Titre
COVID-19 encephalopathy: Clinical and neurobiological features.
Type
article
Institution
Externe
Périodique
Auteur(s)
Uginet, M.
Auteure/Auteur
Breville, G.
Auteure/Auteur
Assal, F.
Auteure/Auteur
Lövblad, K.O.
Auteure/Auteur
Vargas, M.I.
Auteure/Auteur
Pugin, J.
Auteure/Auteur
Serratrice, J.
Auteure/Auteur
Herrmann, F.R.
Auteure/Auteur
Lalive, P.H.
Auteure/Auteur
Allali, G.
Auteure/Auteur
Liens vers les personnes
ISSN
1096-9071
Statut éditorial
Publié
Date de publication
2021-07
Volume
93
Numéro
7
Première page
4374
Dernière page/numéro d’article
4381
Peer-reviewed
Oui
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Résumé
Severe acute respiratory coronavirus 2 (SARS-CoV-2) has been associated with neurological complications, including acute encephalopathy. To better understand the neuropathogenesis of this acute encephalopathy, we describe a series of patients with coronavirus disease 2019 (COVID-19) encephalopathy, highlighting its phenomenology and its neurobiological features. On May 10, 2020, 707 patients infected by SARS-CoV-2 were hospitalized at the Geneva University Hospitals; 31 (4.4%) consecutive patients with an acute encephalopathy (64.6 ± 12.1 years; 6.5% female) were included in this series, after exclusion of comorbid neurological conditions, such as stroke or meningitis. The severity of the COVID-19 encephalopathy was divided into severe and mild based on the Richmond Agitation Sedation Scale (RASS): severe cases (n = 14, 45.2%) were defined on a RASS < -3 at worst presentation. The severe form of this so-called COVID-19 encephalopathy presented more often a headache. The severity of the pneumonia was not associated with the severity of the COVID-19 encephalopathy: 28 of 31 (90%) patients did develop an acute respiratory distress syndrome, without any difference between groups (p = .665). Magnetic resonance imaging abnormalities were found in 92.0% (23 of 25 patients) with an intracranial vessel gadolinium enhancement in 85.0% (17 of 20 patients), while an increased cerebrospinal fluid/serum quotient of albumin suggestive of blood-brain barrier disruption was reported in 85.7% (6 of 7 patients). Reverse transcription-polymerase chain reaction for SARS-CoV-2 was negative for all patients in the cerebrospinal fluid. Although different pathophysiological mechanisms may contribute to this acute encephalopathy, our findings suggest the hypothesis of disturbed brain homeostasis and vascular dysfunction consistent with a SARS-CoV-2-induced endotheliitis.
PID Serval
serval:BIB_680F9FD5FEB5
PMID
Open Access
Oui
Date de création
2023-08-11T12:49:30.002Z
Date de création dans IRIS
2025-05-20T23:55:39Z
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Nom
Journal of Medical Virology - 2021 - Uginet.pdf
Version du manuscrit
published
Licence
https://creativecommons.org/licenses/by/4.0
Taille
781.33 KB
Format
Adobe PDF
PID Serval
serval:BIB_680F9FD5FEB5.P001
Somme de contrôle
(MD5):f94be3194940eee43e1bf9e7990e6acb