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Encephalomyelitis Associated with Coronavirus Disease 2019: A Case Report 

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Encephalomyelitis Associated with Coronavirus Disease 2019: A Case Report 

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Francesca Polino
GNUR 160-001

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SYMPTOMS:
-Pain in lower extremities
-Tingling sensations
-Weakness in all limbs
-Inability to urinate or defecate

DIAGNOSIS:
-COVID-19
-Longitudinally extensive transverse myelitis resulting from COVID-19
-Tetraparesis
-Hyperreflexia
-Hypoesthesia
-Paresthesia
-Lymphocytic pleocytosis

TREATMENT:
-1g/day of high-dose methylprednisolone for 5 days
-Intravenous antipyretics combined with a surface cooling device for 3 days
-250mg of intravenous methylprednisolone for one day and 500mg the following day for 7 days
-Intravenous immunoglobulin for 5 days

RESULTS:
-Patient's strength improved after 5 day dose of 1g methylprednisolone but was admitted back to the hospital 2 days following due to high fever and decreasing strength in lower limbs
-Patient did not make progress with intravenous antipyretics for 3 days and still had a high fever
-After experiencing hallucinations and disorientation the patient was given 250mg of intravenous methylprednisolone for one day
-The day after the patient was given 250mg of intravenous methylprednisolone, the dose was raised to 500mg as a result of a lack of consciousness and the patient was taken into the ICU
-Patient was in and out of consciousness from days 7-14 of the 500mg dose of methylprednisolone, so intravenous immunoglobulin was given for 5 days
-Patient's consciousness and conditions improved greatly and after 23 days in the hospital, she was discharged

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LONGITUDINALLY EXTENSIVE TRANSVERSE MYELITIS:
-LETM is a rare neurological condition by itself, but has been associated with coronavirus
-In a global report, LETM was one of the least common associative diseases with COVID-19. 0.1% of hospital patients have been found with it and 0.2% of hospital patients with COVID-19 have been diagnosed with it
-LETM and post-COVID encephalomyelitis usually happen independent of each other but in rare cases may happen together
-LETM and encephalomyelitis have a low recovery rate and high mortality rate

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ORGANIC CHEMISTRY:
-I chose to evaluate organic chemistry techniques used in this case study. Organic chemistry techniques include drug design, over the counter and prescription pharmaceuticals, and supplements
-This case uses aspects of organic chemistry since the patient received various treatments of pharmaceuticals to aid her recovery
-Doses of the pharmaceuticals were adjusted and tweaked until the patient started showing signs of progression

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Figure 2: Organic Chemistry in this Study 

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Figure 2: Organic Chemistry in this Study 

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Figure 2 is a timeline of the treatment that the patient received throughout her time in the hospital. It explains which pharmaceuticals were given to treat various symptoms that she was experiencing, as well as the dosages that were adjusted

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Hyposmia: An inability to detect odors through your nose and an overall decreased sense of smell
Hypogeusia: Inability to taste or a lack of ability to taste
Myelitis: Inflammation of the spinal cord
Encephalitis: Inflammation of the brain
MRI Scan: Type of medical imaging that uses a magnetic field and radio-waves to make an image of soft tissue and organs inside of the body
Lumbar Puncture (Spinal Tap): A needle is inserted in the spinal canal to collect a sample of cerebrospinal fluid, which is then used for diagnostic testing
Antibody: A protein in your immune system that identifies and protects your body from foreign substances like virus or bacteria
Encephalomyelitis: Widespread inflammation in the brain AND spinal cord
Immunoglobulin: Antibodies or glycoproteins made by plasma cells
Motor Functions: Any movement or activity is produced from motor neurons (ex: walking or running)

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In this study I learned how important the use of organic chemistry (pharmaceuticals) are in order to help patients. Pharmaceuticals are important in aiding recovery and it is crucial that patients are given the correct dosage and type of drug in order to successfully recover or show progression. In this case, the patient was critically ill and after trying various dosages and combinations of pharmaceuticals, they were able to find one that was successful in recovering the patient from longitudinally extensive transverse myelitis