COVID-19-related neuroimaging findings correlated to epidemiological and clinical characteristics

Background Coronavirus disease-2019 (COVID-19) disease was primarily described as a pandemic of respiratory illness, however, with the disease progression, variable cases with extrapulmonary manifestations have been reported all over the world. Severe acute respiratory-syndrome coronavirus- 2 infection can affect different body systems with the neurologic, abdominal, thromboembolic, cardiac, mediastinal, and hematological manifestations that had been reported in many literatures. The understanding of this multisystemic involvement is being better understood as the pandemic progresses. Objective The aim was to study the different neuroimaging findings in patients with severe acute respiratory- syndrome coronavirus-2 infection and their clinical and epidemiological characteristics. Patients and methods Our study was a retrospective study in the period between April 1 and August 30, 2020. It included 98 patients who were proved to be COVID-19 and showed neurological manifestations with neuroimaging abnormalities on computed tomography and/or MRI studies. Results This study included 98 COVID-19 patients that have neurological manifestations and acute neuroimaging abnormalities. There were 78 (88.7%) males and 20 (20.3%) females with mean age 58 ± 10.18 years old, ranging from 2 to 81 years. The most common neurologic manifestations were alteration of consciousness 71.4% (70 cases), confusion 31.6% (31 cases), and agitation 18.4% (18 cases). The most frequent MRI findings were acute infarcts 38 cases (38.7%) and cortical fluid- attenuation inversion-recovery signal abnormality 33 cases (33.7%). Extensive and isolated white matter microhemorrhages are seen in three patients (3.1%). Hemorrhagic brain lesions were associated with more severe clinical presentation, especially in ICU patients. Conclusion Many neurological complications of COVID-19 infection were encountered with a wide spectrum of neuroimaging findings. Different imaging modalities (computed tomography/MRI) have a great role in the assessment of these neurological complications to avoid any untreated causes of morbidity/mortality.