{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T21:12:38Z","timestamp":1780089158050,"version":"3.54.0"},"reference-count":18,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,23]],"date-time":"2021-04-23T00:00:00Z","timestamp":1619136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Severe acute respiratory coronavirus 2 (SARS\u2010CoV\u20102) has been associated with neurological complications, including acute encephalopathy. To better understand the neuropathogenesis of this acute encephalopathy, we describe a series of patients with coronavirus disease 2019 (COVID\u201019) encephalopathy, highlighting its phenomenology and its neurobiological features.\u00a0On May 10, 2020, 707 patients infected by SARS\u2010CoV\u20102 were hospitalized at the Geneva University Hospitals; 31 (4.4%) consecutive patients with an acute encephalopathy (64.6\u2009\u00b1\u200912.1 years; 6.5% female) were included in this series, after exclusion of comorbid neurological conditions, such as stroke or meningitis. The severity of the COVID\u201019 encephalopathy was divided into severe and mild based on the Richmond Agitation Sedation Scale (RASS): severe cases (<jats:italic>n<\/jats:italic>\u2009=\u200914, 45.2%) were defined on a RASS\u2009&lt;\u2009\u22123 at worst presentation.\u00a0The severe form of this so\u2010called COVID\u201019 encephalopathy presented more often a headache. The severity of the pneumonia was not associated with the severity of the COVID\u201019 encephalopathy: 28 of\u00a031 (90%) patients did develop an acute respiratory distress syndrome, without any difference between groups (<jats:italic>p<\/jats:italic>\u2009=\u2009.665). Magnetic resonance imaging\u00a0abnormalities were found in 92.0% (23 of 25 patients) with an intracranial vessel gadolinium enhancement in 85.0% (17\u00a0of 20 patients), while an increased cerebrospinal fluid\/serum quotient of albumin suggestive of blood\u2010brain barrier disruption was reported in 85.7% (6 of 7 patients). Reverse transcription\u2010polymerase chain reaction for SARS\u2010CoV\u20102 was negative for all patients in the cerebrospinal fluid.\u00a0Although different pathophysiological mechanisms may contribute to this acute encephalopathy, our findings suggest the hypothesis of disturbed brain homeostasis and vascular dysfunction consistent with a SARS\u2010CoV\u20102\u2010induced endotheliitis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.26973","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T07:16:17Z","timestamp":1617088577000},"page":"4374-4381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["COVID\u201019 encephalopathy: Clinical and neurobiological features"],"prefix":"10.1002","volume":"93","author":[{"given":"Marjolaine","family":"Uginet","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences, Division of Neurology Geneva University Hospitals and Faculty of Medicine, University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gautier","family":"Breville","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Division of Neurology Geneva University Hospitals and Faculty of Medicine, University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Assal","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Division of Neurology Geneva University Hospitals and Faculty of Medicine, University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl\u2010Olof","family":"L\u00f6vblad","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology Geneva University Hospitals and University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Isabel","family":"Vargas","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology Geneva University Hospitals and University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9r\u00f4me","family":"Pugin","sequence":"additional","affiliation":[{"name":"Division of Intensive Care Geneva University Hospitals and Faculty of Medicine, University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques","family":"Serratrice","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine Geneva University Hospital and Faculty of Medicine, University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois R.","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Geriatrics, Division of Geriatrics Geneva University Hospitals and Faculty of Medicine Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice H.","family":"Lalive","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Division of Neurology Geneva University Hospitals and Faculty of Medicine, University of Geneva Geneva Switzerland"},{"name":"Diagnostic Department, Division of Laboratory Medicine Geneva University Hospital Geneva Switzerland"},{"name":"Department of Pathology and Immunology, Faculty of Medicine University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4455-6719","authenticated-orcid":false,"given":"Gilles","family":"Allali","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, Division of Neurology Geneva University Hospitals and Faculty of Medicine, University of Geneva Geneva Switzerland"},{"name":"Division of General Internal Medicine Geneva University Hospital and Faculty of Medicine, University of Geneva Geneva Switzerland"},{"name":"Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine Yeshiva University Bronx New York 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