Cerebral microbleeds in patients with COVID-19: is there an inevitable connection?

Abstract

The COVID-19 pandemic has underscored the critical interplay between systemic infections and neurological complications, notably cerebral microbleeds (CMBs). This comprehensive review meticulously aggregates and analyzes current evidence on CMBs’ prevalence, pathophysiological underpinnings, and clinical implications within COVID-19 cohorts. Our findings reveal a pronounced correlation between CMBs and increased severity of COVID-19, emphasizing the role of direct viral effects, inflammatory responses, and coagulation disturbances. The documented association between CMBs and elevated risks of morbidity and mortality necessitates enhanced neurological surveillance in managing COVID-19 patients. Although variability in study methodologies presents challenges, the cumulative evidence substantiates CMBs as a critical illness manifestation rather than mere coincidence. This review calls for harmonization in research methodologies to refine our understanding and guide targeted interventions. Prioritizing the detection and study of neurological outcomes, such as CMBs, is imperative for bolstering pandemic response strategies and mitigating the long-term neurological impact on survivors.