Presentation Title

Post COVID-19 Demyelinating Disease

Speaker Credentials

MD

Format

Poster

Start Date

6-11-2020 12:30 PM

End Date

6-11-2020 12:45 PM

Abstract

Post COVID-19 Demyelinating Disease Daniel Lopez, MD1, Nicole Irizarry, MD2, Daniel Martinez, MD3 Isabel Brea, MD4 1Emergency Medicine Resident PGY-1, Kendall Regional Medical Center 2Emergency Medicine Teaching Faculty, Kendall Regional Medical Center 3Emergency Medicine Teaching Faculty, Kendall Regional Medical Center 4Emergency Medicine Core Clinical Faculty, Kendall Regional Medical Center Introduction: COVID-19 has surprised physicians and health care providers with increased deaths worldwide. Patients with this virus have presented to Emergency Departments across the globe with a variety of clinical manifestations, ranging from common flu-like symptoms, pneumonia, acute respiratory distress syndrome, and multi-organ failure resulting in increased ICU admission rates. A rare clinical relationship exists in the literature with secondary neurological illnesses and COVID-19. Case Description: A 42 year old Hispanic female with no PMH presented to the ER with bilateral leg weakness and urinary retention for 1 day. COVID-19 testing 11 days prior to these symptoms was positive. Physical exam notable for bilateral thigh and leg muscle weakness and absent plantar reflexes bilaterally. Bladder bedside ultrasound revealed 682 mL of urine in the bladder. MRI of the lumbar, thoracic, and cervical spine was negative for acute spinal cord abnormalities. Brain MRI was significant for subtle T2/FLAIR hyperintensity involving the bilateral thalami and white matter tracts. CSF analysis showed Myelin Basic Protein at 71.6 ng/mL (range 0.0-3.7) indicating an acute demyelinating process. Patient was admitted to the hospital for further evaluation by a neurologist. 1g of Methylprednisolone for 5 days resulted in complete recovery of neurological symptoms and she was discharged on her 5th day after hospitalization. Discussion: Our case identifies a patient with post-COVID-19 demyelinating disease. Given the current pandemic, recent viral illnesses including COVID-19 should be considered when evaluating a patient with new neurological findings. Continued efforts should be made for the treatment, prevention, and awareness of COVID-19. The research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.

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Nov 6th, 12:30 PM Nov 6th, 12:45 PM

Post COVID-19 Demyelinating Disease

Post COVID-19 Demyelinating Disease Daniel Lopez, MD1, Nicole Irizarry, MD2, Daniel Martinez, MD3 Isabel Brea, MD4 1Emergency Medicine Resident PGY-1, Kendall Regional Medical Center 2Emergency Medicine Teaching Faculty, Kendall Regional Medical Center 3Emergency Medicine Teaching Faculty, Kendall Regional Medical Center 4Emergency Medicine Core Clinical Faculty, Kendall Regional Medical Center Introduction: COVID-19 has surprised physicians and health care providers with increased deaths worldwide. Patients with this virus have presented to Emergency Departments across the globe with a variety of clinical manifestations, ranging from common flu-like symptoms, pneumonia, acute respiratory distress syndrome, and multi-organ failure resulting in increased ICU admission rates. A rare clinical relationship exists in the literature with secondary neurological illnesses and COVID-19. Case Description: A 42 year old Hispanic female with no PMH presented to the ER with bilateral leg weakness and urinary retention for 1 day. COVID-19 testing 11 days prior to these symptoms was positive. Physical exam notable for bilateral thigh and leg muscle weakness and absent plantar reflexes bilaterally. Bladder bedside ultrasound revealed 682 mL of urine in the bladder. MRI of the lumbar, thoracic, and cervical spine was negative for acute spinal cord abnormalities. Brain MRI was significant for subtle T2/FLAIR hyperintensity involving the bilateral thalami and white matter tracts. CSF analysis showed Myelin Basic Protein at 71.6 ng/mL (range 0.0-3.7) indicating an acute demyelinating process. Patient was admitted to the hospital for further evaluation by a neurologist. 1g of Methylprednisolone for 5 days resulted in complete recovery of neurological symptoms and she was discharged on her 5th day after hospitalization. Discussion: Our case identifies a patient with post-COVID-19 demyelinating disease. Given the current pandemic, recent viral illnesses including COVID-19 should be considered when evaluating a patient with new neurological findings. Continued efforts should be made for the treatment, prevention, and awareness of COVID-19. The research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity. The views expressed in this publication represent those of the author(s) and do not necessarily represent the official views of HCA Healthcare or any of its affiliated entities.