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J Neurol . Brain MRI findings in neurologically symptomatic COVID-19 patients: a systematic review and meta-analysis

tetano

Editor, Senior Moderator
J Neurol


. 2023 Aug 3.
doi: 10.1007/s00415-023-11914-9. Online ahead of print. Brain MRI findings in neurologically symptomatic COVID-19 patients: a systematic review and meta-analysis

Amir Masoud Afsahi[SUP] 1 [/SUP], Alexander M Norbash[SUP] 2 [/SUP], Shahla F Syed[SUP] 3 [/SUP], Maya Sedaghat[SUP] 4 [/SUP], Ghazaleh Afsahi[SUP] 5 [/SUP], Ramin Shahidi[SUP] 6 [/SUP], Zohreh Tajabadi[SUP] 7 [/SUP], Mahsa Bagherzadeh-Fard[SUP] 8 [/SUP], Shaghayegh Karami[SUP] 9 [/SUP], Pourya Yarahmadi[SUP] 9 [/SUP], Shabnam Shirdel[SUP] 10 [/SUP], Ali Asgarzadeh[SUP] 11 [/SUP], Mansoureh Baradaran[SUP] 12 [/SUP], Fattaneh Khalaj[SUP] 7 [/SUP], Hamidreza Sadeghsalehi[SUP] 13 [/SUP], Maryam Fotouhi[SUP] 14 [/SUP], Mohammad Amin Habibi[SUP] 8 [/SUP], Hyungseok Jang[SUP] 2 [/SUP], Abass Alavi[SUP] 15 [/SUP], Sam Sedaghat[SUP] 2 16 [/SUP]



Affiliations
Abstract

Background: Coronavirus disease 2019 (COVID-19) has been associated with nervous system involvement, with more than one-third of COVID-19 patients experiencing neurological manifestations. Utilizing a systematic review, this study aims to summarize brain MRI findings in COVID-19 patients presenting with neurological symptoms.
Methods: Systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist. The electronic databases of PubMed/MEDLINE, Embase, Scopus, and Web of Science were systematically searched for literature addressing brain MRI findings in COVID-19 patients with neurological symptoms.
Results: 25 publications containing a total number of 3118 COVID-19 patients with neurological symptoms who underwent MRI were included. The most common MRI findings and the respective pooled incidences in decreasing order were acute/subacute infarct (22%), olfactory bulb abnormalities (22%), white matter abnormalities (20%), cerebral microbleeds (17%), grey matter abnormalities (12%), leptomeningeal enhancement (10%), ADEM (Acute Disseminated Encephalomyelitis) or ADEM-like lesions (10%), non-traumatic ICH (10%), cranial neuropathy (8%), cortical gray matter signal changes compatible with encephalitis (8%), basal ganglia abnormalities (5%), PRES (Posterior Reversible Encephalopathy Syndrome) (3%), hypoxic-ischemic lesions (4%), venous thrombosis (2%), and cytotoxic lesions of the corpus callosum (2%).
Conclusion: The present study revealed that a considerable proportion of patients with COVID-19 might harbor neurological abnormalities detectable by MRI. Among various findings, the most common MRI alterations are acute/subacute infarction, olfactory bulb abnormalities, white matter abnormalities, and cerebral microbleeds.

Keywords: COVID-19; MRI; Magnetic resonance imaging; Neuroimaging; SARS-CoV-2.

 
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