Neuroprognostication of Consciousness Recovery in a Patient with COVID-19 Related Encephalitis: Preliminary Findings from a Multimodal Approach

Sangare, Aude; Dong, Anceline; Valente, Melanie; Pyatigorskaya, Nadya; Cao, Albert; Altmayer, Victor; Zyss, Julie; Lambrecq, Virginie; Roux, Damien; Morlon, Quentin; Perez, Pauline; Ben Salah, Amina; Virolle, Sara; Puybasset, Louis; Sitt, Jacobo D; Rohaut, Benjamin; Naccache, Lionel

Predicting the functional recovery of patients with severe neurological condition due to coronavirus disease 2019 (COVID-19) is a challenging task. Only limited outcome data are available, the pathophysiology is poorly understood, and the time-course of recovery is still largely unknown. Here, we report the case of a patient with COVID-19 associated encephalitis presenting as a prolonged state of unresponsiveness for two months, who finally fully recovered consciousness, functional communication, and autonomy after immunotherapy. In a multimodal approach, a high-density resting state EEG revealed a rich brain activity in spite of a severe clinical presentation. Using our previously validated algorithms, we could predict a possible improvement of consciousness in this patient. This case report illustrates the value of a multimodal approach capitalizing on advanced brain-imaging and bedside electrophysiology techniques to improve prognosis accuracy in this complex and new aetiology.