Effective Continuous Renal Replacement Therapy and Music Therapy for a Comatose Patient with Encephalopathy: A Case Report

A 35-year-old woman presented with a one-week history of Covid-19 symptoms. Despite negative results for COVID-19 and influenza virus, she suffered a tonic-clonic seizure lasting one minute and experienced a subsequent decrease in the level of consciousness to 7, which further decreased to 2+T/15 accompanied by low oxygen saturation. Despite various clinical and paraclinical evaluations, no definite cause for the patient's low LOC could be determined, and various therapies and medications failed to improve her condition. Given the septic phase, two rounds of continuous renal replacement therapy were conducted, in conjunction with music therapy and reminiscence featuring the voices of her loved ones. After 48 hours from the last round of CRRT, and following 50 days of hospitalization in the intensive care unit, her LOC improved to 8+T/15. We propose CRRT and music therapy and reminiscence as possible treatment approaches for patients with unexplained coma and unresponsiveness to therapies.