Síndrome de encefalopatía posterior reversible (PRES) asociado a SARS-CoV-2. Reporte de caso

Ordoñez-Boschetti, Laura; Torres-Romero, C.M.; Leo, Mario

doi:10.1016/j.nrl.2020.08.001

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…Extensive superimposed hemorrhages in the parietooccipital region with abnormal contrast enhancement. Present Present Discharged P21/M/46 Ordoñez-Boschetti L et al 39 Normotensive Absent Present NR Mechanical ventilation NR T2 FLAIR hyperintensities in frontal and occipital white matter. NR Absent Discharged P22/M/74 Gómez-Enjuto S et al 40 Hypertensive Present Present Present NR Carfilzomib T2 FLAIR hyperintensities frontalparietal and occipital subcortical areas.…”

Section: Resultsmentioning

confidence: 99%

Brain MRI findings in COVID-19 patients with PRES: A systematic review

et al. 2022

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Background Numerous case reports and case series have described brain Magnetic Resonance Imaging (MRI) findings in Coronavirus disease 2019 (COVID-19) patients with concurrent posterior reversible encephalopathy syndrome (PRES). Purpose We aim to compile and analyze brain MRI findings in patients with COVID-19 disease and PRES. Methods PubMed and Embase were searched on April 5th, 2021 using the terms “COVID-19”, “PRES”, “SARS-CoV-2” for peer-reviewed publications describing brain MRI findings in patients 21 years of age or older with evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and PRES. Results Twenty manuscripts were included in the analysis, which included descriptions of 30 patients. The average age was 57 years old. Twenty-four patients (80%) required mechanical ventilation. On brain MRI examinations, 15 (50%) and 7 (23%) of patients exhibited superimposed foci of hemorrhage and restricted diffusion respectively. Conclusions PRES is a potential neurological complication of COVID-19 related disease. COVID-19 patients with PRES may exhibit similar to mildly greater rates of superimposed hemorrhage compared to non-COVID-19 PRES patients.

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Section: Resultsmentioning

confidence: 99%

Brain MRI findings in COVID-19 patients with PRES: A systematic review

et al. 2022

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“…As a radiographic manifestation of many medical conditions, PRES is a heterogeneous disorder triggered by a variety of proximate causes [9,11,12]. The systemic illness associated with an inflammatory response to SARS-CoV-2, endothelial dysfunction, and comorbidities observed in patients with severe COVID-19 are only a few potential explanations for the development of PRES that have been reported in these patients [13][14][15][16][17][18][19]. PRES has been historically characterized by an impairment of brain blood vessel autoregulation after severe hypertension [9], or as a consequence of severe infections, inflammation, or vasotoxicity.…”

Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome (PRES) associated with COVID-19

Lallana

Chen

Requena

et al. 2021

Journal of Clinical Neuroscience

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The novel human coronavirus disease (COVID-19) has been associated with vascular and thrombotic complications, some of which may result from endothelial dysfunction, including the posterior reversible encephalopathy syndrome (PRES). We report a case series of 8 patients with COVID-19 and PRES diagnosed at two academic medical centers between March and July of 2020. The clinical, laboratory and radiographic data, treatment, and short-term outcomes were retrospectively analyzed. The mean age was 57.9 ± 12 years, and 50% were women. Four patients had previous vascular comorbidities. All the patients suffered from severe pneumonia, requiring intensive care unit admission. Five patients were not hypertensive at presentation (all SBP < 127 mmHg). Neurologic symptoms included seizures in 7 patients; impaired consciousness in 5 patients; focal neurological signs in 3 patients; and visual disturbances in 1 patient. All patients underwent brain magnetic resonance imaging which indicated asymmetric T2 prolongation or diffusion changes (50%), extensive fronto-parieto-occipital involvement (25%), vascular irregularities (12.5%) and intracranial hemorrhage (25%). Four patients were treated with tocilizumab. Three patients were discharged without neurologic disability, 2 patients had persistent focal neurologic deficits and 2 expired. One patient's prognosis remains guarded. Together, these data support the relationship between PRES and endothelial dysfunction associated with severe COVID-19. In patients with severe COVID-19, PRES can be triggered by uncontrolled hypertension, or occur independently in the setting of systemic illness and certain medications. Like other infectious processes, critically ill patients with COVID-19 may be at greater risk of PRES because of impaired vasoreactivity or the use of novel agents like Tocilizumab.

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“…The remaining 34 articles, including case reports, case series, letters to the editor, pictorial essays etc. reporting cases of PRES in COVID-19 were finally shortlisted after rigorous screening [ [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] ]. Since a total of 31 patients were described in the nine case series, individual data of 56 patients is described in our systematic review in the form of two tables [ Table 1 and Table 2 ].…”

Section: Resultsmentioning

confidence: 99%

“…et al (2020) [ 21 ] 25,F – (+) HCQ, Oseltamivir, Piperacillin-Tazobactam, Azithromycin High Headache, Seizures, AMS Pregnancy – Recovered 11 F.X. Doo et al (2020) [ 22 ] 64,M Smoking (+) HCQ, Azithromycin, Vancomycin, Ceftriaxone, Tocilizumab – Rhythmic jerking movements Tocilizumab AEDs, Midazolam, Lacosamide, – 12 L. Ordonez-Boschetti et al (2020) [ 23 ] 46,M DM (+) HCQ, Azithromycin, Cefuroxime High AMS, Psychomotor agitation, Disconnection with the environment – – Partial recovery with lower limb weakness 13 G. Conte et al (2020) [ 24 ] 63, F HTN (+) Lopinavir/Ritonavir, Piperacillin-Tazobactam, Anti-IL1 Initially high, then controlled Gaze deviation, seizures HTN Diazepam, Lacosamide Partial visual loss in the left eye 14 Talluri K et al (2021) [ 25 ] 70,M Asthma, HTN, CAD – Azithromycin, HCQ, Tocilizumab High Hyperactive delirium HTN, Tocilizumab Dexmedetomidine, Quetiapine, AEDs, Haloperidol Death …”

Section: Resultsmentioning

confidence: 99%