Possible acute multifocal demyelinating lesions in a COVID-19 patient

A 49-year-old man was admitted with cough, dyspnea, and fever. Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) polymerase chain reaction (PCR) from nasopharyngeal swab was positive. Due to severe acute respiratory syndrome, he was intubated. On day 19, sedatives were held. On neurological examination, he was lethargic, with asymmetric quadriplegia (left>right) and global hyporeflexia. Brain magnetic resonance imaging revealed multifocal brain lesions. He was treated with high-dose steroids and showed clinical and radiological improvement. This case highlights that possible acute disseminated encephalitis should be considered a potentially treatable cause of encephalopathy or multiple neurological deficits in COVID-19 patients.