Table 1.
A Summary of individual cases reporting COVID-19-associated CLOCCs/MERS/RESLES in order of patient age.
| First author | Article type | Country | Patient age/gender | Risk | Diagnosis | SARS-CoV-2 PCR | SARS-CoV-2 serology | Time between reported COVID-19 symptoms and onset of CLOCCs (days) | Hypoxemia (oxygen saturation ≤ 94% on room air) | Pneumonia | CRP (mg/L) | Na (mmol/L) | Overall outcome | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ID 1 | Hayashi M | CR | Japan | 75/M | Alzheimer's disease | C | Positive for oropharyngeal swab | NR | A few | + | + | 53.2 | Normal | Died due to respiratory failure |
| ID 2 | Kakadia B | CR | United States | 69/M | Hypertension | C | Negative for nasopharyngeal swab | Positive IgA/IgG | NR | NR | NR | 503.2 | NR | Resloved |
| (our case) | Kubo M | CR | Japan | 61/F | Asthma | C | Positive for nasopharyngeal swab | NR | 1 | - | - | 75.9 | 129 | Resloved, discharged |
| ID 3 | El Aoud S | CR | France | 60/M | Dyslipidemia | C | Negative for oropharyngeal swab | Positive IgG | 9 | - | + | 50 | NR | Improved |
| ID 4 | Usta NC | CS | Turkey | 57/M | Hypertension, diabetes | C | NR | NR | NR | NR | + | NR | NR | Recovered |
| ID 5 | Forestier G | CR | France | 55/M | None | C | Positive for nasopharyngeal swab | NR | NR | NR | + | 8.1 | Normal | NR |
| ID 6 | Edjlali M | CS | France | 51/M | NR | C | Positive for nasopharyngeal swab | NR | NR | NR | NR | NR | NR | NR |
| ID 7 | Esra Demir | CR | Turkey | 50/M | None | C | Positive for nasopharyngeal and oropharyngeal swab | NR | 0 | - | + | 170 | NR | Resolved, discharged |
| ID 8 | Klironomos S | CS | Sweden | late 40s/F | NR | C | NR | NR | NR | NR | NR | NR | NR | NR |
| ID 9 | Edjlali M | CS | France | 49/M | NR | C | Positive for nasopharyngeal swab | NR | NR | NR | NR | NR | NR | NR |
| ID 10 | Eren F | CR | Turkey | 47/M | None | C | Positive for nasopharyngeal swab | NR | 5 | - | + | 14.2 | NR | Recovered completely, discharged |
| ID 11 | Chauffier J | CR | France | 47/M | None | C | Positive for nasopharyngeal swab | NR | 13 | + | + | 171 | Hyponatremia | Improved, discharged |
| ID 12 | Micci L | CR | United States | 45/M | None | C | Positive | NR | 4 | + | + | NR | NR | Discharged |
| ID 13 | Chevalier K | CR | France | 45/M | None | C | NR | NR | 3 | NR | NR | NR | NR | Recovered, discharged |
| ID 14 | Arıkan FA | CR | Turkey | 43/M | None | C | Positive for nasopharyngeal swab | NR | 5 | NR | + | 94 | NR | Recovered |
| ID 15 | DE Oliveira FAA | CR | Brazil | 40/M | NR | C | Positive for nasal swab | NR | 4 | NR | NR | NR | NR | Improved |
| ID 16 | Usta NC | CS | Turkey | 38/M | None | C | Positive | NR | 3≦ | NR | + | NR | NR | NR |
| ID 17 | Benameur K | CS | United States | 34/M | Hypertension | C | NR | Positive IgM/IgG | 8 | + | + | NR | NR | NR |
| ID 18 | Sen M | CR | Turkey | 33/F | NR | C | Negative | Positive IgM | NR | NR | + | 123 | Normal | Improved, discharged |
| ID 19 | Moreau A | CR | Belgium | 26/M | None | C | Negative for nasopharyngeal swab | Positive IgG | 2 | - | + | 200 | NR | Improved |
| ID 20 | Elkhaled W | CR | Qatar | 23/M | None | C | Positive for nasopharyngeal swab | NR | 0 | + | ARDS | 379.8 | 137 | Died due to multiple organ failure |
| ID 21 | Aksu Uzunhan T | CS | Turkey | 16/M | None | C | Positive | NR | NR | NR | NR | 45 | 138 | NR |
| ID 22 | Elmas B | CS | Brazil | 15/M | NR | C | Positive | Positive IgM/IgG | 2 | NR | - | 7.64 | NR | Recovered |
| ID 23 | Abdel-Mannan O | CS | United Kingdom | 15/F | NR | MIS-C | Positive for nasopharyngeal swab | Positive IgG | 5 | NR | NR | 328 | Normal | Resolved, fully ambulant |
