Brain abnormalities in COVID-19 acute/subacute phase: A rapid systematic review
Open accessAbstract
Objective This systematic review aimed to synthesize early data on typology and topography of brain abnormalities in adults with COVID-19 in acute/subacute phase.Methods We performed systematic literature search via PubMed, Google Scholar and ScienceDirect on articles published between January 1 and July 05, 2020, using the following strategy and key words: ((covid[Title/Abstract]) OR (sars-cov-2[Title/Abstract]) OR (coronavirus[Title/Abstract])) AND (brain[Title/Abstract]). A total of 286 non-duplicate matches were screened for original contributions reporting brain imaging data related to SARS-Cov-2 presentation in adults.Results The selection criteria were met by 26 articles (including 21 case reports, and 5 cohort studies). The data analysis in a total of 361 patients revealed that brain abnormalities were noted in 124/361 (34%) reviewed cases. Neurologic symptoms were the primary reason for referral for neuroimaging across the studies. Modalities included CT (-angiogram, -perfusion, -venogram), EEG, MRI (-angiogram, functional), and PET. The most frequently reported brain abnormalities were brain white matter (WM) hyperintensities on MRI 66/124 (53% affected cases) and hypodensities on CT (additional 23% affected cases), followed by microhemorrhages, hemorrhages and infarcts, while other types were found in <5% affected cases. WM abnormalities were most frequently noted in bilateral anterior and posterior cerebral WM (50% affected cases).Conclusion About a third of acute/subacute COVID-19 patients referred for neuroimaging show brain abnormalities suggestive of COVID-19-related etiology. The predominant neuroimaging features were diffuse cerebral WM hypodensities / hyperintensities attributable to leukoencephalopathy, leukoaraiosis or rarefield WM.
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In the recent SARS-CoV-2 or COVID-19 viral outbreak, similar structural damage of frontal cortical areas could be observed, most likely due to an inflammatory response in which parenchymal cells and the choroid plexus are involved.
“In the recent SARS-CoV-2 or COVID-19 viral outbreak, similar structural damage of frontal cortical areas could be observed, most likely due to an inflammatory response in which parenchymal cells and the choroid plexus are involved [345–347].”
From Development of prefrontal cortex (2022) · cites this paper as [346]
The Results (Topography of brain abnormalities in COVID-19; page not provided) report frontal-lobe abnormalities, primarily in white matter, but do not establish structural damage specifically to frontal cortical areas. The Discussion says the mechanisms remain unclear and are beyond the review’s scope; it does not support the proposed inflammatory involvement of parenchymal cells and the choroid plexus. (LLM, conf=0.87)
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References 43 · Cited by 120
- Authors
- Egbert, A. R., Cankurtaran, S., & Karpiak, S.
- Affiliations
- Gay Men's Health Crisis (US)
- University of Warsaw (PL)
- Corresponding author
- Egbert, Anna Rita
- ORCID
- Egbert, Anna Rita
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 89
- Pages
- 543-554
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC7366124
- OpenAlex
- W3042968242
- Cited by
- 120
- References
- 43
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 18 · 2023: 15 · 2022: 36 · 2021: 36 · 2020: 7
- FWCI
- 2.64
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 pandemic, SARS-CoV-2, brain abnormalities, neuroimaging findings, white matter hyperintensities, leukoencephalopathy, microhemorrhages, cerebral infarction, neurological symptoms
- MeSH terms
- Computed Tomography Angiography, Betacoronavirus, COVID-19, SARS-CoV-2, Acute Disease, Brain, Cerebral Angiography, Cerebral Hemorrhage, Cerebral Infarction, Electroencephalography, Humans, Magnetic Resonance Imaging, Pneumonia, Viral, Tomography, X-Ray Computed, Coronavirus Infections, Positron-Emission Tomography, Leukoaraiosis, Leukoencephalopathies, Pandemics, White Matter
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