COVID-19 in the brain? New study offers clues

Systematically characterize neurological symptoms and neuroimaging features in hospitalized COVID-19 patients.

According to the new study, altered mental status and stroke are the most common neurological symptoms in COVID-19 patients.

This new review by the University of Cincinnati scientists and four Italian institutions on neuroimaging and neurological symptoms in patients with COVID-19 may shed light on the virus’s impact on the central nervous system. These newly discovered patterns could help doctors better and sooner recognize associations with COVID-19 and possibly provide earlier interventions.

Studies have described the spectrum of chest imaging features of COVID-19. But only a few cases were reported to have neurological symptoms. 

Scientists investigated neurological symptoms and imaging findings in patients from three major institutions in Italy: University of Brescia, Brescia; University of Eastern Piedmont, Novara; and University of Sassari, Sassari.

The study included images from 725 hospitalized patients with confirmed COVID-19 infection between Feb. 29, and April 4. Of these, 108 (15%) had severe neurological symptoms and underwent brain or spine imaging. Most patients (99%) had brain CT scans, while 16% had head and neck CT imaging, and 18% had brain MRI.

Scientists found that 59% of patients reported an altered mental state, and 31% experienced a stroke, which was the most common neurological symptom. Patients also experienced headaches (12%), seizure (9%), and dizziness (4%), among other symptoms.

Lead author Abdelkader Mahammedi, MD, assistant professor of radiology at UC and a UC Health neuroradiologist, said“Of these 108 patients, 31, or 29%, had no known past medical history. Of these, aged 16 to 62 years, ten experienced strokes, and two had brain bleeds. Seventy-one, or 66%, of these patients had no findings on the brain CT, out of which 7 of them (35%) brain MRI showed abnormalities.”

He adds that altered mental status was more common in older adults.

Although, the study further clarifies that the neurological features of patients with COVID-19 vary, and an altered mental status and stroke are the most prevalent in patients.

More research is still required on this topic as scientists are not sure whether these symptoms are arising from critical illness or direct central nervous system invasion of SARS-CoV-2.

Journal Reference:
  1. Abdelkader Mahammedi, Imaging in Neurological Disease of Hospitalized COVID-19 Patients: An Italian Multicenter Retrospective Observational Study. DOI: 10.1148/radiol.2020201933

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