Predictors of Acute Encephalopathy in Patients with COVID-19

Abstract

Introduction: The majority of patients with severe COVID-19 suffer from delirium as the main sign of encephalopathy associated with this viral infection. The aim of this study was to identify early markers of the development of this condition. Materials: The prospective cohort-based study included patients with community-acquired pneumonia and confirmed pulmonary tissue infiltration based on CT data, with a lesion consisting of at least 25% of one lung. The main group included patients who have developed acute encephalopathy (10 patients, 3 (30%) women; average age, 47.9 ± 7.3 years). The control group included patients who at discharge did not have acute encephalopathy (20 patients, 11 (55%) women; average age, 51.0 ± 10.5 years). The study collected clinical examination data, comprehensive laboratory data, neurophysiological data, pulse oximetry and CT data to identify the predictors of acute encephalopathy (study ClinicalTrials.gov identifier NCT04405544). Results: Data analysis showed a significant relationship between encephalopathy with the degree of lung tissue damage, arterial hypertension, and type 2 diabetes mellitus, as well as with D-dimer, LDH, and lymphopenia. Conclusions: The development of encephalopathy is secondary to the severity of the patient’s condition since a more severe course of the coronavirus infection leads to hypoxic brain damage.

Analysis of Severe COVID-19 among Children in Foshan, China

“…Consistent with our study, previous analyses have shown that elevated D-dimer and LDH levels are associated with encephalopathy and lung tissue injury, serving as potential early warning indicators for severe neurological changes [12]. Our study also found that IL-6 levels signi cantly increased in patients with severe neurological impairment, consistent with the cytokine storm hypothesis [13], suggesting that using anti-in ammatory therapy to inhibit the cytokine storm may have a certain effect.…”

SARS-CoV-2 Spike Protein Intensifies Cerebrovascular Complications in Diabetic hACE2 Mice through RAAS and TLR Signaling Activation

“…Aggressive neurological manifestations can predict COVID-19 severity. For example, acute encephalopathy has been linked with severe cases of COVID-19, which was attributed to COVID-19-induced hypoxic brain damage [9]. Another predictor of COVID-19 outcomes was also attributed to the presence of other cardiovascular comorbidities, such as hypertension and diabetes [18][19][20][21][22].…”

“…The diabetic population also suffers a higher rate of intensive care unit (ICU) admission and mechanical ventilation [7]. SARS-CoV-2 has been shown to cause severe inflammation in various organs, such as the lungs, kidneys, and brain, of diabetic patients [8][9][10][11]. Moreover, Mechi et al reported that diabetic COVID-19 survivors experienced a greater frequency of fatigue and disruptions in concentration and memory, yet the molecular mechanisms are unclear [12].…”