A Case of Persistent Cortical Blindness as a Complication of COVID-19 Pneumonia

Researchers have reported a 54-year-old COVID-19 patient who presented with SARS-CoV-2 elated pneumonia, posterior reversible encephalopathy syndrome (PRES), and persistent cortical blindness. At the time of hospital admission, the patient had a high body temperature, significantly elevated heart rate, and 82% oxygen saturation level. Because of further deterioration of the health condition of the patient, non-invasive ventilation was started. Because of increased oxygen demand, the patient was subjected to endotracheal intubation and mechanical ventilation after ten days of admission.

With further examinations, the patient was diagnosed with acute respiratory distress syndrome and systemic inflammatory response syndrome. Based on the patient’s clinical profile, a possibility of sepsis could not be ruled out, and thus, the treatment with broad-spectrum antibiotics was initiated. Throughout the course of the hospital stay, the patient was not administered any steroids or immunomodulatory medicines.

On day 21, the patient had a generalized seizure and a brain CT scan was performed, which suggested the possibility of PRES. As the patient stabilized, mechanical ventilation was removed and neurological examination demonstrated the presence of complete cortical blindness and Anton’s syndrome. Based on the available literature, cerebral hyper-perfusion caused by hypertension is a significant risk factor for PRES. Because sepsis was suspected, the researchers suggest that COVID-19-related endothelial dysfunction might be a potential cause of PRES. The researchers suggest that PRES, along with persistent cortical blindness, should be regarded as one of the rare complications associated with SARS-CoV-2 infection. 

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Ref link: https://www.cureus.com/articles/50263-persistent-cortical-blindness-following-posterior-reversible-encephalopathy-syndrome-pres-as-a-complication-of-covid-19-pneumonia

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