Young woman with COVID-19 develops brain lesions, UC San Diego case report finds

While vasculitis — blood vessel damage and inflammation — has been seen in a few older patients with a severe COVID-19 infection, a recent report details the first known case of such damage in a 26-year-old patient. 

The patient is described as a healthy woman who initially had a mild COVID-19 infection. Her symptom onset began a few days after an airplane flight in March 2020, according to the case report, led by physicians at UC San Diego School of Medicine and published July 28 in Neurology: Neuroimmunology & Neuroinflammation. 

Two to three weeks later, the patient began experiencing weakness on the left side of her body, and had difficulty moving her left foot. An MRI found multiple lesions in the right frontoparietal region of the patient's brain — the area involved in the left side of the body's motor control and sensation. A biopsy showed she had central nervous system vasculitis, which refers to inflammation or blood vessel swelling in the brain and spine. 

The patient did not report headaches, a change in mental status or condition, according to the case study. 

"This patient was the first confirmed case of COVID-19 CNS vasculitis, confirmed by biopsy, in a young healthy patient with otherwise mild COVID-19 infection," said Jennifer Graves, MD, PhD, corresponding author on the case report and a neurologist at UC San Diego Health. "Her case tells researchers and clinicians to consider these serious potential brain complications even in young patients and those with minor initial COVID-19 infections." 

The woman's lesions had substantially decreased by September, 2020, about six months later. She was treated with a series of corticosteroids and a long-term immunosuppressive medication.


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