Lifelong Learning: Consensus Clinical Guidance for Diagnosis and Management of Adult COVID-19 Encephalopathy Patients-View Article

View Article

Pdf Summary

The document outlines clinical guidance for diagnosing and managing COVID-19-related encephalopathy, a common neurological complication in hospitalized COVID-19 patients. The Global COVID-19 Neuro Research Coalition provides this guidance to address the severity and challenges posed by encephalopathy, which often manifests as delirium, subsyndromal delirium, or coma. Encephalopathy's occurrence is linked to both systemic conditions like hypoxia and specific complications such as brain inflammation or seizures, which can exist independently of the severity of COVID-19 infection.<br /><br />A systematic review and a modified Delphi approach were used to create the recommendations. It evaluates the epidemiology, pathophysiology, clinical assessment, and management strategies for COVID-19 encephalopathy. The guidance emphasizes the importance of differentiating between systemic causes of encephalopathy and direct central nervous system (CNS) involvement due to SARS-CoV-2.<br /><br />Key recommendations include thorough neurological assessment for patients with COVID-19, especially those with systemic complications. Diagnostic approaches should involve neuroimaging and cerebrospinal fluid analysis where necessary. Management strategies focus on preventing further brain injury by managing systemic complications and employing appropriate therapies like antiepileptic drugs and immunomodulatory therapies (e.g., corticosteroids) when applicable.<br /><br />Engagement with multidisciplinary rehabilitation services is crucial for patients who have experienced significant neurological impacts. Such services must be scalable due to the pandemic's magnitude, and emerging long-term issues like post-traumatic stress disorder (PTSD) highlight ongoing areas for research.<br /><br />The document concludes with a call to prioritize rehabilitation interventions and conduct further studies on long-term outcomes, highlighting the need for adaptable patient-centered care pathways in treatment and rehabilitation of COVID-19-related encephalopathy.

Keywords

COVID-19 encephalopathy

neurological complications

Global COVID-19 Neuro Research Coalition

systemic conditions

brain inflammation

systematic review

neurological assessment

immunomodulatory therapies

multidisciplinary rehabilitation

patient-centered care