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Neurological Manifestations and Neuroimaging Features of COVID-19 Patients: A Multicenter Italian Experience
23 Pages Posted: 2 Jun 2020
More...Abstract
Background: To describe the neurological manifestations and neuroimaging features of hospitalized COVID-19 patients.
Methods: In this retrospective, multicenter study from Italy, we reviewed the electronic medical records and imaging of hospitalized COVID-19 patients from February 29, 2020 to April 4, 2020. Our inclusion criteria included patients with acute neurological manifestations requiring brain imaging.
Findings: A total of 725 COVID-19 patients were reviewed. Out of these, 108 (14.9%) fit our inclusion criteria. The commonest neurological manifestations were altered mental status 64 (59.3%), acute cerebrovascular disease 34 (31.5%), headache 13 (12.0%) and epilepsy 10 (9.2%). The neuroimaging hallmark of these patients were acute ischemic 34 (31.5%) and hemorrhagic cerebrovascular disease 6 (5.6%). Additional neuroimaging findings included acute toxic encephalopathy, posterior reversible encephalopathy syndrome (PRES), hypoxic-ischemic encephalopathy (HIE), cerebral venous thrombosis, cranial and caudal nerve enhancement, exacerbation of demyelinating disease and nonspecific encephalitis. There was a statistical significant difference (P<0.006) between the prevalence of altered mental status and age of patient.
Interpretation: Neurological complications with associated abnormal neuroimaging findings are not uncommon in COVID-19. Neurologists and neuro-radiologists should be aware of the broad-spectrum of neuroimaging and neurologic disease that can be associated with COVID-19.
Funding Statement: None.
Declaration of Interests: The authors declare no competing interests.
Ethics Approval Statement: Institutional review board (IRB) approvals and waivers were obtained at all institutions.
Keywords: Coronavirus; COVID-19; Neuroimaging; Neurological Manifestations; Multicenter retrospective study
Suggested Citation: Suggested Citation