COVID-19-related encephalopathy responsive to high doses glucocorticoids

One hundred twenty patients with coronavirus disease 2019 (COVID-19) were hospitalized in our intensive care unit, Geneva, Switzerland, between March 9 and April 16, 2020. We report the clinical evolution of 5 consecutive patients intubated because of COVID-19– related acute respiratory distress syndrome, presenting with a pathologic recovery of consciousness, which was responsive to high-dose glucocorticoids. These patients all presented with angio-MRI signs of inflammation of CNS arteries, consistent with an endothelialitis rather than a vasculitis. The median time between COVID-19 first symptoms and intubation was 10 days (IQR 10–11 days). The clinical data, as well as biological and radiological data, were collected separately and analyzed as described in Supplemental tables 1 to 3.