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A case of successive development of possible acute necrotizing encephalopathy after COVID-19 pneumonia

COVID-19 infection often results in an excessive inflammatory response with a spectrum of neurological manifestations. Here, we describe an 81-year-old female with severe COVID-19 pneumonia and subsequent alteration of consciousness after high-dose intravenous dexamethasone and remdesivir. A non-con...

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Detalles Bibliográficos
Autores principales: Hemachudha, Pasin, Pongpitakmetha, Thanakit, Rattanawong, Wanakorn, Thanapornsungsuth, Poosanu, Joyjinda, Yutthana, Bunprakob, Saowalak, Ruchisrisarod, Chanida, Hemachudha, Thiravat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8928348/
https://www.ncbi.nlm.nih.gov/pubmed/35308052
http://dx.doi.org/10.1177/2050313X221083653
Descripción
Sumario:COVID-19 infection often results in an excessive inflammatory response with a spectrum of neurological manifestations. Here, we describe an 81-year-old female with severe COVID-19 pneumonia and subsequent alteration of consciousness after high-dose intravenous dexamethasone and remdesivir. A non-contrast head computed tomography (CT) demonstrated bilateral hypodensities involving bilateral cerebellar hemispheres, thalami, cerebral peduncles and medial parieto-occipital areas. There was no improvement and repeat CT showed progression with findings suggestive of acute necrotizing encephalopathy. Interleukin-6 levels were initially normal; however, subsequent levels were found to be markedly elevated. Acute necrotizing encephalopathy associated with COVID-19 may occur in the setting of severe pneumonia and may represent an immune-mediated process involving inflammatory cytokines such as interleukin-6.