MRI findings in COVID-19 positive and COVID-19negative patients presenting with acute neurologicalsymptoms – a case-control study

[摘要] Background & Objective: Neurological manifestations of novel-coronavirus disease (COVID-19) havebeen described in various studies. None of these studies has compared the findings in COVID-19patients with COVID-negative patients presenting with similar clinical symptomatology during thesame period. We undertook this case-control study with an aim to establish a direct relationship betweenCOVID-19 infection and CNS related clinical and imaging presentations. Methods: This study wasa review of retrospectively collected data of the patients who presented with different neurologicalsymptoms to a tertiary care hospital in India. Based on results of Reverse transcriptase-polymerasechain reaction for SARS-Co-V-2, patients were classified into COVID-19 positive and COVID-19negative groups. MRI findings in both groups were reviewed for acute ischemic stroke, intracranialbleed and other acute imaging abnormalities. Basic demographic information and stroke-relatedco-morbidities were also compared. Results: Eighty four patients in COVID-19 positive group and323 patients in COVID-19 negative group underwent brain MRI for acute neurological symptomsduring the same period. There was no statistically significant difference in presenting symptoms, sexdistribution and risk factors for stroke. There was a higher prevalence of increased coagulability inCOVID-19 positive group (p-value = 0.009). No statistically significant association was observed forinfarcts or their hemorrhagic transformation, intracranial bleed, intracranial infection or dural sinusthrombosis. An association was found between acute diffuse leukoencephalopathy and COVID-19infection (p value < 0.05).Conclusion: The current study points towards a weak direct association between COVID-19 infectionand acute abnormalities in MRI brain studies, especially in patients with pre-existing co-morbidities.

[学科分类] 精神健康和精神病学

[关键词] COVID-19;MR imaging;Stroke;Brain hemorrhage;Leukoencephalopathy