EEG findings and clinical prognostic factors associated with mortality in a prospective cohort of inpatients with COVID-19.

PURPOSE: Our objective is to describe the most prevalent electroencephalographic findings in COVID-19 hospitalized patients, and to determine possible predictors of mortality including EEG and clinical variables. METHODS: A multicentric prospective observational study in patients with COVID-19 requiring EEG during hospitalization. RESULTS: We found 94 EEG from 62 patients (55 % men, mean age 59.7 ± 17.8 years) were analyzed. Most frequent comorbidity was cardiac (52 %), followed by metabolic (45 %) and CNS disease (39 %). Patients required ICU management by 60 %, with a mortality of 27 % in the whole cohort. The most frequent EEG finding was generalized continuous slow-wave activity (66 %). Epileptic activity was observed in 19 % including non-convulsive status epilepticus, seizures and interictal epileptiform discharges. Periodic patterns were observed in 3 patients (3.2 %). Multivariate analysis found that cancer comorbidity and requiring an EEG during the third week of evolution portended a higher risk of mortality CONCLUSION: We observed that the most prevalent EEG finding in this cohort was generalized continuous slow-wave activity, while epileptic activity was observed in less than 20 % of the cases. Mortality risk factors were comorbidity with cancer and requiring an EEG during the third week of evolution, possibly related to the hyperinflammatory state.

Post-COVID-19 inflammatory syndrome manifesting as refractory status epilepticus.

There have been multiple descriptions of seizures during the acute infectious period in patients with COVID-19. However, there have been no reports of status epilepticus after recovery from COVID-19 infection. Herein, we discuss a patient with refractory status epilepticus 6 weeks after initial infection with COVID-19. Extensive workup demonstrated elevated inflammatory markers, recurrence of a positive nasopharyngeal SARS-CoV-2 polymerase chain reaction, and hippocampal atrophy. Postinfectious inflammation may have triggered refractory status epilepticus in a manner similar to the multisystemic inflammatory syndrome observed in children after COVID-19.

COVID-19 Precipitating Status Epilepticus in a Pediatric Patient.

BACKGROUND As the severe acute respiratory syndrome coronavirus 2 (SARS CoV2) spreads around the world infecting people of all ages, clinicians and researchers are working to gather data on the presentation of coronavirus disease (COVID-19). Further study is necessary to better diagnose and treat COVID-19 patients. CASE REPORT We describe the case of an 8-year-old boy admitted with status epilepticus, who also tested positive for COVID-19, while afebrile, with no initial respiratory symptoms. Benzodiazepines were given per treatment guidelines, abating the seizure activity. He subsequently developed respiratory distress and desaturation requiring temporary emergent intubation. All clinical symptoms resolved within a few hours. Results of a computed tomography (CT) scan of the brain were within normal limits. Results of a 24-h electroencephalogram (EEG) were abnormal, indicative of diffuse cerebral dysfunction. As a result of intubation and findings of bilateral infiltrates on chest x-ray, a COVID-19 test was administered and the result was positive. CONCLUSIONS For proper diagnosis and treatment, patients and clinicians should be aware that COVID-19 may not present in the typical fashion of respiratory distress and fever. The present case suggests a rare neurological presentation of COVID-19.

Orbitofrontal involvement in a neuroCOVID-19 patient.

Neurological manifestations of coronavirus disease 19 (COVID-19) such as encephalitis and seizures have been reported increasingly, but our understanding of COVID-19-related brain injury is still limited. Herein we describe prefrontal involvement in a patient with COVID-19 who presented prior anosmia, raising the question of a potential trans-olfactory bulb brain invasion.