Abstract Objective To report four patients with coronavirus disease 2019 (COVID-19) who developed posterior reversible encephalopathy syndrome (PRES). Methods Patient data was abstracted from medical records at Weill Cornell Medical Center. Results Four patients with SARS-CoV-2 infection and PRES were identified. The patients' ages ranged from 64 to 74 years, and two were women. All four patients were admitted to the hospital with acute respiratory distress syndrome requiring intensive care unit admission and mechanical ventilation. PRES was diagnosed after persistent confusion, lethargy, new focal neurological deficits, or seizures were noted, with evidence of seizures on electroencephalogram for two of the patients. Imaging confirmed the presence of cerebral vasogenic edema. All four patients had elevated blood pressure and renal injury in the days preceding PRES diagnosis, as well as evidence of systemic inflammation and systemic hypercoagulability. Symptoms of PRES improved with blood pressure control. Conclusions Our four cases demonstrate the occurrence of PRES in critically-ill patients with COVID-19. PRES should be considered in the differential for acute neurological deficits and seizures in this setting.

中文翻译：

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COVID-19 患者后部可逆性脑病综合征

摘要 目的报告四名发生后部可逆性脑病综合征（PRES）的 2019 冠状病毒病（COVID-19）患者。方法 从威尔康奈尔医学中心的病历中提取患者数据。结果 确定了 4 名 SARS-CoV-2 感染和 PRES 患者。患者的年龄从 64 岁到 74 岁不等，其中两名是女性。所有四名患者均因急性呼吸窘迫综合征入院，需要重症监护病房和机械通气。在注意到持续性意识模糊、嗜睡、新的局灶性神经功能缺损或癫痫发作后诊断出 PRES，其中两名患者的脑电图有癫痫发作的证据。影像学证实存在脑血管源性水肿。在 PRES 诊断前的几天内，所有四名患者均出现血压升高和肾损伤，以及全身炎症和全身高凝状态的证据。PRES 的症状随着血压的控制而改善。结论 我们的四个案例证明了 COVID-19 危重患者发生 PRES。在这种情况下，在鉴别急性神经功能缺损和癫痫发作时应考虑 PRES。