Hediye Pınar GÜNBEY
(Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Kartal Lütfi Kırdar Şehir Hastanesi, İstanbul, Türkiye)
Günay RONA
(Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Kartal Lütfi Kırdar Şehir Hastanesi, İstanbul, Türkiye)
Özge ADIGÜZEL KARAOYSAL
(Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Radyoloji Anabilim Dalı, Kartal Lütfi Kırdar Şehir Hastanesi, İstanbul, Türkiye)
Ayşe BATIREL
(Sağlık Bilimleri Üniversitesi, Tıp Fakültesi, Enfeksiyon Hastalıkları Anabilim Dalı, Kartal Lütfi Kırdar Şehir Hastanesi, İstanbul, Türkiye)
Banu ÖZEN BARUT
(Nöroloji Anabilim Dalı, Tıp Fakültesi, Sağlık Bilimleri Üniversitesi, Kartal Lütfi Kırdar Şehir Hastanesi, İstanbul, Türkiye)
Yıl: 2021Cilt: 51Sayı: 6ISSN: 1300-0144 / 1303-6165Sayfa Aralığı: 2850 - 2860İngilizce

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Correlation of neuroimaging and thorax CT findings in patients with COVID-19: A large single-center experience
Background/aim: The aim of this current study was to describe the neuroimaging findings among patients with COVID-19 and to compare them with thorax CT imaging findings and clinicobiological profiles. Materials and methods: Between the period March 11 and December 31, 2020, we evaluated brain computed tomography (CT) and magnetic resonance (MR) images of patients with COVID-19. A total of 354 patients (mean age 65.2 ± 16.6, 52% female, 42% male) who had brain imaging were included in the study. Of this total sample, 218 had thorax CT scanning (65.5%). Neuroimaging and thorax CT findings, clinical course, neurologic findings, and laboratory data were evaluated. White matter lesions (WML) and thorax CT scans were scored. Participants were divided according to whether or not they had an infarction. Results: The neuroimaging findings indicated infarcts, parenchymal hemorrhage, encephalitis, cortical signal abnormality, posterior reversible encephalopathy syndrome (PRES), and cranial nerve involvement. WML significantly positively correlated with age (p < 0.01) but not with sex (p > 0.05). Thorax CT findings did not demonstrate significant correlations with infarcts, WML, or hemorrhages (p > 0.05). D-dimer and ferritin levels were significantly higher among patients with infarcts (p < 0.05). Conclusion: Immune-mediated prothrombic state and cytokine storm appear to be more responsible for etiopathogenesis than direct viral neurotropism. Neuroimaging and thorax CT findings were not correlated among patients with COVID-19 in our study. These results suggest that neurological manifestations may occur independently of pulmonary involvement and age. Key words: COVID-19, brain, CT, MR
DergiAraştırma MakalesiErişime Açık
  • 1. Zhou S, Wang Y, Zhu T, Xia L. CT features of coronavirus disease 2019 (COVID-19) pneumonia in 62 patients in Wuhan, China. American Journal of Roentgenology 2020; 214 (6): 1287- 1294. doi: 10.2214/AJR.20.22975
  • 2. Mao L, Jin H, Wang M, He Q, Chang J, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. JAMA Neurology 2020; 77 (6): 683-690. doi: 10.1001/ jamaneurol.2020.1127
  • 3. Li Y, Li M, Wang M, Zhou Y, Chang Y, et al. Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study. Stroke and Vascular Neurology 2020; 5 (3). doi: 10.1136/svn-2020-000431
  • 4. Huang C, Wang Y, Li X, Ren L, Zhao J, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet 2020; 395 (10223): 497-506. doi: 10.1016/ S0140-6736(20)30183-5
