Retrospective Observational Study of Brain MRI Findings in Patients with Acute SARS-CoV-2 Infection and Neurologic Manifestations

Abstract

Key Results 1. Of the 73 patients who presented neurological symptoms, 43 had pathological MRI findings (58.9%), including 17 with acute ischemic infarcts (23.3%), 1 with a deep venous thrombosis (1.4%), 8 with multiple microhemorrhages (11.3%), 22 with perfusion abnormalities (47.7%), 3 with restricted diffusion foci within the corpus callosum consistent with cytotoxic lesions of the corpus callosum (CLOCC, 4.1%). 2. Imaging patterns possibly related to COVID-19 were observed in patients in intensive care and included multifocal white matter enhancing lesions seen (4 patients, 5%) and basal ganglia abnormalities (4 patients, 5%). Summary Statement MRI abnormalities included cerebrovascular lesions, perfusion abnormalities, cytotoxic lesions of the corpus callosum, ICU-related complications, white matter enhancing lesions and basal ganglia abnormalities.

Neuroimaging findings of brain MRI and CT in patients with COVID-19: A systematic review and meta-analysis

“…An updated literature search for studies published between July 30, 2020 and October 9, 2020 resulted in 346 studies, of which seven studies met the same eligibility criteria [ [27] , [28] , [29] , [30] , [31] , [32] , [33] ]. Overall, 21 articles with a total of 2125 patients were included [ 4 , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] ]. No additional eligible study was found after a search of references within the included studies.…”

“…Of the 21 studies, all study designs were retrospective, except for two prospective studies [ 28 , 39 ]. Nine studies were multi-center studies [ 4 , 29 , 31 , 33 , 36 , 38 , 40 , 42 , 43 ] whereas the other 12 were performed at single centers [ 27 , 28 , 30 , 32 , 34 , 35 , 37 , 39 , 41 , [44] , [45] , [46] ]. The cohort sizes ranged from 9 to 454 patients.…”

“…The cohort sizes ranged from 9 to 454 patients. The countries of origin of the selected studies were heterogeneous, including China [ 40 ], Turkey [ 42 ], Europe [ 4 , 30 , [35] , [36] , [37] , 39 , 41 , 43 , 45 , 46 ], and the USA [ 27 , 28 , [31] , [32] , [33] , [34] , 38 , 44 ]. One study was a multinational study involving all three continents [ 29 ].…”

“…One study was a multinational study involving all three continents [ 29 ]. Brain MRI was the only neuroimaging modality used in ten of the studies [ 4 , 28 , 32 , 33 , 37 , 39 , [41] , [42] , [43] , [44] ] whereas ten studies used brain CT and/or MRI [ 27 , [29] , [30] , [31] , [34] , [35] , [36] , 38 , 45 , 46 ]; one study used only brain CT [ 40 ].…”

Neurological manifestations of coronavirus infections – a systematic review

“…43 Cerebral susceptibility abnormalities (i.e., microbleeds/-thrombosis) were also described as a relatively common neuroimaging feature, particularly in atypical locations such as in the corpus callosum or juxtacortically. [61][62][63][64] Several cases of cerebral venous thromboses have been observed. 56,61 Inflammatory and/or demyelinating syndromes of both the central and the peripheral nervous system have been reported, among them GBS, 53,56,65 ADEM, 53 Miller-Fisher syndrome, and facial nerve palsy (Table S7).…”