{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T15:28:17Z","timestamp":1790263697922,"version":"4.1.0"},"reference-count":31,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T00:00:00Z","timestamp":1589932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FIS PI17\/02193"],"award-info":[{"award-number":["FIS PI17\/02193"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>We used quantified electroencephalography (qEEG) to define the features of encephalopathy in patients released from the intensive care unit after severe illness from COVID-19. Artifact-free 120\u2013300 s epoch lengths were visually identified and divided into 1 s windows with 10% overlap. Differential channels were grouped by frontal, parieto-occipital, and temporal lobes. For every channel and window, the power spectrum was calculated and used to compute the area for delta (0\u20134 Hz), theta (4\u20138 Hz), alpha (8\u201313 Hz), and beta (13\u201330 Hz) bands. Furthermore, Shannon\u2019s spectral entropy (SSE) and synchronization by Pearson\u2019s correlation coefficient (\u03c1) were computed; cases of patients diagnosed with either infectious toxic encephalopathy (ENC) or post-cardiorespiratory arrest (CRA) encephalopathy were used for comparison. Visual inspection of EEGs of COVID patients showed a near-physiological pattern with scarce anomalies. The distribution of EEG bands was different for the three groups, with COVID midway between distributions of ENC and CRA; specifically, temporal lobes showed different distribution for EEG bands in COVID patients. Besides, SSE was higher and hemispheric connectivity lower for COVID. We objectively identified some numerical EEG features in severely ill COVID patients that can allow positive diagnosis of this encephalopathy.<\/jats:p>","DOI":"10.3390\/jcm9051545","type":"journal-article","created":{"date-parts":[[2020,5,20]],"date-time":"2020-05-20T10:37:38Z","timestamp":1589971058000},"page":"1545","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Specific EEG Encephalopathy Pattern in SARS-CoV-2 Patients"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6870-8409","authenticated-orcid":false,"given":"Jes\u00fas","family":"Pastor","sequence":"first","affiliation":[{"name":"Clinical Neurophysiology and Instituto de Investigaci\u00f3n Biom\u00e9dica, Hospital Universitario de La Princesa, C\/Diego de Le\u00f3n 62, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3240-2234","authenticated-orcid":false,"given":"Lorena","family":"Vega-Zelaya","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology and Instituto de Investigaci\u00f3n Biom\u00e9dica, Hospital Universitario de La Princesa, C\/Diego de Le\u00f3n 62, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Mart\u00edn Abad","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology, Hospital Universitario de La Princesa, C\/Diego de Le\u00f3n 62, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Sun, T., and Guan, J. (2020). Novel coronavirus and central nervous system. Eur. J. Neurol., 26.","DOI":"10.1111\/ene.14227"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Moriguchi, T., Harii, N., Goto, J., Harada, D., Sugawara, H., Takamino, J., Ueno, M., Sakata, H., Kondo, K., and Myose, N. (2020). A first Case of Meningitis\/Encephalitis associated with SARS-Coronavirus-2. Int. J. Infect Dis., 3.","DOI":"10.1016\/j.ijid.2020.03.062"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Wu, Y., Xu, X., Chen, Z., Duan, J., Hashimoto, K., Yang, L., Liu, C., and Yang, C. (2020). Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav. Immun., 30.","DOI":"10.1016\/j.bbi.2020.03.031"},{"key":"ref_4","first-page":"e7352","article-title":"Neurological complications of coronavirus (COVID-19): Encephalopathy","volume":"12","author":"Filatov","year":"2020","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Poyiadji, N., Shahin, G., Noujaim, D., Stone, M., Patel, S., and Griffith, B. (2020). COVID-19-associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features. Radiology, 31.","DOI":"10.1148\/radiol.2020201187"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Vaira, L.A., Salzano, G., Deiana, G., and De Riu, G. (2020). Anosmia and ageusia: Common findings in COVID-19 patients. Laryngoscope, 1.","DOI":"10.1002\/lary.28753"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0140-6736(20)30628-0","article-title":"COVID-19: Consider cytokine storm syndromes and immunosuppression","volume":"395","author":"Mehta","year":"2020","journal-title":"Lancet"},{"key":"ref_8","unstructured":"Chen, C., Zhang, X.R., Ju, Z.Y., and He, W.F. (2020). Advances in the research of cytokine storm mechanism induced by Corona Virus Disease 2019 and the corresponding immunotherapies. Zhonghua Shao Shang Za Zhi, 1."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"3398","DOI":"10.1128\/JVI.78.7.3398-3406.2004","article-title":"Coronavirus neurovirulence correlates with the ability of the virus to induce proinflammatory cytokine signals from astrocytes and microglia","volume":"78","author":"Li","year":"2004","journal-title":"J. Virol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/WNP.0b013e31821c33a0","article-title":"EEG patterns and imaging correlations in encephalopathy: Encephalopathy part II","volume":"28","author":"Kaplan","year":"2011","journal-title":"J. Clin. Neurophysiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1600-0404.2007.00809.x","article-title":"Acute encephalopathy associated with influenza and other viral infections","volume":"186","author":"Mizuguchi","year":"2007","journal-title":"Acta Neurol. Scand. Suppl."