COVID-19 presenting with agraphia and conduction aphasia in a patient with left-hemisphere ischemic stroke
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COVID-19
COVID-19 presenting with agraphia and conduction aphasia in a patient with left-hemisphere ischemic stroke Konstantinos Priftis 1,2
&
Lorella Algeri 3 & Stella Villella 4 & Maria Simonetta Spada 3
Received: 21 August 2020 / Accepted: 24 September 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract COVID-19 following infection by SARS-CoV-2 can affect the brain causing confusion, depression, and dementia-like signs. Nonetheless, the presence of more specific neuropsychological signs because of COVID-19 remains unexplored. We report on LA, a patient who was affected by a left-hemisphere ischemic stroke, probably because of SARS-CoV-2. The patient showed a highly specific neuropsychological profile characterized by severe agraphia and some signs of conduction aphasia. All other cognitive and sensorimotor functions remained intact. We sustain that specific neuropsychological signs can be observed in patients with COVID-19. Therefore, in-depth and comprehensive neuropsychological assessment should be included to better explore and qualify the neuropsychological consequences of COVID-19. This is a new challenge for diagnosis and rehabilitation, with important consequences for the involved neuropsychological services. Keywords COVID-19 . SARS-CoV-2 . Conduction aphasia . Agraphia
Introduction Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), resulting in corona virus disease 2019 (COVID-19), has caused a pandemic. Indeed, more than 950,000 deaths have been reported world-wide (https://covid19.who.int/). Although COVID-19 is mainly characterized by severe pulmonary signs, there is now growing evidence that the brain can be also affected [1, 2]. Indeed, neurological disorders have been reported in patients with COVID-19. These disorders include brain inflammation, hyposmia/hypogeusia, GuillainBarré syndrome, and stroke [1, 2]. Confusion, agitation, dementia-like signs, and psychotic signs following COVID-
* Konstantinos Priftis [email protected] 1
Department of General Psychology, University of Padua, Padua, Italy
2
Human Inspired Technology Center, University of Padua, Padua, Italy
3
UOC Psychology, Papa Giovanni XXIII Hospital, Bergamo, Italy
4
UOC Special Rehabilitation, Papa Giovanni XXIII Hospital, Bergamo, Italy
19 have been also described [1, 2]. Furthermore, Helms et al. [3] have reported the presence of dysexecutive syndromes in 14 out of 39 patients affected by COVID-19. Nevertheless, the presence of more focal neuropsychological disorders (e.g. aphasia, agraphia, alexia, agnosia, and neglect), following SARS-CoV-2, remains a largely unexplored issue. Therefore, in the present study, we aimed to investigate, more in depth, the specific and focal neuropsychological consequences of SARS-CoV-2, in a patient affected by lefthemisphere stroke.
Case report The study was conducted according to the principles of the Declaration of Helsinki. The patient gave his informed consent to participate. LA was a 53-year-old, right-handed male, with 8 years of education. On
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