Association of Clinical, Biological, and Brain Magnetic Resonance Imaging Findings With Electroencephalographic Findings for Patients With COVID-19

Abstract

Key Points Question Can electroencephalography (EEG), combined with clinical, biological, and magnetic resonance imaging (MRI) analyses, help to better characterize patients with neurologic coronavirus disease 2019 (COVID-19) and diagnose specific COVID-19–related encephalopathy? Findings Neurologic manifestations, biological findings, EEG findings, and brain MRI images were analyzed in a cohort study of 78 adult patients with COVID-19. Nine patients had no identified cause of brain injury, as revealed by biological and MRI findings; their injury was defined as COVID-19–related encephalopathy. Meaning This study suggests that, although neurologic manifestations, EEG findings, and MRI findings may appear heterogeneous and nonspecific, multimodal monitoring may better identify patients with COVID-19–related encephalopathy and guide treatment strategy.

Dynamic Changes in Central and Peripheral Neuro-Injury vs. Neuroprotective Serum Markers in COVID-19 Are Modulated by Different Types of Anti-Viral Treatments but Do Not Affect the Incidence of Late and Early Strokes

“…Our data concur with prior observations regarding stroke being commonplace in patients with COVID-19 [ 7 ]. What is surprising is the late incidence of strokes.…”

“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been linked to abnormalities in the central nervous system such as the loss of smell and taste, cognitive decline, delirium, cerebrovascular accidents, neuronal autoimmune illnesses, and psychiatric disorders [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. However, the heterogeneity of symptoms remains puzzling [ 1 , 3 , 7 , 8 , 9 , 10 ]. The development of these abnormalities often occurs within two days from the onset of symptoms [ 1 , 5 , 7 , 11 , 12 ].…”

“…However, the heterogeneity of symptoms remains puzzling [ 1 , 3 , 7 , 8 , 9 , 10 ]. The development of these abnormalities often occurs within two days from the onset of symptoms [ 1 , 5 , 7 , 11 , 12 ]. In addition, an increasing number of survivors suffer from long-term neurological sequela [ 13 , 14 , 15 , 16 ].…”

“…Coronaviruses contribute to the emergence of neuropathologies via several mechanisms: direct neurotoxic effects to homogenous and retrosynaptic transport, localized neuroinflammation, blood–brain barrier (BBB) dysfunction, and secondary nervous tissue damage in response to generalized inflammation and hypoxia [ 7 , 8 , 17 , 18 , 19 , 20 ]. Moreover, SARS-CoV-2 co-localizes with the phosphorylated tau (τ) protein, triggering neuronal death or interfering with the distribution of τ [ 21 ].…”

COVID 19-Seizing the Host, an Unusual Presentation

“…Although seizure was included in clinical manifestation of neurological symptoms none was reported [5]. According to a case series published by Lambrecq V, et al 0.8% of the COVID-19 positive patients, who were admitted due to severe illness had seizures as their manifesting presentation [6].…”