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Management considerations for stroke-like episodes in MELAS with concurrent COVID-19 infection.
Sen, Kuntal; Harrar, Dana; Hahn, Andrea; Wells, Elizabeth M; Gropman, Andrea L.
  • Sen K; Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Washington, DC, USA. ksen2@childrensnational.org.
  • Harrar D; Division of Neurogenetics and Developmental Pediatrics, Children's National Hospital, Washington, DC, USA. ksen2@childrensnational.org.
  • Hahn A; Center for Neuroscience and Behavioral Medicine, Children's National Hospital, Washington, DC, USA.
  • Wells EM; Program in Stroke and Critical Care Neurology, Children's National Hospital, Washington, DC, USA.
  • Gropman AL; Division of Infectious Diseases, Children's National Hospital, Washington, DC, USA.
J Neurol ; 268(11): 3988-3991, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1163035
ABSTRACT
There have been considerations since the beginning of the Coronavirus pandemic that COVID-19 infection, like any other viral illness, can trigger neurological and metabolic decompensation in patients with mitochondrial diseases. At the time of writing, there were no published reports reviewing experiences and guidelines about management of COVID-19 infection in this patient population. We present a challenging case of an adult patient with a known diagnosis of Mitochondrial Encephalomyopathy, Lactic Acidosis and Stroke-like Episodes (MELAS) complicated by COVID-19 infection. She initially presented with altered mental status and vomiting and went on to develop a stroke-like episode, pancreatitis, and pneumatosis intestinalis. We review salient features of her hospitalization, including initiation of thromboprophylaxis in relation to intravenous arginine therapy, caution regarding medications such as remdesivir, and the incidence of gastrointestinal complications.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acidosis, Lactic / MELAS Syndrome / Stroke / Venous Thromboembolism / COVID-19 Type of study: Case report / Observational study / Qualitative research Topics: Long Covid Limits: Adult / Female / Humans Language: English Journal: J Neurol Year: 2021 Document Type: Article Affiliation country: S00415-021-10538-1

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acidosis, Lactic / MELAS Syndrome / Stroke / Venous Thromboembolism / COVID-19 Type of study: Case report / Observational study / Qualitative research Topics: Long Covid Limits: Adult / Female / Humans Language: English Journal: J Neurol Year: 2021 Document Type: Article Affiliation country: S00415-021-10538-1