Neurologic Involvement in COVID-19: Cause or Coincidence? A Neuroimaging Perspective

Fellows’ Journal Club

Despite a large cohort of 103 patients with COVID-19, the authors found a large number of symptomatic patients with negative neuroimaging findings, and no conclusions can be drawn concerning concrete associations between neuroimaging and COVID-19.

Abstract

Summary of results, including all patients undergoing neuroimaging (MR imaging/CT). Reasons for neuroimaging are on the y-axis. Neuroimaging findings are color-coded in the legend. Note that “Mild nonfocal neurologic symptoms” refer to any mild state of altered consciousness, mild transient dysarthria, mild transient gait abnormality, or headache. Lacunar or small distal cortical infarctions not susceptible to thrombectomy were considered “small-vessel.”

The rapid spread of the coronavirus disease 2019 (COVID-19) pandemic has shaken hospitals worldwide. Some authors suggest that neurologic involvement could further complicate the disease. This descriptive study is a cross-sectional review of 103 patients diagnosed with COVID-19 who underwent neuroimaging (of a total of 2249 patients with COVID-19 in our center). Analyzed variables were neurologic symptoms and acute imaging findings. The most frequent symptoms that motivated neuroimaging examinations were mild nonfocal neurologic symptoms, code stroke (refers to patients presenting with signs and symptoms of stroke whose hyperacute assessment and care is prioritized), focal neurologic symptoms, postsedation encephalopathy, and seizures. No cases of encephalitis or direct central nervous system involvement were detected. Thirteen patients presented with acute ischemic events, and 7, with hemorrhagic events; however, most reported multiple vascular risk factors. Despite the large cohort of patients with COVID-19, we found a large number of symptomatic patients with negative neuroimaging findings, and no conclusions can be drawn concerning concrete associations between neuroimaging and COVID-19.

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