Onset of cognitive disorders few days after a covid-19 infection disease: difficulties to set a diagnosis in middle and low-income countries.
The coronavirus disease 2019 (COVID-19) was first known by its respiratory symptoms. Neurological complications are increasingly seen and described. Our case emphasizes the difficulties of differential diagnosis between encephalitis and post-traumatic stress disorder (PTSD) in SARS-COV2 patients.
A healthy 62 years old man tested positive for COVID-19 during a travel procedure. He was admitted to hospital because of a sudden drop of oxygen saturation from 99% to 89% with pulmonary CT scan showing a parenchymal bilateral ground-glass lesions and consolidative opacities of about 50% of lung while the patient remained asymptomatic. After he has been discharged from hospital he developed isolated executive disorders. Post COVID-19 encephalitis or PTSD were questioning.
Discussion and conclusion
Our patient had an acute hypoxemia which is well known to be associated with executive disorders such as in acute respiratory distress. But these signs appeared after the COVID-19 came negative hence the executive disorders were likely to be related to direct brain infection or to a non-infectious condition like the PTSD. Functional neuroimaging is then the gold standard to rule out a brain damage.