| ID 24 | Çetin H | CS | Turkey | 14/M | NR | C | Positive | NR | NR | NR | NR | NR | NR | Recovered |
| ID 25 | Ucan B | CS | Turkey | 14/M | None | MIS-C | NR | NR | NR | NR | NR | NR | NR | NR |
| ID 26 | Lin J | CR | United States | 13/M | None | MIS-C | Positive | NR | 3 | - | - | 109 | 128 | Recovering |
| ID 27 | Gaur P | CS | United Kingdom | 12/M | NR | MIS-C | Negative for 2 nasopharyngeal swabs | Positive IgG | 5 | + | NR | Elevated | NR | Recovered, discharged |
| ID 28 | Çelebi Y | CR | Turkey | 11/M | None | MIS-C | Negative for 2 nasal swab | Positive IgG | 2 | NR | - | Elevated | Hyponatremia | Recovered |
| ID 29 | Bektaş G | CS | Turkey | 10/M | None | MIS-C | Negative | Positive IgM/IgG | 2 | - | - | 392 | 133 | Recovered completely, discharged |
| First author | Neurological symptoms | Olfactory and taste dysfunction | CT | MRI DWI Findings (days since first neurological symptoms) | CSF | Neurological symptoms (days since CLOCCs occurred) | MRI (days since first imaging) | Neuroradiological terms | |
|---|---|---|---|---|---|---|---|---|---|
| ID 1 | Hayashi M | Alerted consciousness, ataxia, kinetic tremor in his hands, walking instability, urinary incontinence | Normal | NR | (a) (a few days) | Not performed | Partially improved (neurological deficit and cerebellar ataxia had resolved on admission day 2), but died due to respiratory failure | NR | MERS |
| ID 2 | Kakadia B | Disorientation, inattention, and bradyphrenia without focal deficits. | NR | NR | (a) | Normal cell, protein, glucose | Resolved over the course of two weeks | Completely disappeared (14 days) | MERS |
| (our case) | Kubo M | Aletered consiousness (drowsiness), truncal ataxia, dysarthria, intension tremor | Normal | Normal | (a) (0 day) | Not performed | Resloved (2 days) | Completely disappeared (10 days) | CLOCC/MERS/RESLES |
| ID 3 | El Aoud S | Psychomotor slowing, vertigo, headaches, intermittent disturbance of consciousness | NR | Normal | (a) (0 day) | Normal cell, protein, glucose | Psychomotor impairment gradually improved, vertigo and headaches completely recovered | Completely disappeared (1 month) | MERS |
| ID 4 | Usta NC | Dizziness | NR | NR | (a) | NR | Resolved | Not performed | diffusion restriction in the splenium of the corpus callosum (DRCC) |
| ID 5 | Forestier G | Fainting sensations on standing with dizziness and impaired consciousness, headache | NR | NR | (a) | Normal cell, protein, glucose | No interval modification of the neurological symptoms | Completely disappeared (24 days) | CLOCC/MERS |
| ID 6 | Edjlali M | Acute encephalopathy | NR | NR | (a) | NR | NR | NR | CLOCC |
| ID 7 | Esra Demir | Impaired consciousness, slow messy thinking, Romberg sign +, impaired finger-to-nose testing | NR | Normal | (a) (3 days) | Normal cell, protein, glucose | Resolved (7 days) | Completely disappeared (4 days) | CLOCC/MERS |
| ID 8 | Klironomos S | Consciousness @disturbance, paretic extremities |
NR | NR | (a) (14 days after the ICU adimission) | NR | NR | NR | CLOCC |
| ID 9 | Edjlali M | Acute encephalopathy | NR | NR | (a) | NR | NR | NR | CLOCC |
| ID 10 | Eren F | Personality @changes, confusion, and aggression |
NR | NR | (a) (0 day) | Not performed due to high probability of MERS | Regressed (4 days) | Completely disappeared (15 days) | MERS |
| ID 11 | Chauffier J | Confusion, behavioral abnormalities, dysexecutive and memory disorder | Normal | NR | (a) (2 days) | Normal cell, protein, glucose | Improved (7 days) | NR | MERS |
| ID 12 | Micci L | Intermittent blurred vision | NR | NR | (a) (1 day) | NR | NR | NR | CLOCC |
