Clinical, cerebrospinal fluid, and neuroimaging findings in COVID-19 encephalopathy: a case series

• DOI: 10.1007/s10072-020-04946-w
• Publication Date: 2021-01-07T04:35:59Z
• Authors: Raphael L. Tuma; Bruno F. Guedes; Rafael Carra; Bruno Iepsen; Júlia Rodrigues; Antonio Edvan Cam...; Gabriel Kubota; Maíra Ferrari; Adalberto Studart...; Mariana Hiromi Oku; Sara Terrim; Cesar C. B. Lopes; Carlos E. B. Pass...; Matheus D. Fioren...; Julia C. C. Souza; José Pedro S. Baima; Tomás Silva; Iago Perissinotti; Maria da Graça M....; Marcia Gonçalves; Ida Fortini; Jerusa Smid; Tarso Adoni; Leandro Lucato; Ricardo Nitrini; Hélio Gomes; Luiz H. Castro
• Keywords: Neuroradiology

To describe the clinical, neurological, neuroimaging, and cerebrospinal fluid (CSF) findings associated with encephalopathy in patients admitted to a COVID-19 tertiary reference center. We retrospectively reviewed records of consecutive evaluated by consulting neurology team from March 30, 2020 through May 15, 2020. Fifty-five confirmed SARS-CoV-2 were included, 43 whom showed encephalopathy, further divided into mild, moderate, severe groups. Nineteen (44%) had undergone mechanical ventilation received intravenous sedatives. Eleven (26%) on dialysis. Laboratory markers severity very common patients, but did not correlate encephalopathy. Thirty-nine underwent neuroimaging studies, which mostly non-specific changes. One patient lesions possibly related CNS demyelination. Four suffered an acute stroke. was detected RT-PCR only one 21 CSF samples. Two samples elevated white blood cell count all negative for oligoclonal bands. In our case series, correlated higher probability death during hospitalization (OR = 5.5 each increment degree absent (0) mild (1), moderate (2), or (3), p < 0.001). series cases, analysis support role direct viral invasion inflammation as cause