LAUSR

INTRODUCTION: While SARS-CoV-2 is primarily regarded as a respiratory disease, the neurologic complications are becoming more recognized Recent studies have documented meningitis and encephalitis associated with SARS-CoV-2 However, there have been limited accounts of status epilepticus in the setting of SARS-CoV-2 encephalitis METHODS: A 22-year-old woman with a history of infantile seizures was brought to the emergency department due to acute altered mental status, along with a two-day history of headache She was febrile and non-verbal with no focal neurologic deficits She tested positive for SARS-CoV-2 by polymerase chain reaction, although she had no respiratory symptoms and no infiltrates on chest radiograph While hospitalized, she developed a convulsive seizure refractory to lorazepam, phenytoin, and levetiracetam She was started on a versed drip, with resolution of status epilepticus Magnetic resonance imaging brain showed no acute intracranial process Basic labs were unremarkable and urine drug screen was negative Cerebrospinal fluid (CSF) analysis was remarkable for white blood cell count of 1 cells/uL, glucose of 88 MG/DL, and protein of 108 MG/DL CSF cultures were negative Infectious workup was negative for human immunodeficiency virus, syphilis, herpes simplex virus, enterovirus, Epstein-Barr virus, varicella zoster, toxoplasmosis, Cryptococcus, West Nile virus, and anti-N-methyl D-aspartate receptor Four days after admission, computerized tomography brain showed severe diffuse cerebral edema with cerebellar tonsillar herniation Despite maximal medical treatment, the patient was declared brain dead and lifesupport was withdrawn RESULTS: This case depicts a young woman with SARSCoV- 2 presenting with encephalitis who preceded to develop status epilepticus, without any other identifiable infectious, metabolic, or toxic etiologies In light of the current pandemic, patients with new onset headaches should be evaluated for SARS-CoV-2, as this could be the presenting symptom of a severe neurologic complication, such as meningitis or encephalitis Early diagnosis and treatment of SARS-CoV-2 encephalitis is key to preventing mortality SARS-CoV-2 patients with otherwise unexplained encephalopathy may benefit from anti-epileptic therapy