The association of posterior reversible encephalopathy syndrome with COVID-19: A systematic review
| Autor: | Muhammad Ebaad Ur Rehman, Muhammad Aemaz Ur Rehman, Ahmad Nawaz, Sadaf Iftikhar, Abyaz Asmar, Aqeeb Ur Rehman, Muhammad Zain Ameer, Hareem Farooq |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Systematic Review / Meta-analysis
medicine.medical_specialty medicine.diagnostic_test SARS-CoV-2 business.industry COVID-19 Magnetic resonance imaging Posterior reversible encephalopathy syndrome General Medicine medicine.disease PRES Cerebral edema Posterior leukoencephalopathy syndrome Systematic review Blood pressure Posterior Leukoencephalopathy Syndrome Diabetes mellitus Internal medicine medicine Surgery business Cytokine storm |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| DOI: | 10.1016/j.amsu.2021.103080 |
| Popis: | The rise in Coronavirus disease 2019 (COVID-19) cases is revealing its unique neurological manifestations. In light of the emerging evidence, a possible association with Posterior Reversible Encephalopathy Syndrome (PRES) is being consistently reported. We conducted a systematic literature search on four databases namely Pubmed/MEDLINE, Cochrane, Google Scholar, and Science Direct. After rigorous screening as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a total of 34 articles describing 56 cases were selected as a part of this review. The mean age of the patients was 56.6 ± 15.3 years. The most common clinical presentation of PRES was altered mental status (58.9%) followed by seizures (46.4%) and visual disturbances (23.2%) while hypertension and diabetes mellitus were the most commonly reported comorbidities. 91.1% of the cases reported Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) findings suggestive of PRES in the brain. Symptomatic management was employed in most of the cases to control seizures and blood pressure, and 44 patients (78.5%) fully or partially recovered. The most likely underlying mechanism involves COVID-19 mediated cytokine storm syndrome that leads to endothelial damage and increased permeability of the cerebral vessels, thus causing the characteristic edema of PRES. High neuronal and glial cell expression of Angiotensin Converting Enzyme-2 (ACE-2) receptors also suggests the possibility of direct viral damage. Since timely diagnosis and treatment reports a good prognosis, it is vital for physicians and neurologists to be well-versed with this association. Highlights • Posterior Reversible Encephalopathy Syndrome (PRES) is a neurological complication of COVID-19. • SARS-CoV-2 disrupts the integrity of cerebral blood vessels through cytokine storm, thus driving the edema of PRES. • COVID-19 is probably additive with hypertension, diabetes and tocilizumab in causing PRES. • Timely diagnosis and treatment are necessary to avoid complications such as cerebral hemorrhage, epilepsy and vision loss. • A favorable outcome is observed in most cases. |
| Databáze: | OpenAIRE |
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