Ameer Muhammad Atif, Chaudhry Haroon, Babar Maham, Patel Nimi, Song Monata, Mathew Mathew
Department of Medicine, Punjab Rangers Teaching Hospital, Lahore, PAK.
Internal Medicine, Suburban Community Hospital, East Norriton, USA.
Cureus. 2023 Jan 1;15(1):e33233. doi: 10.7759/cureus.33233. eCollection 2023 Jan.
The coronavirus disease 2019 (COVID-19) virus primarily affects the pulmonary system, but neurological manifestations and complication of COVID-19 has been reported in abundance in the literature. We present a case of a middle-aged Caucasian male who was brought to the emergency department for altered mental status. His chief complaints were neurological rather than respiratory. A positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction (RT-PCR) nasal swab confirmed the diagnosis. Brain imaging showed mildly dilated ventricles with no other acute findings. As the patient did not require oxygen, he was treated with remdesivir alone without corticosteroids, which is also a precipitating factor of psychosis but, unfortunately, thickly used in practice. That led to remarkable results in full recovery without exposing the patient to steroid therapy. We strongly believe that remdesivir alone is sufficient in treating COVID-19-induced encephalopathy in a patient who does not require oxygen, and evidence supports this practice.
2019冠状病毒病（COVID-19）病毒主要影响肺部系统，但COVID-19的神经学表现和并发症在文献中已有大量报道。我们报告一例中年白种男性病例，该患者因精神状态改变被送至急诊科。他的主要症状是神经方面的而非呼吸方面的。严重急性呼吸综合征冠状病毒2（SARS-CoV-2）逆转录聚合酶链反应（RT-PCR）鼻拭子检测呈阳性，确诊了该病例。脑部影像学检查显示脑室轻度扩张，无其他急性病变。由于该患者不需要吸氧，因此仅使用瑞德西韦进行治疗，未使用皮质类固醇，而皮质类固醇也是导致精神病的一个诱发因素，但遗憾的是在实际应用中却大量使用。这使得患者在未接受类固醇治疗的情况下完全康复，取得了显著效果。我们坚信，对于不需要吸氧的患者，单独使用瑞德西韦足以治疗COVID-19诱发的脑病，并且有证据支持这种做法。
