Cargando…

Spectrum of Hemorrhagic Encephalitis in COVID-19 Patients: A Case Series and Review

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is an ongoing pandemic that has affected over 400 million people worldwide and caused nearly 6 million deaths. Hemorrhagic encephalitis is an uncommon but serious complication of COVID-19. The etiology of this disease is multifactorial, i...

Descripción completa

Detalles Bibliográficos
Autores principales: Sharma, Rohan, Nalleballe, Krishna, Shah, Vishank, Haldal, Shilpa, Spradley, Thomas, Hasan, Lana, Mylavarapu, Krishna, Vyas, Keyur, Kumar, Manoj, Onteddu, Sanjeeva, Gokden, Murat, Kapoor, Nidhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032293/
https://www.ncbi.nlm.nih.gov/pubmed/35453972
http://dx.doi.org/10.3390/diagnostics12040924
_version_ 1784692606641373184
author Sharma, Rohan
Nalleballe, Krishna
Shah, Vishank
Haldal, Shilpa
Spradley, Thomas
Hasan, Lana
Mylavarapu, Krishna
Vyas, Keyur
Kumar, Manoj
Onteddu, Sanjeeva
Gokden, Murat
Kapoor, Nidhi
author_facet Sharma, Rohan
Nalleballe, Krishna
Shah, Vishank
Haldal, Shilpa
Spradley, Thomas
Hasan, Lana
Mylavarapu, Krishna
Vyas, Keyur
Kumar, Manoj
Onteddu, Sanjeeva
Gokden, Murat
Kapoor, Nidhi
author_sort Sharma, Rohan
collection PubMed
description Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is an ongoing pandemic that has affected over 400 million people worldwide and caused nearly 6 million deaths. Hemorrhagic encephalitis is an uncommon but serious complication of COVID-19. The etiology of this disease is multifactorial, including secondary to severe hypoxemia, systemic inflammation, direct viral invasion, hypercoagulability, etc. The clinical spectrum of COVID-19-related hemorrhagic encephalitis is also varied, ranging from leukoencephalopathy with microhemorrhage, acute necrotizing hemorrhagic encephalitis (ANHE) involving the cortex, basal ganglia, rarely brain stem and cervical spine, hemorrhagic posterior reversible encephalopathy syndrome (PRES) to superimposed co-infection with other organisms. We report a case series of three young patients with different presentations of hemorrhagic encephalitis after COVID-19 infection and a review of the literature. One patient had self-limiting ANHE in the setting of mild COVID-19 systemic illness. The second patient had self-limiting leukoencephalopathy with microhemorrhages in the setting of severe systemic diseases and ARDS, and clinically improved with the resolution of systemic illness. Both patients were healthy and did not have any premorbid conditions. The third patient with poorly controlled diabetes and hypertension had severe systemic illness with neurological involvement including multiple ischemic strokes, basal meningitis, hemorrhagic encephalitis with pathological evidence of cerebral mucormycosis, and Epstein–Barr virus coinfection, and improved after antifungal therapy.
format Online
Article
Text
id pubmed-9032293
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-90322932022-04-23 Spectrum of Hemorrhagic Encephalitis in COVID-19 Patients: A Case Series and Review Sharma, Rohan Nalleballe, Krishna Shah, Vishank Haldal, Shilpa Spradley, Thomas Hasan, Lana Mylavarapu, Krishna Vyas, Keyur Kumar, Manoj Onteddu, Sanjeeva Gokden, Murat Kapoor, Nidhi Diagnostics (Basel) Case Report Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is an ongoing pandemic that has affected over 400 million people worldwide and caused nearly 6 million deaths. Hemorrhagic encephalitis is an uncommon but serious complication of COVID-19. The etiology of this disease is multifactorial, including secondary to severe hypoxemia, systemic inflammation, direct viral invasion, hypercoagulability, etc. The clinical spectrum of COVID-19-related hemorrhagic encephalitis is also varied, ranging from leukoencephalopathy with microhemorrhage, acute necrotizing hemorrhagic encephalitis (ANHE) involving the cortex, basal ganglia, rarely brain stem and cervical spine, hemorrhagic posterior reversible encephalopathy syndrome (PRES) to superimposed co-infection with other organisms. We report a case series of three young patients with different presentations of hemorrhagic encephalitis after COVID-19 infection and a review of the literature. One patient had self-limiting ANHE in the setting of mild COVID-19 systemic illness. The second patient had self-limiting leukoencephalopathy with microhemorrhages in the setting of severe systemic diseases and ARDS, and clinically improved with the resolution of systemic illness. Both patients were healthy and did not have any premorbid conditions. The third patient with poorly controlled diabetes and hypertension had severe systemic illness with neurological involvement including multiple ischemic strokes, basal meningitis, hemorrhagic encephalitis with pathological evidence of cerebral mucormycosis, and Epstein–Barr virus coinfection, and improved after antifungal therapy. MDPI 2022-04-07 /pmc/articles/PMC9032293/ /pubmed/35453972 http://dx.doi.org/10.3390/diagnostics12040924 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Sharma, Rohan
Nalleballe, Krishna
Shah, Vishank
Haldal, Shilpa
Spradley, Thomas
Hasan, Lana
Mylavarapu, Krishna
Vyas, Keyur
Kumar, Manoj
Onteddu, Sanjeeva
Gokden, Murat
Kapoor, Nidhi
Spectrum of Hemorrhagic Encephalitis in COVID-19 Patients: A Case Series and Review
title Spectrum of Hemorrhagic Encephalitis in COVID-19 Patients: A Case Series and Review
title_full Spectrum of Hemorrhagic Encephalitis in COVID-19 Patients: A Case Series and Review
title_fullStr Spectrum of Hemorrhagic Encephalitis in COVID-19 Patients: A Case Series and Review
title_full_unstemmed Spectrum of Hemorrhagic Encephalitis in COVID-19 Patients: A Case Series and Review
title_short Spectrum of Hemorrhagic Encephalitis in COVID-19 Patients: A Case Series and Review
title_sort spectrum of hemorrhagic encephalitis in covid-19 patients: a case series and review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9032293/
https://www.ncbi.nlm.nih.gov/pubmed/35453972
http://dx.doi.org/10.3390/diagnostics12040924
work_keys_str_mv AT sharmarohan spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT nalleballekrishna spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT shahvishank spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT haldalshilpa spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT spradleythomas spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT hasanlana spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT mylavarapukrishna spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT vyaskeyur spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT kumarmanoj spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT onteddusanjeeva spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT gokdenmurat spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview
AT kapoornidhi spectrumofhemorrhagicencephalitisincovid19patientsacaseseriesandreview