Neurological repercussions after COVID-19 in a young pregnant patient: a case report

Abstract

Context: Most patients with COVID-19 have mild respiratory disease, however, neurological manifestations have also been associated. Case report: Female, 21 years old, 24 weeks pregnant, admitted with severe acute respiratory distress syndrome, by COVID-19. Evolved with respiratory failure. On the 14th day of hospitalization, fetal death occurred. After clinical stabilization, she started neurological symptoms, with altered state of consciousness, delusions, tremor in extremities, paresis in right dimidium and paresthesia in extremities. Nuclear magnetic resonance imaging showed numerous old micro- hemorrhagic foci, complemented with angio resonance and inflammatory activity evaluation, with embolic event and vasculitis ruled out. Electroneuromyography showed multiple mononeuritis. She recovered gradually, maintaining the tremor in extremities. Conclusions: Neurological manifestations can occur both by viral cytopathic action and by systemic complications resulting from immunomediated phenomena. In a study carried out in the United Kingdom, by Varatharaj et al, with 125 patients with COVID-19 and neuropsychiatric disorders, the most observed conditions were cerebrovascular event (62%), altered mental status (31%), both present in the case and, in addition, encephalopathy (23%) and encephalitis (18%). The neurological manifestations observed in COVID-19 can affect both the central and the peripheral nervous system. This patient has multiple mononeuropathy, characterized by the involvement of two or more peripheral nerve trunks, with motor and sensory manifestations.