Reversible Encephalopathy Syndrome (PRES) in a COVID-19 patient

Princiotta Cariddi, Lucia; Tabaee Damavandi, Payam; Carimati, Federico; Banfi, Paola; Clemenzi, Alessandro; Marelli, Margherita; Giorgianni, Andrea; Vinacci, Gabriele; Mauri, Marco; Versino, Maurizio

Recently WHO has declared novel coronavirus disease 2019 (COVID-19) outbreak a pandemic. Acute respiratory syndrome seems to be the most common manifestation of COVID-19. Besides pneumonia, it has been demonstrated that SARS-CoV-2 infection affects multiple organs, including brain tissues, causing different neurological manifestations, especially acute cerebrovascular disease (ischemic and hemorrhagic stroke), impaired consciousness and skeletal muscle injury. To our knowledge, among neurological disorders associated with SARS-CoV2 infection, no Posterior Reversible Encephalopathy Syndrome (PRES) has been described yet. Herein, we report a case of a 64-year old woman with COVID19 infection who developed a PRES, and we suggest that it could be explained by the disruption of the blood brain barrier induced by the cerebrovascular endothelial dysfunction caused by SARS-CoV-2.