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. 2024 Dec 19;16(12):e76005.
doi: 10.7759/cureus.76005. eCollection 2024 Dec.

COVID-19-Associated Encephalopathy: A Case Series Demonstrating the Rapid Deterioration of Mental Status and a Review of the Literature

Affiliations

COVID-19-Associated Encephalopathy: A Case Series Demonstrating the Rapid Deterioration of Mental Status and a Review of the Literature

Jacky Reny et al. Cureus. .

Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is known for its severe inflammatory response, often leading to multi-organ dysfunction. Among the less-recognized complications is COVID-19-associated encephalopathy, particularly in the elderly, where it contributes significantly to morbidity and mortality. This report explores the rapid neurocognitive decline observed in six hospitalized patients with COVID-19, with or without pre-existing neurological conditions. Each case highlights the challenges of managing complex clinical courses and emphasizes the importance of early, multidisciplinary intervention, including palliative care, to address the goals of care. Given the underreporting of COVID-19-associated encephalopathy, this case series underscores the need for increased awareness and specialized care to improve patient outcomes, particularly in older populations.

Keywords: care disposition; cognitive impairment; covid-19; delirium; encephalopathy.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Jefferson Office of Human Research Institutional Review Board issued approval 2023-2401. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Chest X-ray showing mild edema, pulmonary venous congestion, and left basilar atelectasis.
Figure 2
Figure 2. Chest X-ray showing mild edema, pulmonary venous congestion, and left basilar atelectasis (A). Computerized tomography of the chest showing left pleural effusion with left lower lobe opacities and calcified pleural plaques (B).
Figure 3
Figure 3. Chest X-ray showing mild pulmonary vascular congestion with opacity at bilateral lung bases.
Figure 4
Figure 4. Chest X-ray on presentation showing pulmonary edema (A). Chest X-ray on hospital day 5 showed venous congestion and mild-to-moderate edema with bilateral small effusions (B).
Figure 5
Figure 5. Chest X-ray on admission showed diminished lung volumes, clear lungs, and cardiomegaly.
The aorta is noted to be tortuous and calcified (A). Chest X-ray on hospital day 3: new right lower lobe alveolar opacity consistent with pneumonia (B).

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