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  1. TI=Posterior Reversible Encephalopathy Syndrome in a Patient With SARS CoV 2 Infection Treated With Tocilizumab
  2. TI=Clinical Manifestations of Hospitalized COVID 19 Patients in Bangladesh: A 14 day Observational Study

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  1. Article: Posterior Reversible Encephalopathy Syndrome in a Patient With SARS-CoV-2 Infection Treated With Tocilizumab.

    Talluri, Krishna / Lall, Naveena / Moreno, Marcos A / Nichols, Laura / Bande, Dinesh

    Cureus

    2021  Volume 13, Issue 2, Page(s) e13475

    Abstract: ... reversible encephalopathy syndrome (PRES). PRES was felt to be from SARS-CoV-2 infection, tocilizumab, or ... has emerged suggesting that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection ... of the association with SARS-CoV-2 infection and tocilizumab therapy, particularly when considering tocilizumab ...

    Abstract As the world has struggled to adapt to the coronavirus disease (COVID-19) pandemic, new evidence has emerged suggesting that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may manifest with a wide variety of neurologic symptoms. We present the case of a 70-year-old patient hospitalized for COVID-19 related pneumonia who was treated with off-label interleukin (IL)-6 inhibitor tocilizumab and eventually developed prolonged delirium. MRI findings were consistent with posterior reversible encephalopathy syndrome (PRES). PRES was felt to be from SARS-CoV-2 infection, tocilizumab, or a combination. The patient received symptomatic treatment without success. These findings are consistent with few other recent reports, which have chronicled PRES findings in patients with SARS-CoV-2 infections. However, this is only the second example of PRES in a COVID-19 patient treated with tocilizumab. While cases of PRES have been noted to occur with other infectious diseases, clinicians should be aware of the association with SARS-CoV-2 infection and tocilizumab therapy, particularly when considering tocilizumab treatment outside its approved indication. Future research efforts are needed to establish evidence-based guidelines for the management of these patients.
    Language English
    Publishing date 2021-02-21
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.13475
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Posterior Reversible Encephalopathy Syndrome in Patients with Coronavirus Disease 2019: Two Cases and A Review of The Literature.

    Anand, Pria / Lau, K H Vincent / Chung, David Y / Virmani, Deepti / Cervantes-Arslanian, Anna M / Mian, Asim Z / Takahashi, Courtney E

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

    2020  Volume 29, Issue 11, Page(s) 105212

    Abstract: ... for posterior reversible encephalopathy syndrome. One patient was treated with tocilizumab, an interleukin-6 ... Recognition of posterior reversible encephalopathy syndrome in this patient population is critical ... Conclusions: Risk factors for posterior reversible encephalopathy syndrome in patients with coronavirus ...

    Abstract Introduction: Encephalopathy is a common complication of coronavirus disease 2019. Although the encephalopathy is idiopathic in many cases, there are several published reports of patients with posterior reversible encephalopathy syndrome in the setting of coronavirus disease 2019.
    Objective: To describe the diverse presentations, risk factors, and outcomes of posterior reversible encephalopathy syndrome in patients with coronavirus disease 2019.
    Methods: We assessed patients with coronavirus disease 2019 and a diagnosis of posterior reversible encephalopathy syndrome at our institution from April 1 to June 24, 2020. We performed a literature search to capture all known published cases of posterior reversible encephalopathy syndrome in patients with coronavirus disease 2019.
    Results: There were 2 cases of posterior reversible encephalopathy syndrome in the setting of coronavirus 2019 at our institution during a 3-month period. One patient was treated with anakinra, an interleukin-1 inhibitor that may disrupt endothelial function. The second patient had an underlying human immunodeficiency virus infection. We found 13 total cases in our literature search, which reported modest blood pressure fluctuations and a range of risk factors for posterior reversible encephalopathy syndrome. One patient was treated with tocilizumab, an interleukin-6 inhibitor that may have effects on endothelial function. All patients had an improvement in their neurological symptoms. Interval imaging, when available, showed radiographic improvement of brain lesions.
    Conclusions: Risk factors for posterior reversible encephalopathy syndrome in patients with coronavirus disease 2019 may include underlying infection or immunomodulatory agents with endothelial effects in conjunction with modest blood pressure fluctuations. We found that the neurological prognosis for posterior reversible encephalopathy syndrome in the setting of coronavirus disease 2019 infection is favorable. Recognition of posterior reversible encephalopathy syndrome in this patient population is critical for prognostication and initiation of treatment, which may include cessation of potential offending agents and tight blood pressure control.
    MeSH term(s) Betacoronavirus/pathogenicity ; Blood Pressure ; COVID-19 ; Coinfection ; Coronavirus Infections/diagnosis ; Coronavirus Infections/immunology ; Coronavirus Infections/physiopathology ; Coronavirus Infections/virology ; Endothelium, Vascular/physiopathology ; Endothelium, Vascular/virology ; Female ; HIV Infections/immunology ; HIV Infections/physiopathology ; HIV Infections/virology ; Host-Pathogen Interactions ; Humans ; Immunosuppressive Agents/adverse effects ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/immunology ; Pneumonia, Viral/physiopathology ; Pneumonia, Viral/virology ; Posterior Leukoencephalopathy Syndrome/diagnosis ; Posterior Leukoencephalopathy Syndrome/immunology ; Posterior Leukoencephalopathy Syndrome/physiopathology ; Posterior Leukoencephalopathy Syndrome/virology ; Prognosis ; Risk Factors ; SARS-CoV-2
    Chemical Substances Immunosuppressive Agents
    Keywords covid19
    Language English
    Publishing date 2020-07-30
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 1131675-5
    ISSN 1532-8511 ; 1052-3057
    ISSN (online) 1532-8511
    ISSN 1052-3057
    DOI 10.1016/j.jstrokecerebrovasdis.2020.105212
    Database MEDical Literature Analysis and Retrieval System OnLINE

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