AUTHOR=Wijeratne Tissa , Wijeratne Chanith , Karimi Leila , Sales Carmela , Crewther Sheila Gillard 

TITLE=Case Report: Posterior Reversible Leukoencephalopathy Syndrome (PRES) as a Biologically Predictable Neurological Association in Severe COVID-19. First Reported Case From Australia and Review of Internationally Published Cases

JOURNAL=Frontiers in Neurology

VOLUME=Volume 11 - 2020

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.600544

DOI=10.3389/fneur.2020.600544

ISSN=1664-2295

ABSTRACT=Reports of different types of neurological manifestations of COVID-19 are rapidly increasing, including changes  of posterior reversible leukoencephalopathy syndrome (PRES). Here we describe the first reported case of COVID-19   and  PRES in Australia diagnosed on basis of MRI brain imaging and confirmed clinically by presence of confusion, delirium, headaches, also associated with hypertension and blood pressure variability and  stable long-term kidney problems. He made full recovery as his blood pressure was controlled and clinical status was supported with appropriate rehydration.
 Although traditionally a rare condition, PRES is likely to be more common among patients with COVID-19  pathobiology (Involvement of Rennin-Angiotensin-Aldosterone system , downregulated ACE2 receptors, endotheliitis, cytokine storm and hyperimmune response) We advocate clinical suspicion among vulnerable patients and  early brain imaging  with MRI brain specifically looking for classic PRES changes and timely correction of blood pressure and supportive therapy where rehydration and blood pressure correction was the main intervention in the reported case here.