Article Figures & Data
Tables
- Encephalopathy
Presentation: Altered mental status Supportive testing: MRI: Normal; EEG: Abnormal (slowing); CSF: Normal; CSF: SARS-CoV-2 negative Treatment: Supportive; treat underlying COVID-19 CSF = cerebrospinal fluid; EEG = electroencephalogram; MRI = magnetic resonance imaging
- Stroke
Presentation: Acute presentation with focal motor, sensory or speech disturbance Supportive testing: MRI: Abnormal, lesion located in a vascular distribution Treatment: No society guidelines for COVID-19–specific stroke treatment 1. Acute ischemic stroke treatment: thrombolytic and endovascular therapy should be considered. No society guidelines on stroke prevention. Therapeutic anticoagulation should be considered on a case-by-case basis. 2. Acute hemorrhagic stroke (rare): standard treatment with blood pressure control. 3. Cerebral venous sinus thrombosis: standard treatment with full-dose therapeutic anticoagulation, evaluate for other thrombosis sites. MRI = magnetic resonance
- Encephalitis, meningitis
Presentation: Headache, nuchal rigidity, seizures, focal neurologic deficits; plus altered mental status for encephalitis Supportive testing: MRI: Abnormal, WM changes noted; EEG: Abnormal (slow, +/− focal epileptiform discharges); CSF: Pleocytosis, elevated protein; CSF: SARs-CoV-2, positive Treatment: Remains unclear; Role for corticosteroids? CSF = cerebrospinal fluid; EEG = electroencephalogram; MRI = magnetic resonance; WM = white matter
- Acute disseminated encephalomyelitis
Presentation: Headache, acute neurologic symptoms Supportive testing: MRI: Hyperintense FLAIR lesions with variable enhancement Treatment: 2 case reports showing improvement with the following: • 5 days of IVIG (0.4 g/kg/day)19 • 5 days of IV dexamethasone (20 mg/day) with a 10-day taper20 FLAIR = fluid-attenuated inversion recovery; IV = intravenous; IVIG = intravenous immunoglobulin; MRI = magnetic resonance imaging
- >Muscle injury
Presentation: Myalgias Supportive testing: CPK: elevated; Muscle biopsy: necrosis Treatment: Supportive: Remains unclear; Role for corticosteroids? Physical therapy CPK = creatinine phosphate kinase
- Acute inflammatory demyelinating polyneuropathya
Presentation: Flaccid paralysis +/ − respiratory compromise, cranial nerve deficits Supportive testing: CSF: Increased protein, normal WBC; NCS: Abnormal, axonal and demyelinating variants noted Treatment: Standard GBS treatment with 5 days of IVIG (0.4 g/kg/day) Case series noted only minimal improvement in 2 of 5 patients post-treatment28 CSF = cerebrospinal fluid; GBS = Guillain-Barre syndrome; IVIG = intravenous immunoglobulin; NCS = nerve conduction study; WBC = white blood cells
↵a Also known as Guillain-Barre syndrome.
- Anosmia/dysgeusia
Presentation: Olfactory or taste dysfunction Supportive testing: Abnormal smell and taste evaluation Treatment: Supportive: Improvement noted by 2 weeks post-symptom onset