Author: Hixon, Alison M.; Thaker, Ashesh A.; Pelak, Victoria S.
Title: Persistent visual dysfunction following posterior reversible encephalopathy syndrome due to COVIDâ€19: Case series and literature review Cord-id: e9gu9770 Document date: 2021_6_29
ID: e9gu9770
Snippet: BACKGROUND AND PURPOSE: The full spectrum of neurological sequelae in COVIDâ€19 is beginning to emerge. SARSâ€CoVâ€2 has the potential to cause both direct and indirect brain vascular endothelial damage through infection and inflammation that may result in longâ€term neurological signs and symptoms. We sought to illuminate persistent neuroâ€ophthalmological deficits that may be seen following posterior reversible encephalopathy syndrome (PRES) due to COVIDâ€19. METHODS: We identified three
Document: BACKGROUND AND PURPOSE: The full spectrum of neurological sequelae in COVIDâ€19 is beginning to emerge. SARSâ€CoVâ€2 has the potential to cause both direct and indirect brain vascular endothelial damage through infection and inflammation that may result in longâ€term neurological signs and symptoms. We sought to illuminate persistent neuroâ€ophthalmological deficits that may be seen following posterior reversible encephalopathy syndrome (PRES) due to COVIDâ€19. METHODS: We identified three individuals with PRES due to COVIDâ€19 in our hospital system. One patient was identified on presentation to our neuroâ€ophthalmology clinic. The other patients were identified through internal records search. These cases were compared to published reports of PRES in COVIDâ€19 identified through systematic literature search of PubMed/LitCOVID. RESULTS: All three patients were hospitalized with severe COVIDâ€19 and developed altered mental status with new onset seizures that led to the recognition of PRES through diagnostic imaging. During recovery, two patients had persistent visual dysfunction including visual field deficits. One patient also experienced hallucinatory palinopsia and visual hallucinations. Literature search identified 32 other cases of PRES in the context of COVIDâ€19. Visual disturbances were described in 14 cases (40%), with only seven cases (50%) reporting full recovery by the time of publication. CONCLUSIONS: As we learn about enduring neurological complications of COVIDâ€19, it is possible that complications may be underrecognized and underreported. Understanding the range of complications can help in postcare evaluation and management changes in the critical care setting to potentially allow intervention before persistent deficits occur due to COVIDâ€19.
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