  • 5. Chen N, Zhou M, Dong X, Qu J, Gong F, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet 2020; 395 (10223): 507-513. doi: 10.1016/S0140- 6736(20)30211-7
  • 6. Pinzon RT, Wijaya VO, Buana RB, Al Jody A, Nunsio PN. Neurologic characteristics in coronavirus disease 2019 (COVID-19): a systematic review and meta-analysis. Frontiers in Neurology 2020; 11: 565. doi: 10.3389/fneur.2020.00565
  • 7. Nepal G, Rehrig JH, Shrestha GS, Shing YK, Yadav JK, et al. Neurological manifestations of COVID-19: a systematic review. Critical Care 2020; 24: 421. doi: 10.1186/s13054-020- 03121-z
  • 8. Poyiadji N, Shahin G, Noujaim D, M Stone, S Patel, et al. COVID19-associated acute hemorrhagic necrotizing encephalopathy: imaging features. Radiology 2020; 296 (2): E119-E120. doi: 10.1148/radiol.2020201187
  • 9. Zhou B, She J, Wang Y, X Ma. Venous thrombosis and arteriosclerosis obliterans of lower extremities in a very severe patient with 2019 novel coronavirus disease: a case report. Journal of Thrombosis and Thrombolysis 2020; 50 (1): 229– 232. doi: 10.1007/s11239-020-02084-w
  • 10. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, et al. Cochrane handbook for systematic reviews of interventions. 2nd edition. Chichester (UK): John Wiley & Sons 2019. doi: 10.1002/14651858.ED000142
  • 11. Al-olama M, Rashid A, Garozzo D. COVID-19-associated meningoencephalitis complicated with intracranial hemorrhage: a case report. Acta Neurochirurgica 2020; 162 (7): 1495–1499. doi: 10.1007/s00701-020-04402-w
  • 12. Franceschi AM, Ahmed O, Giliberto L, Castillo M. Hemorrhagic posterior reversible encephalopathy syndrome as a manifestation of COVID-19 infection. American Journal of Neuroradiology 2020; 41 (7): 1173–1176. doi: 10.3174/ajnr. A6595
  • 13. Rogg J, Baker A, Tung G. Posterior reversible encephalopathy syndrome (PRES): another imaging manifestation of COVID-19. Interdisciplinary Neurosurgery 2020; 22: 100808. doi: 10.1016/j.inat.2020.100808
  • 14. Reichard RR, Kashani KB, Boire NA, Constantopoulos E, Guo Y, et al. Neuropathology of COVID-19: a spectrum of vascular and acute disseminated encephalomyelitis (ADEM)-like pathology. Acta Neuropathologica 2020; 140 (1): 1–6. doi: 10.1007/s00401-020-02166-2
  • 15. Parsons T, Banks S, Bae C, Gelber J, Alahmadi H. COVID19-associated acute disseminated encephalomyelitis (ADEM). Journal of Neurology 2020 Oct; 267 (10): 2799- 2802. doi: 10.1007/s00415-020-09951-9
  • 16. Hemasian H, Ansari B. First case of Covid-19 presented with cerebral venous thrombosis: a rare and dreaded case. Revue Neurologique 2020; 176 (6): 521–523. doi: 10.1016/j. neurol.2020.04.013
  • 17. Roy-Gash F, Marine DM, Jean-Michel D, V Herve, B Raphael, et al. COVID-19-associated acute cerebral venous thrombosis: clinical, CT, MRI and EEG features. Critical Care 2020; 24 (1): 1-3. doi: 10.1186/s13054-020-03131-x
  • 18. Zhou B, She J, Wang Y, X Ma. A case of coronavirus disease 2019 with concomitant acute cerebral infarction and deep vein thrombosis. Frontiers in Neurology 2020 Apr 22; 11: 296. doi: 10.3389/fneur.2020.00296
  • 19. Goldberg MF, Goldberg MF, Cerejo R, Tayal AH. Cerebrovascular disease in COVID-19. American Journal of Neuroradiology 2020; 41 (7): 1170–1172. doi: 10.3174/ajnr.A6588
  • 20. Feng Pan, Tianhe Ye, Peng Sun, Gui S, Liang B, et al. Time course of lung changes at chest CT during recovery from coronavirus disease 2019 (COVID-19). Radiology 2020; 295 (3): 715-721. doi: 10.1148/radiol.2020200370
