Nikhil Prasad Fact checked by:Thailand Medical News Team Aug 20, 2025 1 hour, 38 minutes ago
Medical News: Rare Neurological Complication of COVID-19 Claims Life of Elderly Woman
Doctors from Southeast Health Medical Center, Dothan, Alabama, and the Alabama College of Osteopathic Medicine have reported a rare and fatal case of acute hemorrhagic leukoencephalitis (AHLE) caused by COVID-19 — but without any lung involvement. AHLE is an aggressive brain inflammation disorder that causes severe swelling, bleeding, and rapid neurological decline. The 76-year-old patient developed the condition as her only symptom of COVID-19, making diagnosis extremely challenging.
Rare Brain Disorder Linked to COVID-19 Emerges Without Lung Symptoms
She was admitted after her family noticed confusion and weakness, following a recent fall. She tested positive for COVID-19 despite having no cough, shortness of breath, or fever beforehand. Initial scans revealed a small brain bleed, but more advanced MRI images showed alarming widespread white matter damage and tiny brain hemorrhages. This
Medical News report highlights the need for urgent brain imaging and testing in COVID-19 patients with sudden neurological deterioration.
Rapid Decline Despite Treatment
Cerebrospinal fluid tests showed high protein levels but no signs of infection or autoimmune disease. Initially, doctors suspected Guillain-Barré syndrome, a nerve disorder, and treated her with high-dose intravenous immunoglobulin (IVIG). When she did not improve, high-dose steroids were given to calm brain inflammation. Unfortunately, her brain scans worsened, showing more bleeding and swelling.
Further testing ruled out other conditions such as multiple sclerosis variants and acute necrotizing encephalopathy. Brain biopsies showed evidence of old microbleeds and inflammation but no tumors, infections, or classic signs of multiple sclerosis.
Understanding the Condition
AHLE is considered the most severe form of a brain inflammation condition called acute disseminated encephalomyelitis (ADEM). It is extremely rare and often fatal, with fewer than 15 biopsy-confirmed COVID-19-related cases reported worldwide as of late 2021. Researchers believe SARS-CoV-2 can trigger a dangerous immune overreaction, damaging the brain’s white matter and blood vessels through inflammation and microscopic bleeding.
The woman’s condition continued to worsen despite intensive care and strong anti-inflammatory medications. She developed a bacterial lung infection while hospitalized, adding further strain to her already critical state. Her family eventually chose comfort care, and she passed away peacefully at home under hospice support.
Why This Case Matters
Most severe COVID-19 brain complications occur alongside respiratory symptoms, making this case particularly alarming. It shows that SARS-CoV-2 can sometimes attack the brain directly without ever affecting the lungs. Older adults appear especially vulnerable, and even quick diagnosis and aggressive treatment may not prevent death.
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The researchers stress that doctors should be alert to AHLE in COVID-19 patients with sudden confusion, weakness, or loss of reflexes — even if they have no breathing problems. Immediate neurological testing, ICU care, and early immune therapy are crucial, though the chances of recovery remain low.
Conclusion
This tragic case reveals the unpredictable nature of COVID-19 and its ability to cause devastating brain inflammation without touching the lungs. It underlines the need for heightened awareness among doctors, quicker diagnostic tools, and urgent research into more effective treatments for COVID-related neuroinflammatory disorders. The lessons learned could save lives, but for now, AHLE remains one of the deadliest brain complications linked to the virus.
The study findings were published in the peer reviewed journal: Cureus.
https://www.cureus.com/articles/390979-fatal-case-of-covid-19-associated-acute-hemorrhagic-leukoencephalitis-without-respiratory-involvement-a-diagnostic-and-therapeutic-challenge#!/
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Read Also:
https://www.thailandmedical.news/news/sars-cov-2-proteins-found-to-damage-brain-cells-and-trigger-inflammation
https://www.thailandmedical.news/news/scientists-from-maryland-discover-that-sars-cov-2-orf3a-protein-causes-brain-cell-death
https://www.thailandmedical.news/news/covid-19-stroke-patients-face-higher-risk-of-sudden-brain-decline
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