Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy.
Infectious Diseases Unit, AOSP and AUSL Bologna, Bologna, Italy.
J Neuroimmunol. 2020 Dec 15;349:577400. doi: 10.1016/j.jneuroim.2020.577400. Epub 2020 Sep 24.
Encephalopathy is emerging as a recurrent complication of COVID-19 yet remains poorly characterized. We report the case of a middle-aged woman with COVID-19-related encephalopathy presenting as expressive aphasia and inattentiveness, subsequently progressing to agitation and marked confusion. Brain MRI and CSF analysis were unremarkable, while EEG showed slowing with frontal sharp waves. Neuropsychiatric symptoms resolved following treatment with tocilizumab. CNS involvement in COVID-19 may present as a subacute encephalopathy characterized by prominent frontal lobe dysfunction, with language disturbances as first neurological manifestation. Future studies should further investigate the role of tocilizumab in treating COVID-19-related encephalopathy.
脑病正成为 COVID-19 的一种反复出现的并发症，但仍未得到充分描述。我们报告了一例与 COVID-19 相关的脑病的中年女性病例，表现为表达性失语和注意力不集中，随后进展为激越和明显的混乱。脑 MRI 和 CSF 分析无明显异常，而 EEG 显示额叶尖波减慢。神经精神症状在使用托珠单抗治疗后得到缓解。COVID-19 对中枢神经系统的影响可能表现为亚急性脑病，以明显的额叶功能障碍为特征，以语言障碍为首发神经表现。未来的研究应进一步探讨托珠单抗在治疗 COVID-19 相关脑病中的作用。
