{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T14:06:20Z","timestamp":1789999580124,"version":"4.0.1"},"reference-count":10,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,3,26]],"date-time":"2021-03-26T00:00:00Z","timestamp":1616716800000},"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":["Euro J of Neurology"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>COVID\u201019 affects the brain in various ways, amongst which delirium is worrying. An assessment was made of whether a specific, long\u2010lasting, COVID\u201019\u2010related brain injury develops in acute respiratory distress syndrome patients after life\u2010saving re\u2010oxygenation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten COVID+ patients (COVID+) with unusual delirium associated with neuroimaging suggestive of diffuse brain injury and seven controls with non\u2010COVID encephalopathy were studied. The assessment took place when the intractable delirium started at weaning off ventilation support. Brain magnetic resonance imaging (MRI) was performed followed by standard cerebrospinal fluid (CSF) analyses and assessment of CSF erythropoietin concentrations (as a marker for the assessment of tissue repair), and of non\u2010targeted CSF metabolomics using liquid chromatography high resolution mass spectrometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients were similar as regards severity scores, but COVID+ were hospitalized longer (25 [11.75; 25] vs. 9 [4.5; 12.5] days, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.03). On admission, but not at MRI and lumbar puncture performance, COVID+ were more hypoxic (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.002). On MRI, there were leptomeningeal enhancement and diffuse white matter haemorrhages only in COVID+. In the latter, CSF erythropoietin concentration was lower (1.73 [1.6; 2.06] vs. 3.04 [2.9; 3.91] mIU\/ml, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.01), and CSF metabolomics indicated (a) increased compounds such as foodborne molecules (sesquiterpenes), molecules from industrialized beverages and micro\u2010pollutants (diethanolamine); and (b) decreased molecules such as incomplete breakdown products of protein catabolism and foodborne molecules (glabridin). At 3\u2010month discharge, fatigue, anxiety and depression as well as MRI lesions persisted in COVID+.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Some COVID+ are at risk of a specific delirium. Imperfect brain repair after re\u2010oxygenation and lifestyle factors might influence long\u2010lasting brain injuries in a context of foodborne micro\u2010pollutants.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.14776","type":"journal-article","created":{"date-parts":[[2021,2,14]],"date-time":"2021-02-14T14:45:26Z","timestamp":1613313926000},"page":"3443-3447","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Acute\u2010onset delirium in intensive care COVID patients: association of imperfect brain repair with foodborne micro\u2010pollutants"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7481-5101","authenticated-orcid":false,"given":"Francis","family":"Schneider","sequence":"first","affiliation":[{"name":"M\u00e9decine Intensive\u2014R\u00e9animation H\u00f4pitaux Universitaires Strasbourg 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