Neurological manifestations of COVID-19: a retrospective observational study based on 1060 patients with a narrative review. (May 2023)

• Record Type: Journal Article
• Authors: Negro, Alberto; Tortora, Mario; Gemini, Laura; de Falco, Arturo; Somma, Francesco; d'Agostino, Vincenzo
• Is Part Of: Acta radiologica. Volume 64:Number 5(2023)
• Page Start: 1950
• Page End: 1957
• Publication Date: 2023-05
• Subjects: COVID-19 -- neuroradiology -- brain -- spine -- stroke; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/02841851221138557
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: In the past two decades, three coronavirus epidemics have been reported. Coronavirus disease 2019 (COVID-19) is caused by a severe acute respiratory syndrome (SARS)-like coronavirus (SARS-CoV-2). In most patients, the disease is characterized by interstitial pneumonia, but features can affect other organs. Purpose: To document the radiological features of the patients and to perform a narrative review of the literature. Material and Methods: We conducted a retrospective, single-center study on 1060 consecutive hospitalized patients with COVID-19 at our institution. According to the inclusion criteria, we selected patients to be studied in more radiological detail. All images were obtained as per standard of care protocols. We performed a statistic analysis to describe radiological features. We then presented a systematic review of the main and conventional neuroimaging findings in COVID-19. Results: Of 1060 patients hospitalized for COVID-19 disease, 15% (159) met the eligibility criteria. Of these, 16 (10%) did not undergo radiological examinations for various reasons, while 143 (90%) were examined. Of these 143 patients, 48 (33.6%) had positive neuroimaging. We found that the most frequent pathology was acute ischemic stroke (n=16, 33.3%). Much less frequent were Guillain–Barre syndrome (n=9, 18.8%), cerebral venous thrombosis (n=7, 14.6%), encephalitis or myelitis (n=6, 12.5%), intracranial hemorrhage and posterior hemorrhagic encephalopathy syndrome (n=4, 8.3%), exacerbation of multiple sclerosis (n=4, 8.3%), and Miller–Fisher syndrome (n=2, 4.2%). Conclusion: Our data are coherent with the published literature. Knowledge of these patterns will make clinicians consider COVID-19 infection when unexplained neurological findings are encountered.