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Brain Behav . COVID-19-Associated Cytotoxic Lesions of the Corpus Callosum in Chinese Patients: A Retrospective Study

tetano

Editor, Senior Moderator
Brain Behav


. 2025 Jun;15(6):e70547.
doi: 10.1002/brb3.70547. COVID-19-Associated Cytotoxic Lesions of the Corpus Callosum in Chinese Patients: A Retrospective Study

Chenyi Wan[SUP] 1 2 [/SUP], Menghua Li[SUP] 1 2 [/SUP], Yanyan Yu[SUP] 1 2 [/SUP], Si Luo[SUP] 1 2 [/SUP], Daojun Hong[SUP] 1 2 3 4 [/SUP], Meihong Zhou[SUP] 1 2 [/SUP], Yu Zhu[SUP] 1 2 [/SUP]



Affiliations
Abstract

Background and purpose: Cytotoxic lesions of the corpus callosum (CLOCCs) are a rare clinicoradiologic syndrome, exceptionally rare in association with coronavirus disease (COVID-2019). This study aimed to investigate the neurological features of COVID-19-associated CLOCCs and gain insights into their underlying pathophysiology.
Methods: A retrospective evaluation was conducted on patients with COVID-19-associated CLOCCs admitted to our neurological diseases unit. The evaluation included comprehensive analysis of clinical presentations, laboratory findings, and radiological data.
Results: From December 17, 2022, to December 31, 2023, our center identified CLOCCs in eight individuals with clinically established COVID-19 who underwent brain magnetic resonance imaging (MRI). The majority of patients (7/8) presented with fever preceding neurological symptoms. The spectrum of neurological findings encompassed altered consciousness (5/8), headache (4/8), cognitive and behavioral disturbances (4/8), ataxia (2/8), dysarthria (2/8), pyramidal signs (2/8), and visual impairments (2/8). Peripheral blood markers of inflammation and cytolysis revealed trends that paralleled disease progression. Elevated cerebrospinal fluid protein levels were observed in a single patient, whereas cell counts, glucose, and chloride levels were unremarkable. Treatment with glucocorticoids and antiviral medications led to complete clinical remission, with subsequent MRIs (7/8) showing radiological improvements within 3 days to 2 weeks posttreatment.
Conclusions: Our study shows that CLOCCs associated with COVID-19 are characterized by a favorable prognosis and distinct MRI features, similar to those observed in other clinical contexts. This underscores the importance of including CLOCCs in the differential diagnosis of COVID-19 and highlights the need for ongoing research to address the neurological condition of SARS-CoV-2 infections and to inform preventive and therapeutic strategies.

Keywords: SARS‐CoV‐2; corpus callosum; encephalopathy; inflammatory; neuroimaging.

 
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