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BIBTEX RIS

Clinical and Radiological Profiles of COVID-19 Patients with Neurological Symptomatology: A Comparative Study

2021; Multidisciplinary Digital Publishing Institute; Volume: 13; Issue: 5 Linguagem: Inglês

10.3390/v13050845

1999-4915

Máría de Fátima Viana Vasco Aragão, Mariana de Carvalho Leal Gouveia, Pedro Andrade, Ocelio Cartaxo Filho, Lucas Vasco Aragao, Tatiana Fonseca, Marcelo Andrade Valença, Maria Regina Vendas Carneiro Leao, Joao Pedro Vasco Aragao, Maria Lúcia Lima Soares, Maria Júlia Martins Oliveira Lima, Sílvio da Silva Caldas Neto, Marcelo Andrade Valença,

Infectious Encephalopathies and Encephalitis

Patients with COVID-19 can require radiological examination, with chest CT being more frequent than neuro-imaging. The objective is to identify epidemiological, clinical and radiological factors considered as predictors of neurological involvement in patients with COVID-19 assessed by neuroimaging and to describe the neuroimaging findings. This retrospective study was performed with 232 consecutive confirmed COVID-19 patients, from two radiological units, which were divided into two groups: (1) those who underwent a brain CT/MRI scan (n = 35) versus (2) those who did not undergo the brain CT/MRI scan, but underwent only chest CT (n = 197). There was a statistically significant difference with associations regarding the COVID-19 brain scan group for: admission to ICU, greater severity of lung injuries, the use of a mechanical ventilator and sepsis. Statistical tendency was found for chronic renal failure and systemic arterial hypertension. Forty-percent of COVID-19 patients from the brain scan group were abnormal on brain CT and/or brain MRI (22.9% of the cases with bleeding or microbleeding, 8.6% with restricted diffusion lesions). One ischemic stroke case was associated with irregularity at the M1 segment of the right middle cerebral artery. There was a case of left facial nerve palsy with enhancement of the left geniculate ganglia. An analysis of the olfactory bulbs was possible in 12 brain MRIs and 100% had enhancement and/or microbleeding. In conclusion, a more severe COVID-19 disease from ICU, a more severe form of lung disease, the use of mechanical ventilator and sepsis were associated to the COVID-19 patients with neurological involvement who had undergone brain scans. Microvascular phenomenon was a frequent finding in the brain and olfactory bulbs evaluated by neuroimaging.