Methanol poisoning during the COVID‐19 pandemic in Iran: A retrospective cross‐sectional study of clinical, laboratory, and brain imaging characteristics and outcomes

Abstract

ObjectiveTo evaluate the frequency and significance of brain imaging findings in methanol poisoning patients and to propose a criterion for prioritizing brain imaging.MethodsWe retrospectively reviewed the data of 306 patients (286 men and 34 women, mean age 32.10 ± 9.9 years) with confirmed methanol poisoning who were admitted to two hospitals in Iran during the COVID‐19 pandemic. We analyzed their demographic, clinical, laboratory, and brain imaging data.ResultsThe main brain computed tomography (CT) scan findings were hypodensity in the putamen (11.1%), cerebellar nuclei (8.2%), diffuse cerebral edema (7.5%), and intracranial hemorrhage (ICH; 1.6%). These findings were associated with blood pH, Glasgow Coma Scale (GCS), renal failure, bicarbonate, oxygen, carbon dioxide, potassium, and glucose levels (p < 0.05). Poor prognosis was related to blindness, opium addiction, chronic alcohol use, hyperglycemia, and abnormal CT scans (p < 0.001 for all). The most predictive brain imaging findings for poor prognosis were hypodensity in the cerebellar nuclei, diffuse cerebral edema, and ICH.ConclusionBrain imaging can provide valuable information for the diagnosis and management of methanol poisoning patients. We suggest that patients with severe acidosis, low GCS, low pH, low oxygen saturation, and high glucose levels should undergo brain CT scan as a priority.

Methanol Poisoning and Its Clinical Complications During the COVID-19 Pandemic in Iran: A Systematic Review

“…Additionally, Esmaeilian et al demonstrated a significant correlation between being over the age of thirty and a history of blindness (75.9%) with a decreased chance of patient survival. Notably, these factors were not associated with abnormal findings in brain CT scans (26). Our findings align with these previous studies, highlighting consistent patterns of clinical outcomes following methanol poisoning.…”

“…Research supports the use of brain imaging as a crucial tool in identifying and managing patients with methanol poisoning. It is recommended that patients displaying severe acidosis and reduced levels of GCS, pH, and oxygen saturation, coupled with elevated glucose levels, should be prioritized for a brain CT scan (26). This approach helps in better understanding the extent of neurological damage and guiding appropriate treatment interventions.…”