TY - JOUR
T1 - Consensus clinical guidance for diagnosis and management of adult COVID-19 encephalopathy patients
AU - Global COVID-19 Neuro Research Coalition
AU - Michael, Benedict D
AU - Walton, Dean
AU - Westenberg, Erica
AU - García-Azorín, David
AU - Singh, Bhagteshwar
AU - Tamborska, Arina A
AU - Netravathi, M
AU - Chomba, Mashina
AU - Wood, Greta K
AU - Easton, Ava
AU - Siddiqi, Omar K
AU - Jackson, Thomas A
AU - Pollak, Thomas A
AU - Nicholson, Timothy R
AU - Nair, Shalini
AU - Breen, Gerome
AU - Prasad, Kameshwar
AU - Thakur, Kiran T
AU - Chou, Sherry H-Y
AU - Schmutzhard, Erich
AU - Frontera, Jennifer A
AU - Helbok, Raimund
AU - Padovani, Alessandro
AU - Menon, David K
AU - Solomon, Tom
AU - Winkler, Andrea S
PY - 2022/7/25
Y1 - 2022/7/25
N2 - 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.
AB - 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.
U2 - 10.1176/appi.neuropsych.22010002
DO - 10.1176/appi.neuropsych.22010002
M3 - Article
C2 - 35872617
JO - Journal of Neuropsychiatry and Clinical Neurosciences
JF - Journal of Neuropsychiatry and Clinical Neurosciences
ER -