TY - JOUR
T1 - Brain and lung imaging correlation in patients with COVID-19
T2 - Could the severity of lung disease reflect the prevalence of acute abnormalities on neuroimaging? A global multicenter observational study
AU - Mahammedi, A.
AU - Ramos, A.
AU - Bargalló, N.
AU - Gaskill, M.
AU - Kapur, S.
AU - Saba, L.
AU - Carrete, H.
AU - Sengupta, S.
AU - Salvador, E.
AU - Hilario, A.
AU - Revilla, Y.
AU - Sanchez, M.
AU - Perez-Nuñez, M.
AU - Bachir, S.
AU - Zhang, B.
AU - Oleaga, L.
AU - Sergio, J.
AU - Koren, L.
AU - Martin-Medina, P.
AU - Wang, L.
AU - Benegas, M.
AU - Ostos, F.
AU - Gonzalez-Ortega, G.
AU - Calleja, P.
AU - Udstuen, G.
AU - Williamson, B.
AU - Khandwala, V.
AU - Chadalavada, S.
AU - Woo, D.
AU - Vagal, A.
N1 - Publisher Copyright:
© 2021 American Society of Neuroradiology. All rights reserved.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - Purpose: Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms. Materials and Methods: In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0-5 (0 corresponded to no involvement and 5 corresponded to >75% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement). Results: A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64%) patients without acute abnormal findings on neuroimaging, 49 (36%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8, P<.001). These patients were more likely to present with ischemic stroke (40 [82%] versus 11 [13%], P<.0001) and were more likely to have either ground-glass opacities or consolidation (46 [94%] versus 73 [84%], P=.01) in the lungs. A threshold of the CT lung severity score of >8 was found to be 74% sensitive and 65% specific for acute abnormal findings on neuroimaging. The neuroimaging hallmarks of these patients were acute ischemic infarct (28%), intracranial hemorrhage (10%) including microhemorrhages (19%), and leukoencephalopathy with and/or without restricted diffusion (11%). The predominant CT chest findings were peripheral ground-glass opacities with or without consolidation. Conclusions: The CT lung disease severity score may be predictive of acute abnormalities on neuroimaging in patients with COVID-19 with neurologic manifestations. This can be used as a predictive tool in patient management to improve clinical outcome.
AB - Purpose: Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms. Materials and Methods: In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0-5 (0 corresponded to no involvement and 5 corresponded to >75% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement). Results: A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64%) patients without acute abnormal findings on neuroimaging, 49 (36%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8, P<.001). These patients were more likely to present with ischemic stroke (40 [82%] versus 11 [13%], P<.0001) and were more likely to have either ground-glass opacities or consolidation (46 [94%] versus 73 [84%], P=.01) in the lungs. A threshold of the CT lung severity score of >8 was found to be 74% sensitive and 65% specific for acute abnormal findings on neuroimaging. The neuroimaging hallmarks of these patients were acute ischemic infarct (28%), intracranial hemorrhage (10%) including microhemorrhages (19%), and leukoencephalopathy with and/or without restricted diffusion (11%). The predominant CT chest findings were peripheral ground-glass opacities with or without consolidation. Conclusions: The CT lung disease severity score may be predictive of acute abnormalities on neuroimaging in patients with COVID-19 with neurologic manifestations. This can be used as a predictive tool in patient management to improve clinical outcome.
UR - https://www.scopus.com/pages/publications/85108309740
U2 - 10.3174/ajnr.A7072
DO - 10.3174/ajnr.A7072
M3 - Article
C2 - 33707278
AN - SCOPUS:85108309740
SN - 0195-6108
VL - 42
SP - 1008
EP - 1016
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 6
ER -