Fulminant Hemorrhagic Vasculopathy Associated with COVID-19

Abstract

Background— Coronavirus disease 2019 (COVID-19)–related neurologic complications remain poorly
understood. Current literature demonstrates that COVID-19 has been associated with cerebral microbleeds and
leukoencephalopathy in as many 30% of critically-ill patients who undergo magnetic resonance imaging suggestive
of endothelial inflammation and thrombotic microangiopathy.
Case Description— We report a patient who presented with the sudden onset of status epilepticus and coma.

Clinical and neuroimaging findings suggested a diffuse novel severe acute respiratory syndrome coronavirus (SARS-
CoV-2)–induced hemorrhagic vasculopathy. Her level of consciousness improved dramatically with high dose

corticosteroids, and she made a good recovery.
Conclusions— We report a patient with COVID-19 who developed clinical syndrome and radiological findings
most consistent with diffuse cerebral vasculitis.