# COVID-19 Presenting as Encephalitis and Myopericarditis: A Report of a Rare Case

## TL;DR

A 45-year-old woman with COVID-19 developed rare complications including encephalitis and heart issues, highlighting the virus's potential to affect multiple organs.

## Contribution

This case report highlights the rare neurological and cardiac manifestations of COVID-19.

## Key findings

- The patient developed encephalitis-like brain lesions with no alternative explanation.
- Cardiac tamponade and atypical ECG changes were observed during ICU treatment.
- Post-treatment MRI showed fibrous tissue in the heart, suggesting long-term cardiac impact.

## Abstract

COVID-19 might present with a wide range of clinical manifestations, from mild respiratory distress to severe multi-organ dysfunction. We present a unique case of complex COVID-19 presentation in a 45-year-old female who initially developed general symptoms such as fever, cough, headache, and weakness, which escalated to coma, requiring intubation and ICU admission. A brain MRI revealed lesions compatible with encephalitis, the cause of which remained unexplained after an in-depth clinical, laboratory, and imaging investigation. While in the ICU, the patient also developed cardiac tamponade, requiring pericardiocentesis, and atypical electrocardiographic changes. After treatment with steroids, her condition improved, and the patient was extubated and transferred to the ward. Upon checkup, cardiac MRI revealed fibrous tissue in the inferior cardiac wall and the adjacent intraventricular septum. In the absence of an alternative diagnosis, it might be important to consider the central nervous system and cardiac involvement in patients with COVID-19.