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Clinical report
DOI: 10.1016/j.medcle.2021.07.001
Encephalitis as a neurological manifestation of COVID-19
Encefalitis como manifestación neurológica del COVID-19
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Herminia Lozano Gómez
Corresponding author
fiex_hermi1990@hotmail.com

Corresponding author.
, Ana Pascual Bielsa, Paula Abansés Moreno, María Pilar Luque Gómez, Almudena Matute Guerrero, Juan José Araiz Burdio
Servicio de Medicina Intensiva, Hospital Clínico Universitario Lozano Blesa, Zargoza, Spain
Received 01 March 2021. Accepted 04 March 2021
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Abstract
Introduction

In the context of the global COVID-19 pandemic, the different clinical manifestations of this infection pose a challenge for healthcare professionals. Respiratory involvement, the main symptom of SARS-CoV-2 infection, means that other manifestations, such as neurological, take a back seat, with the consequent delay in diagnosis and treatment.

Material and methods

All COVID-19 patients admitted with neurological symptoms or diagnosed with encephalitis since March 2020 in a tertiary hospital in Zaragoza, Spain.

Results

Two patients with COVID-19 infection confirmed by nasopharyngeal PCR and whose clinical picture consisted of neurological alterations compatible with encephalitis. Cerebrospinal fluid (CSF) microbiology was negative for bacteria and viruses, including SARS-CoV-2 but, given the clinical suspicion of encephalitis due to the latter, antiviral treatment with immunoglobulins and plasmapheresis was started early. Despite this, the evolution was not satisfactory.

Conclusions

COVID-19 encephalitis is a recently described clinical entity, whose pathophysiology is still unknown and no treatment with clinical evidence is available to date.

Keywords:
Encephalitis
SARS-CoV-2
COVID-19
Neurology
Neurological manifestations
Resumen
Introducción

En el contexto de la pandemia mundial por COVID-19, las distintas manifestaciones clínicas de esta infección suponen un reto para los profesionales sanitarios. La afectación respiratoria, síntoma principal de la infección por SARS-CoV-2, hace que otras manifestaciones, como las neurológicas, pasen a un segundo plano, con el consecuente retraso en el diagnóstico y tratamiento.

Material y métodos

Todo paciente COVID-19 que ha ingresado con sintomatología neurológica o diagnosticado de encefalitis desde Marzo de 2020 en un hospital de tercer nivel en Zaragoza, España.

Resultados

Dos pacientes con infección COVID-19 confirmada por PCR nasofaríngea y cuyo cuadro clínico consistía en alteraciones neurológicas compatibles con encefalitis. La microbiología del líquido cefalorraquídeo (LCR) fue negativa para bacterias y virus, incluido el SARS-CoV-2 pero, ante la sospecha clínica de encefalitis por este último, se instauró tratamiento antiviral, con inmunoglobulinas y plasmaféresis de forma precoz. A pesar de ello la evolución no fue satisfactoria.

Conclusiones

La encefalitis por COVID-19 es una entidad clínica descrita recientemente, cuya fisiopatología aún se desconoce y no se dispone, hasta la fecha, de un tratamiento con evidencia clínica.

Palabras clave:
Encefalitis
SARS-CoV-2
COVID-19
Neurología
Manifestaciones neurológicas

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