As the world has struggled to adapt to the coronavirus disease (COVID-19) pandemic, new evidence has emerged suggesting that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may manifest with a wide variety of neurologic symptoms. We present the case of a 70-year-old patient hospitalized for COVID-19 related pneumonia who was treated with off-label interleukin (IL)-6 inhibitor tocilizumab and eventually developed prolonged delirium. MRI findings were consistent with posterior reversible encephalopathy syndrome (PRES). PRES was felt to be from SARS-CoV-2 infection, tocilizumab, or a combination. The patient received symptomatic treatment without success. These findings are consistent with few other recent reports, which have chronicled PRES findings in patients with SARS-CoV-2 infections. However, this is only the second example of PRES in a COVID-19 patient treated with tocilizumab. While cases of PRES have been noted to occur with other infectious diseases, clinicians should be aware of the association with SARS-CoV-2 infection and tocilizumab therapy, particularly when considering tocilizumab treatment outside its approved indication. Future research efforts are needed to establish evidence-based guidelines for the management of these patients.
【저자키워드】 COVID-19, SARS-CoV-2, Tocilizumab, Case report, PRES, 【초록키워드】 Treatment, coronavirus disease, coronavirus, pandemic, Diseases, Hospitalized, Pneumonia, SARS-COV-2 infection, Infection, Symptoms, MRI, infections, delirium, management, Research, Patient, Symptomatic treatment, Encephalopathy, inhibitor, patients, association, Evidence, Combination, COVID-19 patient, acute respiratory syndrome, clinician, syndrome, effort, tocilizumab therapy, off-label, while, Future, neurologic, example, approved, treated, occur, variety, patients with SARS-CoV-2, 【제목키워드】 Posterior, Reversible,