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Intern Med . Significance of Persistent Systemic Support in the Clinical Course of Delayed Post-hypoxic leukoencephalopathy Following Severe Corona

tetano

Editor, Senior Moderator
Intern Med


. 2024 Feb 1.
doi: 10.2169/internalmedicine.1412-22. Online ahead of print. Significance of Persistent Systemic Support in the Clinical Course of Delayed Post-hypoxic leukoencephalopathy Following Severe Coronavirus Disease 2019

Juri Kawasaki[SUP] 1 [/SUP], Naoko Mato[SUP] 1 [/SUP], Hiroyuki Fujii[SUP] 2 [/SUP], Kumiko Miura[SUP] 3 [/SUP], Takafumi Mashiko[SUP] 3 [/SUP], Shinshu Katayama[SUP] 4 [/SUP], Yoshitaka Yamanouchi[SUP] 1 [/SUP], Miki Sato[SUP] 5 [/SUP], Toshikazu Takasaki[SUP] 1 [/SUP], Ayako Takigami[SUP] 1 [/SUP], Shu Hisata[SUP] 1 [/SUP], Shin Nunomiya[SUP] 4 [/SUP], Koichi Hagiwara[SUP] 1 [/SUP], Makoto Maemondo[SUP] 1 [/SUP]



Affiliations
Free article Abstract

A 45-year-old woman was hospitalized with severe coronavirus disease 2019 pneumonia. Following cytokine storm-induced multiorgan failure and lethal arrhythmia, the patient developed a sustained coma with flaccid quadriplegia. A cerebrospinal fluid examination excluded infectious and immunogenic encephalopathies, and diffusion-weighted magnetic resonance imaging demonstrated high-intensity areas in the white matter with a cortex-sparing distribution, suggesting delayed post-hypoxic leukoencephalopathy. As a result of intensive cardiopulmonary support for a month, the neurological function gradually recovered. Based on the reversible clinical course noted in this patient, accurate diagnosis and persistent medical approaches are important for the management of coronavirus disease 2019-related delayed post-hypoxic leukoencephalopathy.

Keywords: arrhythmia; coronavirus disease 2019 (COVID-19); cytokine storm; delayed post-hypoxic leukoencephalopathy (DPHL); multiorgan failure.

 
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