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"243","DOI":"10.5491\/SHAW.2012.3.4.243","article-title":"Toxic encephalopathy","volume":"4","author":"Kim","year":"2012","journal-title":"Saf. Health Work"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1097\/WNP.0b013e3182a73d83","article-title":"Encephalopathy of infection and systemic inflammation","volume":"30","author":"Young","year":"2013","journal-title":"J. Clin. Neurophysiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/14787210.2017.1265448","article-title":"Septic encephalopathy and septic encephalitis","volume":"15","author":"Tauber","year":"2017","journal-title":"Expert Rev. Anti. Infect Ther."},{"key":"ref_15","unstructured":"Schomer, D.L., and Lopes da Silva, F. (2011). Metabolic Disorders and EEG. Niedermeyer\u2019s Electroencephalography: Basic Principles, Clinical Applications, and Related Fields, Lippincott Williams & Wilkins. [6th ed.]."},{"key":"ref_16","unstructured":"Vega-Zelaya, L., Garn\u00e9s-Camarena, O., Sanz-Garc\u00eda, A., Ortega, G.J., and Pastor, J. (2016). Mathematical foundations of quantified electroencephalography. Clinical Advances in Neurophysiology, Avid Science."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Vega-Zelaya, L., Mart\u00edn Abad, E., and Pastor, J. (2020). Quantified EEG for the characterization of epileptic seizures versus periodic activity in critically ill patients. Brain Sci., 10.","DOI":"10.3390\/brainsci10030158"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1126\/science.7434026","article-title":"Developmental equations for the electroencephalogram","volume":"210","author":"John","year":"1980","journal-title":"Science"},{"key":"ref_19","unstructured":"Gevins, A.S., and Remond, A. (1987). Normative Data Banks and Neurometrics: Basic Concepts, Methods and Results of Norm Construction. Handbook of Electroencephalography and Clinical Neurophysiology, Elsevier."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/WNP.0b013e3182784729","article-title":"American Clinical Neurophysiology Society\u2019s Standardized Critical Care EEG Terminology","volume":"30","author":"Hirsch","year":"2013","journal-title":"J. Clin. Neurophysiol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hirsch, L.J., and Brenner, R.P. (2010). Atlas of EEG in Critical Care, Willey-Blackwell.","DOI":"10.1002\/9780470746707"},{"key":"ref_22","unstructured":"Franco, J.I., and Artieada, J. (2013). Electroencefalograf\u00eda en Patolog\u00edas no Epil\u00e9pticas. Manual de Neurofisiolog\u00eda Cl\u00ednica, Panamericana."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Mao, L., Wang, M.D., Chen, S.H., He, Q.W., Chang, J., Hong, C.D., Zhou, Y., Wang, D., Li, Y., and Jin, H. (2020). Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: A retrospective case series study. MedRxiv.","DOI":"10.1101\/2020.02.22.20026500"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.annfar.2012.04.013","article-title":"Interaction brain-lungs","volume":"31","author":"Abdennour","year":"2012","journal-title":"Ann. Fr. Anesth. Reanim."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.cnc.2019.07.006","article-title":"Postintensive Care Syndrome","volume":"31","author":"Bryant","year":"2019","journal-title":"Crit. Care Nurs. Clin. North Am."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Lee, M., Kang, J., and Jeong, Y.J. (2019). Risk factors for post\u2013intensive care syndrome: A systematic review and meta-analysis. Aust. Crit. Care, 12.","DOI":"10.1016\/j.aucc.2020.04.130"},{"key":"ref_27","first-page":"169","article-title":"Assessing the equivalence between etomidate and seizure network dynamics in temporal lobe epilepsy","volume":"127","author":"Pastor","year":"2015","journal-title":"Clin. Neurophysiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2294","DOI":"10.1016\/j.clinph.2004.04.029","article-title":"Indentifyng true brain interaction from EEG data using the imaginary part of coherency","volume":"115","author":"Nolte","year":"2004","journal-title":"Clin. Neurophysiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3389\/fnsys.2015.00175","article-title":"A Tutorial Review of Functional Connectivity Analysis Methods and Their Interpretational Pitfalls","volume":"9","author":"Bastos","year":"2016","journal-title":"Front Syst. Neurosci."},{"key":"ref_30","unstructured":"Van Drongelen, W. (2007). Signal Processing for Neuroscientists, Elsevier."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Sanz-Garc\u00eda, A., P\u00e9rez-Romero, M., Pastor, J., Sola, R.G., Vega-Zelaya, L., Monasterio, F., Torrecilla, C., Vega, G., Pulido, P., and Ortega, G. (2018). Identifying causal relationships between EEG activity and intracranial pressure changes in neurocritical care patients. J. Neural. Eng., 15.","DOI":"10.1088\/1741-2552\/aadeea"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/5\/1545\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:30:47Z","timestamp":1760175047000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/5\/1545"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,20]]},"references-count":31,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["jcm9051545"],"URL":"https:\/\/doi.org\/10.3390\/jcm9051545","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,20]]}}}