A prospective observational study on posterior reversible encephalopathy syndrome in COVID-19 eclampsia patients in tertiary care hospital

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with neurological symptoms in one third of COVID-19 patients which is attributed to its hypercoagulable state or its neurotropism which is not yet defined. PRES (Posterior Reversible Encephalopathy Syndrome) is a rare clinico- neuro-radiological entity which can be associated with multiple clinical conditions and was observed frequently with preeclampsia and eclampsia patients. Neuro- imaging is important to diagnose PRES. This study is a prospective observational study in COVID -19 positive eclampsia patients at Gandhi Hospital, Telangana during March 2021-august 2021.Among 55 COVID-19 positive eclampsia patients, 17 had PRES out of which 64.7% had antepartum eclampsia. Seven patients had severe COVID-19 disease out of which five patients required noninvasive ventilation and two patients required invasive ventilation. In my study, PRES was more common among primigravida, common age group 21-25 years. Mean SBP/DBP is 177±12 / 110±6 mm Hg respectively. Incidence of Thrombocytopenia is more in COVID-19 eclampsia patients. COVID -19 related complications are seen in 41.17% whereas eclampsia related maternal complications are seen in 29.4%. There was one maternal death and perinatal mortality was 17.64%.COVID -19 positive eclampsia patients have more predilection to PRES. Diagnosis, treatment of eclampsia in COVID-19 should be evaluated and treated for PRES. Regular antenatal visits and regular bp monitoring can prevent eclampsia and its complications and can reduce maternal morbidity, mortality. Use of anticoagulants and corticosteroids may fasten the recovery rate.