: Discussionmentioning

confidence: 99%

Brain MRI findings in COVID-19 patients with PRES: A systematic review

et al. 2022

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Background Numerous case reports and case series have described brain Magnetic Resonance Imaging (MRI) findings in Coronavirus disease 2019 (COVID-19) patients with concurrent posterior reversible encephalopathy syndrome (PRES). Purpose We aim to compile and analyze brain MRI findings in patients with COVID-19 disease and PRES. Methods PubMed and Embase were searched on April 5th, 2021 using the terms “COVID-19”, “PRES”, “SARS-CoV-2” for peer-reviewed publications describing brain MRI findings in patients 21 years of age or older with evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and PRES. Results Twenty manuscripts were included in the analysis, which included descriptions of 30 patients. The average age was 57 years old. Twenty-four patients (80%) required mechanical ventilation. On brain MRI examinations, 15 (50%) and 7 (23%) of patients exhibited superimposed foci of hemorrhage and restricted diffusion respectively. Conclusions PRES is a potential neurological complication of COVID-19 related disease. COVID-19 patients with PRES may exhibit similar to mildly greater rates of superimposed hemorrhage compared to non-COVID-19 PRES patients.

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“…We are in a worldwide SARS‐CoV‐2 pandemic, COVID‐19 infection could be complicated by many neurological symptoms and disorders: Guillain‐Barre syndrome, encephalopathy, cerebrovascular diseases, meningitis, neuralgia, ataxia, or epileptic crisis 7,8 . In the literature, there are also reports of patients with ADEM associated with confirmed COVID‐19 disease 9–17 …”

Section: Figurementioning

confidence: 99%

Acute disseminated encephalomyelitis in a patient vaccinated against SARS‐CoV‐2

Kania

Ambrosius

Kupczyk

et al. 2021

Ann Clin Transl Neurol

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Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease, and there are some data that link this event with various vaccinations. We report a young female admitted to the hospital with headache, fever, back pain, nausea, vomiting, and urinary retention. Two weeks prior, she received the first dose of SARS‐CoV‐2 mRNA vaccine. Brain and spinal cord magnetic resonance imaging (MRI) showed distinctive for ADEM widespread demyelinating lesions. The patient was successfully treated with methylprednisolone.

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Acute hemorrhagic leukoencephalitis in a COVID-19 patient—a case report with literature review

Cited by 44 publications

References 32 publications

COVID-19 and neuroinflammation: a literature review of relevant neuroimaging and CSF markers in central nervous system inflammatory disorders from SARS-COV2

COVID-19 and neuroinflammation: a literature review of relevant neuroimaging and CSF markers in central nervous system inflammatory disorders from SARS-COV2

Brain MRI findings in COVID-19 patients with PRES: A systematic review

Acute disseminated encephalomyelitis in a patient vaccinated against SARS‐CoV‐2

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