Prolonged unconsciousness following severe COVID-19

Objective: We report a case series of patients with prolonged but reversible unconsciousness following COVID-19 related severe respiratory failure. Methods: A case series of  patients who were admitted to the ICU due to COVID-19 related acute respiratory failure is described. Results: After cessation of sedatives the described cases all showed a prolonged comatose state. Diagnostic neurological work-up did not show signs of devastating brain injury. The clinical pattern of awakening started with early eye opening without obeying commands and persistent flaccid weakness in all cases. Time between cessation of sedatives to the first moment of being fully responsive with obeying commands ranged from 8 to 31 days. Conclusion: Prolonged unconsciousness in patients with severe respiratory failure due to COVID-19 can be fully reversible warranting a cautious approach for prognostication based on a prolonged state of unconsciousness.研究目的：本研究报告一组新型冠状病毒感染（COVID-19）相关重症呼吸衰竭后出现长时间但可逆性意识障碍的患者病例系列。 研究方法：本研究描述了一组因新冠病毒感染相关急性呼吸衰竭入住重症监护病房（ICU）的患者病例系列。 研究结果：停用镇静剂后，所有纳入病例均出现长时间昏迷状态。诊断性神经系统检查未发现严重脑损伤的征象。所有病例的觉醒临床模式均以早期睁眼但无法遵嘱动作为起始表现，并持续存在弛缓性肌无力。从停用镇静剂至首次完全恢复遵嘱反应的时间跨度为8至31天。 研究结论：新冠病毒感染相关重症呼吸衰竭患者出现的长时间意识障碍可完全逆转，因此基于长时间意识障碍状态进行预后判断时需采取谨慎态度。