Unusual Presentation of COVID-19: Encephalitis and Syndrome of Inappropriate Anti-Diuretic Hormone Secretion

Maresca Andrea,Zerba Francesco,Baj Andreina,Ageno Walter,Dalla Gasperina Daniela,Montalbetti Lorenzo,Guasti Luigina,Dentali Francesco,Sessa Aurelio,Mauri Marco,Grandi Anna Maria,Grossi Paolo,Mongiardi Christian

doi:10.4236/ijcm.2020.1110048

Maresca Andrea, Zerba Francesco + Show 11 more

Open Access

https://doi.org/10.4236/ijcm.2020.1110048

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Abstract

COVID-19 is a new challenge in clinical medicine. Although typical presentations include fever and pneumonia, we describe a case of COVID-19 presenting with neurological symptoms of encephalitis and infectious-related syndrome of inappropriate anti-diuretic hormone secretion. Because of the epidemic health problems, it is crucial to identify these patients as early as possible to follow the isolation procedures. We suggest that unclear neurological clinical presentations of patients should be considered for COVID-19.

Highlights

The unusual case of COVID-19 described here showed an initial clinical presentation with exclusive neurological symptoms and an infectious-related SIADH, followed by fever and dyspnea after few days. The oddity of this case is increased by the fact that the patient was already treated with drugs used for COVID-19 treatment before admission and before developing more classical symptoms and signs of the SARS-CoV-2-related pneumonia
This treatment may have masked for a few days the developing of a COVID-19-related typical lung disease and may have interfered with the finding of SARS-CoV-2 in the cerebrospinal fluid
Ye et al showed encephalitis as an additional manifestation of COVID-19 coming with the classical symptoms [6] and Poyiadji et al reported images of acute hemorrhagic necrotizing encephalopathy associated with COVID-19 [7]

Summary

Introduction

Http://creativecommons.org/licenses/by/4.0/ Coronavirus Disease (COVID-19) has spread as a world pandemic in the last few. Since this epidemic is sustained by a new strain of coronavirus Acute Respiratory Syndrome Coronavirus-2: SARS-CoV-2), new aspects of this disease are emerging. The first clinical descriptions of the disease point to lung disease often leading to pulmonary failure [1] [2]. Neurotropic properties have been shown for coronavirus and SARS-Cov-2 [3] and neurological manifestations such as loss of smell have been described [4]

Clinical Case

Discussion

METHODS