High rates of impaired quality of life and social and economic problems at 6 months after COVID-19-related ARDS.

PURPOSE: Assess long-term quality of life (HR-QoL) and socio-economic impact in COVID-19-related ARDS (C-ARDS) survivors. METHODS: C-ARDS survivors were followed up at 6 months in this prospective, cohort study. HR-QoL was assessed using SF-36 and EQ-5D-5L, and the socio-economic burden of COVID-19 was evaluated with a dedicated questionnaire. Clinical data were prospectively recorded. RESULTS: Seventy-nine survivors, age 63 [57-71], 84% male, were enrolled. The frequency of EQ-5D-5L reported problems was significantly higher among survivors compared to normal, in mobility, usual activities, and self-care; anxiety and depression and pain were not different. SF-36 scores were lower than the reference population, and physical and mental summary scores were below normal in 52% and 33% of the subjects, respectively. In the multivariable analysis, prolonged hospital length of stay (OR 1.45; p 0.02) and two or more comorbidities on admission (OR 7.42; p 0.002) were significant predictors of impaired "physical" and "mental" HR-QoL, respectively. A total of 38% subjects worsened social relations, 42% changed their employment status, and 23% required personal care support. CONCLUSIONS: C-ARDS survivors have long-term impairment in HR-QoL and socio-economic problems. Prolonged hospital stay and previous comorbidities are risk factors for developing health-related issues.

Early Guillain-Barré syndrome in coronavirus disease 2019 (COVID-19): a case report from an Italian COVID-hospital.

Guillain-Barré syndrome (GBS) is an acute polyradiculoneuropathy associated with dysimmune processes, often related to a previous infectious exposure. During Italian severe acute respiratory syndrome coronavirus-2 outbreak, a woman presented with a rapidly progressive flaccid paralysis with unilateral facial neuropathy after a few days of mild respiratory symptoms. Coronavirus was detected by nasopharyngeal swab, but there was no evidence of its presence in her cerebrospinal fluid, which confirmed the typical albumin-cytological dissociation of GBS, along with consistent neurophysiological data. Despite immunoglobulin infusions and intensive supportive care, her clinical picture worsened simultaneously both from the respiratory and neurological point of view, as if reflecting different aspects of the same systemic inflammatory response. Similar early complications have already been observed in patients with para-infectious GBS related to Zika virus, but pathological mechanisms have yet to be established.

Unusual lesion in the splenium of the corpus callosum and coronavirus infectious disease-19.

Coronavirus infectious diseases (COVID-19) is an emerging infectious disease that has taken a strong grip on the entire global community. The diagnosis per se is straightforward; however, the disease seems to affect multiple organs. Cytokine-storm, increased thromboembolic state, deranged overall homeostasis and aggressive medical treatment can cause a variety of lesions in the central nervous system. Interpretation of brain imaging findings will require a thorough understanding of the clinical status of the patient and treatment being offered, keeping in mind the several ways in which the viral pathogen, severe acute respiratory syndrome coronavirus-2 may interact with brain tissue. We present differential diagnosis of a MRI identified solitary lesion in the splenium of the corpus callosum, in a COVID-19 positive patient with altered mental status.