From the Departments of Intensive Care (W.F.A., J.G.v.d.H.), Neurology (C.I.B., A.M.T.), and Radiology (F.J.A.M.), Radboud University Medical Center, Nijmegen; Departments of Intensive Care (B.P.G.), Neurology (A.A.A.C.M.W.), and Radiology (O.V.), Ziekenhuisgroep Twente, Almelo; Department of Intensive Care (M.P.B.), Catharina Hospital, Eindhoven; Department of Intensive Care (M.B.), Streekziekenhuis Winterswijk; and Department of Intensive Care (M.v.d.K.), Bernhoven Hospital, Uden, the Netherlands
From the Departments of Intensive Care (W.F.A., J.G.v.d.H.), Neurology (C.I.B., A.M.T.), and Radiology (F.J.A.M.), Radboud University Medical Center, Nijmegen; Departments of Intensive Care (B.P.G.), Neurology (A.A.A.C.M.W.), and Radiology (O.V.), Ziekenhuisgroep Twente, Almelo; Department of Intensive Care (M.P.B.), Catharina Hospital, Eindhoven; Department of Intensive Care (M.B.), Streekziekenhuis Winterswijk; and Department of Intensive Care (M.v.d.K.), Bernhoven Hospital, Uden, the Netherlands.
Neurology. 2021 Mar 9;96(10):e1437-e1442. doi: 10.1212/WNL.0000000000011355. Epub 2020 Dec 21.
We report a case series of patients with prolonged but reversible unconsciousness after coronavirus disease 2019 (COVID-19)-related severe respiratory failure.
A case series of patients who were admitted to the intensive care unit due to COVID-19-related acute respiratory failure is described.
After cessation of sedatives, the described cases all showed a prolonged comatose state. Diagnostic neurologic workup did not show signs of devastating brain injury. The clinical pattern of awakening started with early eye opening without obeying commands and persistent flaccid weakness in all cases. Time between cessation of sedatives to the first moment of being fully responsive with obeying commands ranged from 8 to 31 days.
Prolonged unconsciousness in patients with severe respiratory failure due to COVID-19 can be fully reversible, warranting a cautious approach for prognostication based on a prolonged state of unconsciousness.
我们报告了一系列 COVID-19 相关严重呼吸衰竭后长时间但可恢复的无意识患者的病例系列。
描述了因 COVID-19 相关急性呼吸衰竭而入住重症监护病房的患者的病例系列。
停止镇静剂后，所描述的病例均表现出长时间昏迷状态。诊断性神经学检查未显示出毁灭性脑损伤的迹象。觉醒的临床模式始于早期睁眼但不服从指令，所有病例均持续出现弛缓性无力。从停止镇静剂到完全反应并服从指令的第一个时刻之间的时间范围为 8 至 31 天。
由于 COVID-19 导致严重呼吸衰竭的患者的无意识状态可能是完全可逆的，因此需要根据长时间无意识状态谨慎预测预后。
