COVID-19-related diffuse leukoencephalopathy with microbleeds and persistent coma: a case report with good clinical outcome

A 60-year-old patient presented with respiratory distress, after recently being tested COVID-19 positive and was mechanically ventilated for 15 days. After cessation of sedation, he remained in deep comatose state, without any reaction on pain stimuli (Glasgow Coma Score 3). MRI of the brain showed...

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Bibliographic Details
Published in:BMJ case reports 2021-08, Vol.14 (8), p.e242504
Main Authors: Witvoet, Elbert Hans, Jiang, Feng Yan, Laumans, Willemijn, de Bruijn, Sebastiaan Franciscus Titus Maria
Format: Article
Language:English
Subjects:
Anesthesia
Blood pressure
Brain
Case Report
Case reports
Clinical outcomes
Coma
Coronaviruses
COVID-19
Diabetes
Dyspnea
Guillain-Barre syndrome
Hypertension
Infections
Intensive care
Patients
Severe acute respiratory syndrome coronavirus 2
Ventilators
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Summary:A 60-year-old patient presented with respiratory distress, after recently being tested COVID-19 positive and was mechanically ventilated for 15 days. After cessation of sedation, he remained in deep comatose state, without any reaction on pain stimuli (Glasgow Coma Score 3). MRI of the brain showed diffuse leukoencephalopathy and multiple (>50) microbleeds. Diffuse COVID-19-associated leukoencephalopathy with microhaemorrhages is associated with a poor prognosis. However, 3 months later, our patient showed a remarkable recovery and was able to walk independently. This case report shows COVID-related leukoencephalopathy and intracerebral microbleeds, even with persistent comatose state, may have a favourable clinical outcome and prolonged treatment should be considered in individual cases.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-242504