COVID-19-related encephalopathy presenting with aphasia resolving following tocilizumab treatment

Encephalopathy is emerging as a recurrent complication of COVID-19 yet remains poorly characterized. We report the case of a middle-aged woman with COVID-19-related encephalopathy presenting as expressive aphasia and inattentiveness, subsequently progressing to agitation and marked confusion. Brain MRI and CSF analysis were unremarkable, while EEG showed slowing with frontal sharp waves. Neuropsychiatric symptoms resolved following treatment with tocilizumab. CNS involvement in COVID-19 may present as a subacute encephalopathy characterized by prominent frontal lobe dysfunction, with language disturbances as first neurological manifestation. Future studies should further investigate the role of tocilizumab in treating COVID-19-related encephalopathy. [Display omitted] •CNS involvement in COVID-19 may present as a subacute encephalopathy.•COVID-19-related encephalopathy may present with early language disturbances.•Cytokine-mediated neuroinflammation has been suggested as the underlying mechanism.•Tocilizumab has shown efficacy in treating cytokine release syndrome.•In our patient, neuropsychiatric symptoms resolved following tocilizumab therapy.