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Posterior reversible encephalopathy syndrome in patients with COVID-19.

TitlePosterior reversible encephalopathy syndrome in patients with COVID-19.
Publication TypeJournal Article
Year of Publication2020
AuthorsParauda SC, Gao V, Gewirtz AN, Parikh NS, Merkler AE, Lantos J, White H, Leifer D, Navi BB, Segal AZ
JournalJ Neurol Sci
Volume416
Pagination117019
Date Published2020 Jul 09
ISSN1878-5883
Abstract

OBJECTIVE: To report four patients with coronavirus disease 2019 (COVID-19) who developed posterior reversible encephalopathy syndrome (PRES).

METHODS: Patient data was abstracted from medical records at Weill Cornell Medical Center.

RESULTS: Four patients with SARS-CoV-2 infection and PRES were identified. The patients' ages ranged from 64 to 74 years, and two were women. All four patients were admitted to the hospital with acute respiratory distress syndrome requiring intensive care unit admission and mechanical ventilation. PRES was diagnosed after persistent confusion, lethargy, new focal neurological deficits, or seizures were noted, with evidence of seizures on electroencephalogram for two of the patients. Imaging confirmed the presence of cerebral vasogenic edema. All four patients had elevated blood pressure and renal injury in the days preceding PRES diagnosis, as well as evidence of systemic inflammation and systemic hypercoagulability. Symptoms of PRES improved with blood pressure control.

CONCLUSIONS: Our four cases demonstrate the occurrence of PRES in critically-ill patients with COVID-19. PRES should be considered in the differential for acute neurological deficits and seizures in this setting.

DOI10.1016/j.jns.2020.117019
Alternate JournalJ. Neurol. Sci.
PubMed ID32679347
PubMed Central IDPMC7347314

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