Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is known for its severe inflammatory response, often leading to multi-organ dysfunction. Among the less-recognized complications is COVID-19-associated encephalopathy, particularly in the elderly, where it contributes significantly to morbidity and mortality. This report explores the rapid neurocognitive decline observed in six hospitalized patients with COVID-19, with or without pre-existing neurological conditions. Each case highlights the challenges of managing complex clinical courses and emphasizes the importance of early, multidisciplinary intervention, including palliative care, to address the goals of care. Given the underreporting of COVID-19-associated encephalopathy, this case series underscores the need for increased awareness and specialized care to improve patient outcomes, particularly in older populations.