Posterior reversible encephalopathy syndrome on COVID-19

Suwanto, Sidharta; Ferriastuti, Widiana

doi:10.1016/j.radcr.2022.06.081

Cited by 5 publications

(5 citation statements)

References 7 publications

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“…Similar to our case, Al Haboob [27] and Suwanto and Ferrriastuti [28] also reported pediatric cases of PRES associated with COVID-19 that had no evidence of hypertension or any risk factors for PRES. All these cases had no significant involvement of systems other than the central nervous system during SARS-CoV-2 infection.…”

Section: Discussionsupporting

confidence: 87%

“…[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. [26] Similar to our case, Al Haboob [27] and Suwanto and Ferrriastuti [28] also reported pediatric cases of PRES associated with COVID-19 that had no evidence of hypertension or any risk factors for PRES. All these cases had no significant involvement of systems other than the central nervous system during SARS-CoV-2 infection.…”

Section: Discussionsupporting

confidence: 85%

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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: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 85%

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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“…Hemorrhage Antivirals, anakinra ASMs Good outcome 43 a 52 Female 34 CKD, HIV 180 Alterations of consciousness, seizures Asymmetric, F-P-O lesions. hemorrhage None None Good outcome Sharma et al 2022 [ 47 ] 44 a 52 Female 7 N/A 145 Visual disturbances F-P-O lesions Corticosteroids, antivirals None Good outcome Boschetti et al 2020 [ 48 ] 45 a 46 Male 22 HTN, DM, obesity 130 Focal signs, alterations of consciousness F-O lesions None None Focal neurological symptoms Suwanto et al 2022 [ 49 ] 46 7 Female N None N/A Visual disturbances O lesions None None Good outcome Ioan et al 2022 [ 50 ] 47 a 38 Male 10 Liver disease 130 ...…”

Section: Resultsmentioning

confidence: 99%

“…Hemorrhage Corticosteroids None Death Noro et al 2020 [ 65 ] 65 67 Female 1 HTN 150 Seizures P-O lesions None None Death Chavez et al 2021 [ 66 ] 66 a 61 Female 26 HTN 140 Alterations of consciousness, seizures P-O lesions. Hemorrhage Corticosteroids None Good outcome Suwanto et al 2022 [ 49 ] 67 7 Female 10 None N/A Visual disturbances, seizures Asymmetric, T-P-O lesions None None Focal neurological symptoms Martins et al [ 67 ] 68 a 63 Female 41 HTN N/A Seizures Asymmetric, T-P-O lesions. hemorrhage antibiotici None Good outcome Shankar et al 2021 [ 68 ] 69 a 34 Female N/A N/A 210 …”

Section: Resultsmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome and reversible cerebral vasoconstriction syndrome in patients with COVID-19 infection: is there a link? A systematic review and case report analysis

et al. 2023

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During the SARS-CoV2 pandemic, several cases of Posterior Reversible Encephalopathy Syndrome (PRES) and of Reversible Cerebral Vasoconstriction Syndrome (RCVS) in COVID-19 patients have been reported, but the link between these syndromes and COVID-19 is unclear. We performed a systematic review, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to evaluate whether SARS-CoV2 infection or the drugs used to treat it could be deemed potential risk factors for PRES or RCVS. We performed a literature search. We found 70 articles (60 on PRES and 10 on RCVS) concerning n = 105 patients (n = 85 with PRES, n = 20 with RCVS). We analyzed the clinical characteristics of the two populations separately, then performed an inferential analysis to search for other independent risk factors. We found fewer than usual PRES-related (43.9%) and RCVS-related (45%) risk factors in patients with COVID-19. Such a low incidence of risk factors for PRES and RCVS might suggest the involvement of COVID-19 as an additional risk factor for both diseases due to its capability to cause endothelial dysfunction. We discuss the putative mechanisms of endothelial damage by SARS-CoV2 and antiviral drugs which may underlie the development of PRES and RCVS.

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“…Reports in children are rare. [114][115][116][117] A 9year-old boy with PRES in the setting of COVID-19 infection also uniquely had subsequent MIS-C, which was postulated to result from cerebral neuroinflammation causing endothelial dysfunction. 118 The pathophysiology of PRES in patients with COVID-19 is likely multifactorial.…”

Section: Posterior Reversible Leukoencephalopathymentioning

confidence: 99%

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

Dinkin

Sathi

2023

Semin Neurol

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We set out to describe in detail the afferent neuro-ophthalmological complications that have been reported in association with coronavirus disease 2019 (COVID-19) infection. We describe and elaborate on mechanisms of disease, including para-infectious inflammation, hypercoagulability, endothelial damage, and direct neurotropic viral invasion. Despite global vaccination programs, new variants of COVID-19 continue to pose an international threat, and patients with rare neuro-ophthalmic complications are likely to continue to present for care.Afferent complications from COVID-19 include homonymous visual field loss, with or without higher cortical visual syndromes, resulting from stroke, intracerebral hemorrhage, or posterior reversible leukoencephalopathy. Optic neuritis has frequently been reported, sometimes along with acute disseminated encephalomyelopathy, often in association with either myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) or less commonly aquaporin-4 seropositivity or in newly diagnosed multiple sclerosis. Ischemic optic neuropathy has rarely been reported. Papilledema, resulting either from venous sinus thrombosis or idiopathic intracranial hypertension in the setting of COVID-19, has also been described.Observed afferent neuro-ophthalmic associations need to be confirmed though larger comparative studies. Meanwhile, the range of possible complications should be recognized by neurologists and ophthalmologists alike, to facilitate faster diagnosis and treatment of both COVID-19 and its neuro-ophthalmic manifestations.

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Posterior reversible encephalopathy syndrome on COVID-19

Cited by 5 publications

References 7 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

Posterior reversible encephalopathy syndrome and reversible cerebral vasoconstriction syndrome in patients with COVID-19 infection: is there a link? A systematic review and case report analysis

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

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