Posterior reversible encephalopathy syndrome in <scp>SARS‐CoV</scp>‐2 infection: A case report and review of literature

Ziaee, Mahsa; Saeedi, Maryam; Rohani, Mohammad; Mehrpour, Masoud; Ashtiani, Bahram Haghi; Zamani, Babak; Akhoundi, Fahimeh Haji; Khalaf, Misagh Salahi; Mirmoeeni, Seyyedmohammadsadeq; Jafari, Amirhossein Azari; Shateri, Zahra

doi:10.1002/ccr3.7173

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…[ 18 ] The binding of SARS-CoV-2 to ACE2 receptors can also stimulate the release of cytokines (ICAM-1, VCAM-1, and MCP-1) and proinflammatory molecules (IL-6, IL-8, and PAI-1), which can lead to cytokine release syndrome and damage the vascular endothelium. [ 19 – 21 ] Finally, some patients with COVID-19-associated PRES have utilized medications, such as tocilizumab and hydroxychloroquine, [ 22 , 23 ] which have been reported to induce PRES. [ 24 , 25 ] More patients with COVID-19 have received steroid therapy, and although controversial, steroids have been suggested to be associated with the development of PRES.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 may play a direct role in the pathogenesis of posterior reversible encephalopathy syndrome (PRES) associated with COVID-19: A CARE-compliant case report and literature review

Wang,

Huang

et al. 2024

Medicine

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Rationale: During the past 3 years of the corona virus disease 2019 (COVID-19) pandemic, COVID-19 has been recognized to cause various neurological complications, including rare posterior reversible encephalopathy syndrome (PRES). In previously reported cases of PRES associated with COVID-19, the majority of patients had severe COVID-19 infection and known predisposing factors for PRES, such as uncontrolled hypertension, renal dysfunction, and use of immunosuppressants. It remains unclear whether these risk factors or infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) contributes to the development of PRES in these patients. Here we report a special case of PRES associated with COVID-19 without any known risk factors for PRES, indicating the SARS-CoV-2’s direct role in the pathogenesis of PRES associated with COVID-19. Patient concerns: An 18-year-old female patient presented to the emergency department with abdominal pain. Preliminary investigations showed no abnormalities, except for positive results in novel coronavirus nucleic acid tests using oropharyngeal swabs. However, the patient subsequently developed tonic–clonic seizures, headaches, and vomiting on the second day. Extensive investigations have been performed, including brain MRI and lumbar puncture. Brain MRI showed hypointense T1-weighted and hyperintense T2-weighted lesions in the bilateral occipital, frontal, and parietal cortices without enhancement effect. Blood and cerebrospinal fluid analyses yielded negative results. The patient had no hypertension, renal insufficiency, autoimmune disease, or the use of immunosuppressants or cytotoxic drugs. Diagnoses: PRES was diagnosed based on the clinical features and typical MRI findings of PRES. Interventions: Symptomatic treatments such as anticonvulsants were administered to the patients. Outcomes: The patient fully recovered within 1 week. The initial MRI abnormalities also disappeared completely on a second MR examination performed 11 days later, supporting the diagnosis of PRES. The patient was followed up for 6 months and remained in a normal state. Lessons: The current case had no classical risk factors for PRES, indicating that although the cause of PRES in COVID-19 patients may be multifactorial, the infection of SARS-CoV-2 may play a direct role in the pathogenesis of PRES associated with COVID-19.

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Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 may play a direct role in the pathogenesis of posterior reversible encephalopathy syndrome (PRES) associated with COVID-19: A CARE-compliant case report and literature review

Wang,

Huang

et al. 2024

Medicine

View full text Add to dashboard Cite

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Ciclosporin

2023

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Posterior reversible encephalopathy syndrome in SARS‐CoV‐2 infection: A case report and review of literature

Abstract: Consider PRES in SARS‐CoV‐2 infected patients who develop encephalopathy, seizures or impaired vision; especially if the disease is complicated by respiratory distress and need for mechanical ventilation.

Cited by 2 publications

References 29 publications

SARS-CoV-2 may play a direct role in the pathogenesis of posterior reversible encephalopathy syndrome (PRES) associated with COVID-19: A CARE-compliant case report and literature review

SARS-CoV-2 may play a direct role in the pathogenesis of posterior reversible encephalopathy syndrome (PRES) associated with COVID-19: A CARE-compliant case report and literature review

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