| ID 13 | Chevalier K | Left hemiparesis and psychomotor retardation (significant slowing in movements and speech) | NR | NR | (b) (0 day) | NR | Improved | Completely disappeared (7 days) | CLOCC |
| ID 14 | Arıkan FA | Dysarthria, ataxia | NR | NR | (a) | Elevated protein only (143 mg/dL) | Resolved | Completely disappeared (after discharge on day 40) | CLOCC/Isolated corpus callosum lesion |
| ID 15 | DE Oliveira FAA | Progressive paresthesias in the extremities, mild headache, and visual turbidity. A decrease in visual acuity in the left eye. | NR | NR | (a) | NR | Improved (7 days) | Completely disappeared (1 month) | Others (Transient lesion in the splenium of the corpus callosum) |
| ID 16 | Usta NC | Short-term loss of @consciousness, urinary incontinence |
NR | NR | (a) | NR | NR | Not performed | diffusion restriction in the splenium of the corpus callosum (DRCC) |
| ID 17 | Benameur K | Consciousness disturbance, multifocal myoclonus involving both arms, absent corneal and gag reflexes, absent withdrawal to painful stimuli | NR | NR | (a) (6 days) | Normal cell, protein, glucose | NR | NR | Others (Lesion within the splenium of the corpus callosum) |
| ID 18 | Sen M | Paranoid delusions symptoms, insomnia and irritability | NR | NR | (a) | NR | Improved | Completely disappeared (4 days) | CLOCC |
| ID 19 | Moreau A | Confusion (agitated and disoriented), violent behavior, inappropriate speech | NR | NR | (a) (2 days) | Normal cell, protein, negative for neurotropic viruses PCR | Improved (2 days) | Completely disappeared (21 days) | CLOCC |
| ID 20 | Elkhaled W | Auditory hallucinations, restlessness, suicidal ideations | NR | Normal | (a) (2 days) | Normal cell, chemistry | Not assessable | NR | CLOCC/MERS |
| ID 21 | Aksu Uzunhan T | Normal | NR | NR | (a) | Normal cell, protein, glucose. Negative for viral and bacterial panel. | NR | Completely disappeared | CLOCC/MERS/RESLES |
| ID 22 | Elmas B | Headache, decreased taste | Decreased taste | NR | (a) | NR | Resloved (14 days) | Completely disappeared (14 days) | Others (Diffusion restriction in the corpus callosum splenium section) |
| ID 23 | Abdel-Mannan O | Confused, disoriented, headache, weakness | NR | NR | (a) (4 days) | Not performed | Resloved | NR | Others (Signal changes in the splenium of the corpus callosum) |
| ID 24 | Çetin H | Headache | Hyposomia, hypogeusia | NR | (a) | NR | Resolved | Completely disappeared (after the odor symptom disappeared on the 17th day) | MERS |
| ID 25 | Ucan B | Cerebellar ataxia | NR | NR | (a) | NR | NR | Completely disappeared | MERS |
| ID 26 | Lin J | Delirium, auditory hallucinations, extremities weakness | Normal | NR | (a) (0 day) | Normal cell, protein, glucose | Improved gradually | Completely disappeared | CLOCC |
| ID 27 | Gaur P | Lethargy, severe headache | NR | NR | (a) | NR | Improved rapidly | Not performed due to clinical resolution | CLOCC |
| ID 28 | Çelebi Y | Auditory and visual hallucinations | NR | NR | (a) | NR | Resolved (3 days) | NR | CLOCC |
| ID 29 | Bektaş G | Personality changes, Hallucinations | NR | NR | (b) (0 day) | Normal cell, protein, glucose | Resloved (10 days) | Completely disappeared (6 days) | MERS/RESLES |
Abbreviations: C= COVID-19, CLOCC= cytotoxic lesion of the corpus callosum, CR= case report, CRP= C-reactive protein, CS= case series, CSF= cerebrospinal fluid, CT= computed tomography, DWI= diffusion-weighted imaging, F= female, IgM/IgG= immunoglobulin M/G, M= male, MERS= mild encephalopathy with reversible splenic lesions, MIS-C= multisystem inflammatory syndrome in children, MRI= magnetic resonance imaging, Na= serum natrium level, NR= not reported, RESLES= reversible splenic lesion syndrome.