  • 21. Desforges M, Le Coupanec A, Dubeau P, Bourgouin A, Lajoie L, et al. Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses 2020; 12 (1): 14. doi: 10.3390/v12010014
  • 22. Chen R, Wang K, Yu J, Howard D, French L, et al. The spatial and cell-type distribution of SARS-CoV-2 receptor ACE2 in human and mouse brain. Frontiers in Neurology 2021; 11: 1860. doi: 10.3389/fneur.2020.573095
  • 23. Ahmed MU, Hanif M, Ali MJ, Haider MA, Kherani D, et al. Neurological manifestations of COVID-19 (SARS-CoV-2): a review. Frontiers in Neurology 2020; 11: 518. doi: 10.3389/ fneur.2020.00518
  • 24. Choi Y, Lee MK. Neuroimaging findings of brain MRI and CT in patients with COVID-19: A systematic review and metaanalysis. European Journal of Radiology 2020; 133: 109393. doi: 10.1016/j.ejrad.2020.109393
  • 25. Radmanesh A, Raz E, Zan E, Derman A and Kaminetzky M. Brain imaging use and findings in COVID-19: a single academic center experience in the epicenter of disease in the United States. American Journal of Neuroradiology 2020; 41 (7): 1179-1183. doi: 10.3174/ajnr.A6610
  • 26. Chougar L, Shor N, Weiss N, Galanaud D, Leclercq D, et al. Retrospective observational study of brain magnetic resonance imaging findings in patients with acute SARS-CoV-2 infection and neurological manifestations. Radiology 2020; 297 (3): E313-E323. doi: 10.1148/radiol.2020202422
  • 27. Bruggemann R, Gietema H, Jallah B, Ten Cate H, Stehouwer C, et al. Arterial and venous thromboembolic disease in a patient with COVID-19: a case report. Thrombosis Research 2020; 191: 153–155. doi: 10.1016/j.thromres.2020.04.046
  • 28. Anderson RC, Patel V, Sheikh-Bahaei N, Liu CSJ, Rajamohan AG, et al. Posterior reversible encephalopathy syndrome (PRES): pathophysiology and neuro-imaging. Frontiers in Neurology 2020; 11: 463. doi: 10.3389/fneur.2020.00463
  • 29. Dixon L, Varley J, Gontsarova A, Mallon D, Tona F, et al. COVID19-related acute necrotizing encephalopathy with brain stem involvement in a patient with aplastic anemia. Neurology Neuroimmunology Neuroinflammation 2020; 7 (5): e789. doi: 10.1212/NXI.0000000000000789
  • 30. Wong PF, Craik S, Newman P, Makan A, SrinivasanK, et al. Lessons of the month 1: a case of rhombencephalitis as a rare complication of acute COVID-19 infection. Clinical Medicine 2020; 20: 293-294. doi: 10.7861/clinmed.2020-0182
  • 31. Corrêa DG, Hygino da Cruz LC Jr, Lopes FCR, Rangel CC, de Araújo Henriques Tessarollo AL, et al. Magnetic resonance imaging features of COVID-19-related cranial nerve lesions. Journal of Neurovirology 2021; 27 (1): 171-177. doi: 10.1007/ s13365-020-00934-0
  • 32. Lima MA, Silva MTT, Soares CN, Coutinho R, Oliveira HS, et al. Peripheral facial nerve palsy associated with COVID-19. Journal of Neurovirolog 2020; 26 (6): 941-944. doi: 10.1007/ s13365-020-00912-6
  • 33. Goh Y, Beh DLL, Makmur A, Somani J, Chan ACY. Pearls and oysters: facial nerve palsy as a neurological manifestation of Covid-19 infection. Neurology 2020; 95: 364–367. doi: 10.1212/WNL.0000000000009863
  • 34. Pons-Escoda A, Naval-Baudín P, Majós C, Camins A, Cardona P, et al. Neurologic involvement in COVID-19: cause or coincidence? a neuroimaging perspective. American Journal of Neuroradiology 2020; 41(8): 1365-1369. doi: 10.3174/ajnr. A6627

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