1887
Volume 2023, Issue 4
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Critical illness-associated cerebral microbleeds and leukoencephalopathy connected to coronavirus disease 2019 (COVID-19) infection are emerging areas of concern in current medical literature.

Methods: We reviewed cases of patients with COVID-19-associated neurological manifestations to study the prevalence and outcome of such conditions.

Case Series Findings: Our review yielded seven distinct patients. Six exhibited cerebral microbleeds, primarily localized in the juxtacortical white matter and the corpus callosum. In contrast, one individual presented with leukoencephalopathy. Tragically, of these patients, five succumbed to their ailments. One was discharged with mild cognitive impairments, while another underwent a tracheostomy and was subsequently moved to a long-term care establishment.

Conclusion: Our findings underscore the significance of neuro-radiological observations in those grappling with severe manifestations of COVID-19, drawing attention to the possible neurological repercussions of the virus.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2023.29
2023-10-10
2024-07-24
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2023/4/qmj.2023.29.html?itemId=/content/journals/10.5339/qmj.2023.29&mimeType=html&fmt=ahah

References

  1. Khatib MY, Peediyakkal MZ, Elshafei MS, Elzeer HS, Ananthegowda DC, Shahen MA, et al.. Comparison of the clinical outcomes of non- invasive ventilation by helmet vs. facemask in patients with acute respiratory distress syndrome. Medicine. 2021; 100:4:e24443.doi: [Crossref].
    https://doi.org/10.1097/MD.0000000000024443 [Google Scholar]
  2. Lai C-C, Shih T, Ko W, Tang H, Hsueh P. Severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020; 55:3:105924.doi: [Crossref].
    https://doi.org/10.1016/j.ijantimicag.2020.105924 [Google Scholar]
  3. Chemaitelly H, Ayoub HH, Faust JS, Coyle P, Tang P, Hasan M, et al.. A turning point in COVID-19 severity and fatality during the pandemic: A national cohort study in Qatar. medRxiv [preprint]. 2023doi: [Crossref].
    https://doi.org/10.1101/2023.05.28.23290641 [Google Scholar]
  4. Haider A, Siddiqa A, Ali N, Dhallu M. COVID-19 and the brain: Acute encephalitis as a clinical manifestation. Cureus. 2020Oct; 12:10:e10784.doi: [Crossref].
    https://doi.org/10.7759/cureus.10784 [Google Scholar]
  5. Khurshid A, Khurshid M, Sohail A, Raza IM, Ahsan MK, Alam Shah MUF, et al.. Facial palsy as a manifestation of COVID-19: A systematic review of cases. Health Sci Rep. 2022; 5:6:e887.doi: [Crossref].
    https://doi.org/10.1002/hsr2.887 [Google Scholar]
  6. Niazkar HR, Zibaee B, Nasimi A, Bahri N. The neurological manifestations of COVID-19: A review article. Neurol Sci. 2020; 41:7:1667–71.doi: [Crossref].
    https://doi.org/10.1007/s10072-020-04486-3 [Google Scholar]
  7. Ahmed MU, Hanif M, Ali MJ, Haider MA, Kherani D, Memon GM, et al.. Neurological manifestations of COVID-19 (SARS-CoV-2): A review. Front Neurol. 2020May; 11::518.doi: [Crossref].
    https://doi.org/10.3389/fneur.2020.00518 [Google Scholar]
  8. Nepal G, Rehrig JH, Shrestha GS, Shing YK, Yadav JK, Ojha R, et al.. Neurological manifestations of COVID-19: A systematic review. Crit Care. 2020Jul; 24::421.doi: [Crossref].
    https://doi.org/10.1186/s13054-020-03121-z [Google Scholar]
  9. Varatharaj A, Thomas N, Ellul MA, Davies NWS, Pollak TA, Tenorio EL, et al.. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: A UK-wide surveillance study. Lancet Psychiatry. 2020Oct; 7:10:875–82.doi: [Crossref].
    https://doi.org/10.1016/S2215-0366(20)30287-X [Google Scholar]
  10. Ellul MA, Benjamin L, Singh BD, Lant S, Michael B, Easton A, et al.. Neurological associations of COVID-19. Lancet Neurol. 2020Sep; 19:9:767–83.doi: [Crossref].
    https://doi.org/10.1016/S1474-4422(20)30221-0 [Google Scholar]
