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Abstract Details

COVID-19 Related Encephalopathy: the Endotheliitis Hypothesis
Infectious Disease
Infectious Disease Posters (7:00 AM-5:00 PM)
016
This study aims to compare the clinical characteristics of patients with COVID-19 related encephalopathy with and without radiological signs of intracranial gadolinium vessels enhancement.
The SARS-CoV-2 has been associated with neurological complications, including an acute encephalopathy. An unusual intracranial gadolinium vessels enhancement has been reported among these patients; however the prevalence, the clinical characteristics and the association with cerebrovascular complications have not been described yet.

Twenty-nine patients (66.9 ± 9.2 years; 10% female) performed an MRI (with 3D T1-weighted black blood VISTA sequences) during acute onset of encephalopathy. The acute encephalopathy was defined by a delirium or a subsyndromal delirium with a pathobiological brain process in patients with a positive SARS-CoV-2 real-time reverse transcription polymerase chain reaction from a nasopharyngeal swab.

Twenty-three patients (79%) presented an intracranial gadolinium vessels enhancement, mainly in the vertebral arteries without sign of stenosis. Clinical characteristics were similar between patients with and without intracranial gadolinium enhancement, as well as the prevalence of acute stroke (9% versus 33%, respectively; p-value = 0.119) and microbleeds (52% versus 33%, respectively; p-value = 0.411). Among the 23 patients with an intracranial vessel gadolinium enhancement, 7 patients were treated by high-dose steroid (methylprednisolone 0.5g/d iv for 5 days) with a good clinical outcome.
Patients with COVID-19 related encephalopathy present an increased prevalence of intracranial gadolinium vessels enhancement, suggestive of an endotheliitis that is not associated with stroke or microbleeds.
Authors/Disclosures
Marjolaine Uginet, MD (Hôpitaux Universitaires de Genève)
PRESENTER 		Dr. Uginet has nothing to disclose.
Gautier Breville, MD Dr. Breville has nothing to disclose.
Frederic Assal, MD (Nerology University Hospital) Dr. Assal has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
No disclosure on file
Patrice LaLive, MD Dr. LaLive has nothing to disclose.
Gilles Allali, MD, PhD Dr. Allali has nothing to disclose.