Computed tomography features of cerebrovascular complications in intensive care unit patients with severe COVID-19

Alves, Vinicius P V; Altoé, Ananda; Veloso, Vanessa Dias; Ferreira, Clécia Lúcia Santos; Ventura, Nina; Corrêa, Diogo Goulart

doi:10.1590/0100-3984.2021.0023

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Surprisingly, the cerebellum was found to be affected in the acute stages of the disease and across most studies and case studies [ 8 , 23 , 24 , 28 – 30 , 39 , 42 , 47 , 48 , 50 , 52 , 54 – 56 , 59 , 60 , 62 , 67 , 69 , 70 , 74 – 76 , 79 – 81 , 84 – 86 , 89 , 92 , 93 , 95 – 97 , 100 , 102 , 108 – 110 , 118 ], mostly presenting as cerebellar ataxia (for example, see [ 123 , 124 ]). This was characterised by accentuation of atrophy in the cerebellum and its corresponding neural connections.…”

Section: Discussionmentioning

confidence: 99%

Topographical Distribution of Neuroanatomical Abnormalities Following COVID-19 Invasion

Kiyak,

Ijezie,

Ackah

et al. 2023

Clin Neuroradiol

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Purpose This systematic review is aimed at synthesising the literature base to date on the frequency and topographical distribution of neuroanatomical changes seen on imaging following COVID-19 invasion with a focus on both the acute and chronic phases of the disease. Methods In this study, 8 databases were systematically searched to identify relevant articles published from December 2019 to March 2022 and supplemented with a manual reference search. Data were extracted from the included studies and narrative synthesis was employed to integrate the findings. Results A total of 110 studies met the inclusion criteria and comprised 119,307 participants (including 31,073 acute and 143 long COVID-19 patients manifesting neurological alterations) and controls. Considerable variability in both the localisation and nature of neuroanatomical abnormalities are noted along the continuum with a wide range of neuropathologies relating to the cerebrovascular/neurovascular system, (sub)cortical structures (including deep grey and white matter structures), brainstem, and predominant regional and/or global alterations in the cerebellum with varying degrees of spinal involvement. Conclusion Structural regional alterations on neuroimaging are frequently demonstrated in both the acute and chronic phases of SARS-CoV‑2 infection, particularly prevalent across subcortical, prefrontal/frontal and cortico-limbic brain areas as well as the cerebrovascular/neurovascular system. These findings contribute to our understanding of the acute and chronic effects of the virus on the nervous system and has the potential to provide information on acute and long-term treatment and neurorehabilitation decisions.

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Section: Discussionmentioning

confidence: 99%

Topographical Distribution of Neuroanatomical Abnormalities Following COVID-19 Invasion

Kiyak,

Ijezie,

Ackah

et al. 2023

Clin Neuroradiol

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show abstract

“…Acute cerebrovascular events, such as acute ischemic stroke and intracranial hemorrhage (intraparenchymal and subarachnoid) are the most common neurological complications of COVID-19, but meningoencephalitis, encephalopathy and encephalomyelitis have also been reported [134].…”

Section: Neurological Complicationsmentioning

confidence: 99%

“…Moreover, the exacerbated inflammatory response with the hypersecretion of cytokines, together with prolonged hypoxemia and a form of small vessel vasculitis, further increases the risk of acute cerebrovascular complications [136,137]. This could explain why cerebrovascular complications seem to affect patients with COVID-19 that are younger and have no history of vascular abnormality compared to patients with ischemic stroke/intracranial hemorrhages due to other causes [134].…”

Section: Neurological Complicationsmentioning

confidence: 99%

An Imaging Overview of COVID-19 ARDS in ICU Patients and Its Complications: A Pictorial Review

et al. 2022

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A significant proportion of patients with COVID-19 pneumonia could develop acute respiratory distress syndrome (ARDS), thus requiring mechanical ventilation, and resulting in a high rate of intensive care unit (ICU) admission. Several complications can arise during an ICU stay, from both COVID-19 infection and the respiratory supporting system, including barotraumas (pneumothorax and pneumomediastinum), superimposed pneumonia, coagulation disorders (pulmonary embolism, venous thromboembolism, hemorrhages and acute ischemic stroke), abdominal involvement (acute mesenteric ischemia, pancreatitis and acute kidney injury) and sarcopenia. Imaging plays a pivotal role in the detection and monitoring of ICU complications and is expanding even to prognosis prediction. The present pictorial review describes the clinicopathological and radiological findings of COVID-19 ARDS in ICU patients and discusses the imaging features of complications related to invasive ventilation support, as well as those of COVID-19 itself in this particularly fragile population. Radiologists need to be familiar with COVID-19's possible extra-pulmonary complications and, through reliable and constant monitoring, guide therapeutic decisions. Moreover, as more research is pursued and the pathophysiology of COVID-19 is increasingly understood, the role of imaging must evolve accordingly, expanding from the diagnosis and subsequent management of patients to prognosis prediction.

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“…As of February 4, 2022, coronavirus disease 2019 (COVID-19) had caused approximately 386 million infections and 5.7 million deaths ( 1 ) . Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) proved to be a complex infectious agent that is responsible for extrapulmonary presentations, including renal, cutaneous, gastrointestinal, neurological, and cardiovascular changes ( 2 , 3 , 4 , 5 , 6 , 7 )…”

Section: Introductionmentioning

confidence: 99%

Ultrasound findings in severe COVID-19: a deeper look through the carotid arteries

et al. 2022

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Objective: To investigate vascular and perivascular abnormalities in the carotid arteries using ultrasound, as well as to evaluate their association with mortality and clinical variables in hospitalized patients with coronavirus disease 2019 (COVID-19). Materials and Methods: This was a prospective study in which 53 hospitalized patients with severe COVID-19 were evaluated and underwent carotid ultrasound. We documented the carotid ultrasound findings in these patients. Clinical, demographic, laboratory, and imaging features were analyzed and compared by statistical analysis to detect correlations between them. Results: Carotid ultrasound demonstrated luminal surface irregularity in 29 patients (55%), carotid plaques in 30 (57%), perivascular infiltration in four (8%), and increased intima–media thickness (IMT) in 31 (58%). Of the 31 patients with increased IMT, 19 (61%) died, and the association between increased IMT and COVID-19–related mortality was significant (p = 0.03). Logistic regression showed that the risk of death was 85% in patients who had increased IMT in combination with acute kidney injury at admission or a history of chronic kidney disease (p < 0.05). Conclusion: In hospitalized patients with severe COVID-19, carotid ultrasound can show increased IMT, luminal surface irregularity, carotid plaques, and perivascular infiltrates. The combination of increased IMT and kidney damage appears to increase the risk of death in such patients.

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Computed tomography features of cerebrovascular complications in intensive care unit patients with severe COVID-19

Cited by 5 publications

References 33 publications

Topographical Distribution of Neuroanatomical Abnormalities Following COVID-19 Invasion

Topographical Distribution of Neuroanatomical Abnormalities Following COVID-19 Invasion

An Imaging Overview of COVID-19 ARDS in ICU Patients and Its Complications: A Pictorial Review

Ultrasound findings in severe COVID-19: a deeper look through the carotid arteries

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