  11. Fanou EM, Coutinho J, Shannon P, Kiehl TR, Levi MM, Wilcox ME, et al.. Critical illness–associated cerebral microbleeds. Stroke. 2017Apr; 48:4:1085–7.doi: [Crossref].
    https://doi.org/10.1161/STROKEAHA.116.016289 [Google Scholar]
  12. Meshref M, Hewila IM, Khlidj Y, Korissi R, Shaheen N, Nashwan AJ, et al.. COVID-19- associated cerebrovascular events: A case series study and a literature review of possible mechanisms. Case Rep Neurol. 2023Feb; 15:1:11–23.doi: [Crossref].
    https://doi.org/10.1159/000529122 [Google Scholar]
  13. Vattoth S, Abdelhady M, Alsoub H, Own A, Elsotouhy A. Critical illness-associated cerebral microbleeds in COVID-19. Neuroradiol J. 2020; 33:5:374–6.doi: [Crossref].
    https://doi.org/10.1177/1971400920939229 [Google Scholar]
  14. Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al.. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020; 87::18–22.doi: [Crossref].
    https://doi.org/10.1016/j.bbi.2020.03.031 [Google Scholar]
  15. Ippolito A, Urban H, Ghoroghi K, Rosbach N, Lingwal N, Adam EH, et al.. Prevalence of acute neurological complications and pathological neuroimaging findings in critically ill COVID-19 patients with and without VV-ECMO treatment. Sci Rep. 2022Oct; 12:1:17423.doi: [Crossref].
    https://doi.org/10.1038/s41598-022-21475-y [Google Scholar]
  16. Chin KS, Hijazi Z, Churilov L, Gajamange S, Desmond PM, Villemagne V, et al.. Cerebral microbleeds in dementia with Lewy bodies. Parkins Related Disord. 2022Nov; 104::68–71.doi: [Crossref].
    https://doi.org/10.1016/j.parkreldis.2022.10.009 [Google Scholar]
  17. Toeback J, Depoortere SD, Vermassen J, Vereecke EL, Van Driessche V, Hemelsoet DM. Microbleed patterns in critical illness and COVID-19. Clin Neurol Neurosurg. 2021Apr; 203::106594doi: [Crossref].
    https://doi.org/10.1016/j.clineuro.2021.106594 [Google Scholar]
  18. Venkatesan A, Tunkel AR, Bloch KC, Lauring AS, Sejvar J, Bitnun A, et al.. Case definitions, diagnostic algorithms, and priorities in encephalitis: Consensus statement of the international encephalitis consortium. Clin Infect Dis. 2013Oct; 57:8:1114–28.doi: [Crossref].
    https://doi.org/10.1093/cid/cit458 [Google Scholar]
  19. Lersy F, Willaume T, Brisset JC, Collange O, Helms J, Schneider F. Critical illness-associated cerebral microbleeds for patients with severe COVID-19: Etiologic hypotheses. J Neurol. 2021Aug; 268:8:2676–84.doi: [Crossref].
    https://doi.org/10.1007/s00415-020-10313-8 [Google Scholar]
  20. Cooper N, Morrison MA, Vladescu C, Hart ACJ, Paul D, Malik A, et al.. Identification of occult cerebral microbleeds in adults with immune thrombocytopenia. Blood. 2020; 136:25:2875–80.doi: [Crossref].
    https://doi.org/10.1182/blood.2020004858 [Google Scholar]
  21. Legriel S, Badenes R, Engrand N, Mendoza-Trujillo R, Soulier P, Benghanem S, et al.. Outcomes in patients with COVID-19 with acute encephalopathy and coma: An international prospective study. Neurology. 2023May30; 100:22:e2247–58.doi: [Crossref].
    https://doi.org/10.1212/WNL.0000000000207263 [Google Scholar]
  22. Dravid A, Kashiva R, Khan Z, Memon D, Kodre A, Potdar P, et al.. Combination therapy of Tocilizumab and steroid for management of COVID-19 associated cytokine release syndrome: A single center experience from Pune, Western India. Medicine. 2021; 100:29:e26705.doi: [Crossref].
    https://doi.org/10.1097/MD.0000000000026705 [Google Scholar]
  23. Muccioli L, Pensato U, Cani I, Guerra L, Provini F, Bordin G, et al.. COVID-19-related encephalopathy presenting with aphasia resolving following tocilizumab treatment. J Neuroimmunol. 2020; 349::577400.doi: [Crossref].
    https://doi.org/10.1016/j.jneuroim.2020.577400 [Google Scholar]
/content/journals/10.5339/qmj.2023.29
Loading
/content/journals/10.5339/qmj.2023.29
Loading

Data & Media loading...

  • Article Type: Case Report
Keyword(s): case seriesCOVID-19critical illness microbleedsencephalopathy and SARS-CoV-2
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error