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Cytokine release syndrome‐associated encephalopathy in patients with COVID‐19

European Journal of Neurology Oct 08, 2020

Perrin P, Collongues N, Baloglu S, et al. - In patients with coronavirus disease (COVID)‐19, researchers sought to describe the neurological manifestations that are seen, as well as to get some pathophysiological insights with respect to the cytokine release syndrome (CRS). Extensive clinical, laboratory, and imaging phenotyping were carried out in five patients admitted to the renal unit in this longitudinal study. Confusion, tremor, cerebellar ataxia, behavioral alterations, aphasia, pyramidal syndrome, coma, cranial nerve palsy, dysautonomia, and central hypothyroidism were the neurological presentations included, which were, notably, accompanied by laboratory evidence of CRS. Findings suggest that in patients with COVID‐19, neurological manifestations can develop that share clinical, laboratory, and imaging similarities with those of chimeric antigen receptor T‐cell‐related encephalopathy. CRS, endothelial activation, blood−brain barrier dysfunction, and immune‐mediated mechanisms appear to be involved in the pathophysiological underpinnings.

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