Consensus Clinical Guidance for Diagnosis and Management of Adult COVID-19 Encephalopathy Patients
Author
Michael, Benedict DWalton, Dean
Westenberg, Erica
García-Azorín, David
Singh, Bhagteshwar
Tamborska, Arina A
Netravathi, M
Chomba, Mashina
Wood, Greta K
Easton, Ava
Siddiqi, Omar K
Jackson, Thomas A
Pollak, Thomas A
Nicholson, Timothy R
Nair, Shalini
Breen, Gerome
Prasad, Kameshwar
Thakur, Kiran T
Chou, Sherry H-Y
Schmutzhard, Erich
Frontera, Jennifer A
Helbok, Raimund
Padovani, Alessandro
Menon, David K
Solomon, Tom
Winkler, Andrea S
Publication date
2022-07-25
Metadata
Show full item recordAbstract
Encephalopathy, a common condition among patients hospitalized with COVID-19, can be a challenge to manage and negatively affect prognosis. While encephalopathy may present clinically as delirium, subsyndromal delirium, or coma and may be a result of systemic causes such as hypoxia, COVID-19 has also been associated with more prolonged encephalopathy due to less common but nevertheless severe complications, such as inflammation of the brain parenchyma (with or without cerebrovascular involvement), demyelination, or seizures, which may be disproportionate to COVID-19 severity and require specific management. Given the large number of patients hospitalized with severe acute respiratory syndrome coronavirus-2 infection, even these relatively unlikely complications are increasingly recognized and are particularly important because they require specific management. Therefore, the aim of this review is to provide pragmatic guidance on the management of COVID-19 encephalopathy through consensus agreement of the Global COVID-19 Neuro Research Coalition. A systematic literature search of MEDLINE, medRxiv, and bioRxiv was conducted between January 1, 2020, and June 21, 2021, with additional review of references cited within the identified bibliographies. A modified Delphi approach was then undertaken to develop recommendations, along with a parallel approach to score the strength of both the recommendations and the supporting evidence. This review presents analysis of contemporaneous evidence for the definition, epidemiology, and pathophysiology of COVID-19 encephalopathy and practical guidance for clinical assessment, investigation, and both acute and long-term management.Citation
Michael BD, Walton D, Westenberg E, García-Azorín D, Singh B, Tamborska AA, Netravathi M, Chomba M, Wood GK, Easton A, Siddiqi OK, Jackson TA, Pollak TA, Nicholson TR, Nair S, Breen G, Prasad K, Thakur KT, Chou SH, Schmutzhard E, Frontera JA, Helbok R, Padovani A, Menon DK, Solomon T, Winkler AS; Global COVID-19 Neuro Research Coalition. Consensus Clinical Guidance for Diagnosis and Management of Adult COVID-19 Encephalopathy Patients. J Neuropsychiatry Clin Neurosci. 2023 Winter;35(1):12-27. doi: 10.1176/appi.neuropsych.22010002. Epub 2022 Jul 25.Type
ArticlePMID
35872617Publisher
American Psychiatric Pressae974a485f413a2113503eed53cd6c53
10.1176/appi.neuropsych.22010002