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Delayed onset of fatal encephalitis in a COVID-19 positive patient.
Zanin, Luca; Saraceno, Giorgio; Renisi, Giulia; Signorini, Liana; Battaglia, Luigi; Ferrara, Marco; Rasulo, Francesco Antonio; Panciani, Pier Paolo; Fontanella, Marco Maria.
  • Zanin L; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
  • Saraceno G; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
  • Renisi G; Department of Infection and Tropical Disease, University of Brescia, Brescia, Italy.
  • Signorini L; Department of Infection and Tropical Disease, University of Brescia, Brescia, Italy.
  • Battaglia L; Dipartimento di Scienza e Tecnologia del Farmaco, Università degli Studi di Torino, Turin, Italy.
  • Ferrara M; Azienda Ospedaliera Spedali Civili di Brescia, Neuroradiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
  • Rasulo FA; University of Brescia, Intensive Care and Anesthesiology, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia and Spedali Civili Hospital, Brescia, Italy.
  • Panciani PP; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
  • Fontanella MM; Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Int J Neurosci ; : 1-4, 2021 Feb 23.
Article in English | MEDLINE | ID: covidwho-2288298
ABSTRACT

BACKGROUND:

The SARS-nCoV-2019 epidemic has spread since December 2019, quickly gaining worldwide attention. Symptoms consist of fever, cough and breathing difficulties. An increasing number of studies are focusing on neurological manifestations. In addition to the typical ageusia and anosmia, up to 30% of cases can present headache, nausea and vomiting. More serious neurological manifestations, such as encephalitis, thrombosis and cerebral haemorrhage have been reported. CASE DESCRIPTION We described the case of a 47-year-old man who tested positive for COVID-19 virus in early March 2020. After two negative nasopharyngeal swabs, 41 days after the diagnosis of COVID-19 infection, he developed intense headache with fever, and he was hospitalized. He had subsequent generalized epileptic seizures and intubation was necessary. Contrast Head MRI was negative for brain abscesses or tumours but detected severe vasogenic oedema of the white matter with 10 mm shift of the midline and compression of the right lateral ventricle. Massive cortisone support therapy was ineffective. We diagnosed brain death on day 43 from the infection diagnosis.

DISCUSSION:

COVID-19 virus can reach the brain, penetrating into the neuronal cells through the interaction between the spike protein S1 and the host ACE-2 receptor, expressed in the capillary endothelium. We believe that in this infection, the pro-inflammatory state induced by the cytokine storm can cause a cerebral cell-mediated response, with subsequent vasodilatation and brain oedema.

CONCLUSION:

To our knowledge, this is the first description of a delayed onset cell-mediated encephalitis caused by COVID-19 virus after more than 40 days from the diagnosis.
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Full text: Available Collection: International databases Database: MEDLINE Language: English Journal: Int J Neurosci Year: 2021 Document Type: Article Affiliation country: 00207454.2021.1886095

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Full text: Available Collection: International databases Database: MEDLINE Language: English Journal: Int J Neurosci Year: 2021 Document Type: Article Affiliation country: 00207454.2021.1886095