Khan Zohaib, Singh Sukhdev, Foster Allison, Mazo Jahinover, Graciano-Mireles Gira, Kikkeri Vinaya
College of Medicine, American University of Antigua, New York, USA.
Department of Radiology, Richmond University Medical Center, Staten Island, NY, USA.
SAGE Open Med Case Rep. 2020 Nov 27;8:2050313X20977032. doi: 10.1177/2050313X20977032. eCollection 2020.
First reported in Wuhan, China, Novel Coronavirus Disease-19 rapidly spread causing an outbreak of viral pneumonia and became a pandemic in early 2020. It was later discovered to be caused by Severe Acute Respiratory Syndrome Coronavirus 2, a novel coronavirus. Although the vast majority of cases have primarily involved the respiratory system, some serious cases have started to emerge with central and peripheral nervous system complications. We present the case of a 30-year-old morbidly obese male who initially presented to the emergency department with seizures, altered mental status, and COVID-19 pneumonia. After a 21-day hospital course including 14 days of intensive care unit management, he was stabilized and discharged to a rehabilitation facility. He returned 1 day later with worsening respiratory distress and was found to have acute pulmonary embolism requiring placement of an inferior vena cava filter. After an additional 6 days in the hospital, he was discharged back to the outpatient facility. He returned for a third time with altered mental status, visual and auditory hallucinations, and confabulation. This report provides critical information in revealing a peculiar neurological sequela of COVID-19 induced leukoencephalopathy and its disease course. We hope to shed light on this sequence of events by providing possible mechanisms to aid clinicians in the identification and management of this complication.
新型冠状病毒肺炎于2019年首次在中国武汉被报道,随后迅速传播,引发病毒性肺炎疫情,并在2020年初成为大流行病。后来发现它是由一种新型冠状病毒——严重急性呼吸综合征冠状病毒2引起的。虽然绝大多数病例主要累及呼吸系统,但一些重症病例开始出现中枢和周围神经系统并发症。我们报告了一例30岁的病态肥胖男性病例,该患者最初因癫痫发作、精神状态改变和新冠肺炎肺炎被送往急诊科。经过为期21天的住院治疗,包括14天的重症监护病房管理,他病情稳定,出院后转至康复机构。一天后,他因呼吸窘迫加重返回医院,被发现患有急性肺栓塞,需要放置下腔静脉滤器。在医院又住了6天后,他出院回到门诊机构。他第三次返回时出现精神状态改变、视幻觉和听幻觉以及虚构症。本报告提供了关键信息,揭示了新冠肺炎诱发的白质脑病的一种特殊神经后遗症及其病程。我们希望通过提供可能的机制来阐明这一系列事件,以帮助临床医生识别和处理这种并发症。