tetano
Editor, Senior Moderator
Brain Sci
. 2020 Dec 21;10(12):E1017.
doi: 10.3390/brainsci10121017.
Relevance and Clinical Significance of Magnetic Resonance Imaging of Neurological Manifestations in COVID-19: A Systematic Review of Case Reports and Case Series
Anisa Chowdhary[SUP] 1 [/SUP], Roshan Subedi[SUP] 2 [/SUP], Medha Tandon[SUP] 3 [/SUP], Sijin Wen[SUP] 4 [/SUP], Jenil Patel[SUP] 5 [/SUP], Saurabh Kataria[SUP] 6 [/SUP], Sarah Peterson[SUP] 7 [/SUP], Ronald Gwinn[SUP] 7 [/SUP], Mahmoud Elkhooly[SUP] 8 [/SUP], Apoorv Prasad[SUP] 9 [/SUP], Lalit Nirwan[SUP] 10 [/SUP], Amelia Adcock[SUP] 11 [/SUP], Shitiz Sriwastava[SUP] 11 12 [/SUP]
Affiliations
Abstract
We performed a systematic literature review of neuroimaging, predominantly focusing on magnetic resonance imaging (MRI) findings associated with neurological manifestations of coronavirus disease-2019 (COVID-19). We screened articles from PubMed, Google Scholar and Scopus, looking for reports that would potentially have neuroimaging findings in patients with COVID-19. Data analysis was performed with patient-based data based on the availability of clinical characteristics and outcomes for each individual patient from the studies. Chi square and Wilcoxon rank-sum tests were used to report COVID-19 severity and outcomes based on neurological imaging indicators and pathophysiology. A total of 171 patients with COVID-19 having neurological complications, from 134 studies, were identified in our review. The most common neuroimaging finding was ischemic stroke (62, 36.2%) cases, followed by CNS inflammatory disorder (44, 25.7%), and hemorrhagic stroke (41, 24.0%). Around 51% of all the fatal COVID-19 cases had an ischemic stroke. Among patients with ischemic stroke, the mean age of those who suffered from COVID-19 infection was 57.5 years (SD = 15.4) whereas it was 50.7 years (SD = 15.1) among those without stroke/other diagnosis. Fatality was more common in patients with ischemic stroke compared to those with other diagnosis (40% vs. 22%, p = 0.011). The most frequently published neuroimaging findings in patients with COVID-19 were ischemic stroke, CNS inflammatory disorder, and hemorrhagic disorder. In those studies, ischemic stroke was associated with fatality, and was more frequently seen in older patients. Based on our findings, early usage of MRI in COVID-19 patients may be recommended.
Keywords: COVID-19; MRI in COVID-19; SARS CoV-2; neuroimaging in COVID-19; stroke.
. 2020 Dec 21;10(12):E1017.
doi: 10.3390/brainsci10121017.
Relevance and Clinical Significance of Magnetic Resonance Imaging of Neurological Manifestations in COVID-19: A Systematic Review of Case Reports and Case Series
Anisa Chowdhary[SUP] 1 [/SUP], Roshan Subedi[SUP] 2 [/SUP], Medha Tandon[SUP] 3 [/SUP], Sijin Wen[SUP] 4 [/SUP], Jenil Patel[SUP] 5 [/SUP], Saurabh Kataria[SUP] 6 [/SUP], Sarah Peterson[SUP] 7 [/SUP], Ronald Gwinn[SUP] 7 [/SUP], Mahmoud Elkhooly[SUP] 8 [/SUP], Apoorv Prasad[SUP] 9 [/SUP], Lalit Nirwan[SUP] 10 [/SUP], Amelia Adcock[SUP] 11 [/SUP], Shitiz Sriwastava[SUP] 11 12 [/SUP]
Affiliations
- PMID: 33371260
- DOI: 10.3390/brainsci10121017
Abstract
We performed a systematic literature review of neuroimaging, predominantly focusing on magnetic resonance imaging (MRI) findings associated with neurological manifestations of coronavirus disease-2019 (COVID-19). We screened articles from PubMed, Google Scholar and Scopus, looking for reports that would potentially have neuroimaging findings in patients with COVID-19. Data analysis was performed with patient-based data based on the availability of clinical characteristics and outcomes for each individual patient from the studies. Chi square and Wilcoxon rank-sum tests were used to report COVID-19 severity and outcomes based on neurological imaging indicators and pathophysiology. A total of 171 patients with COVID-19 having neurological complications, from 134 studies, were identified in our review. The most common neuroimaging finding was ischemic stroke (62, 36.2%) cases, followed by CNS inflammatory disorder (44, 25.7%), and hemorrhagic stroke (41, 24.0%). Around 51% of all the fatal COVID-19 cases had an ischemic stroke. Among patients with ischemic stroke, the mean age of those who suffered from COVID-19 infection was 57.5 years (SD = 15.4) whereas it was 50.7 years (SD = 15.1) among those without stroke/other diagnosis. Fatality was more common in patients with ischemic stroke compared to those with other diagnosis (40% vs. 22%, p = 0.011). The most frequently published neuroimaging findings in patients with COVID-19 were ischemic stroke, CNS inflammatory disorder, and hemorrhagic disorder. In those studies, ischemic stroke was associated with fatality, and was more frequently seen in older patients. Based on our findings, early usage of MRI in COVID-19 patients may be recommended.
Keywords: COVID-19; MRI in COVID-19; SARS CoV-2; neuroimaging in COVID-19; stroke.