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Cited by 466Long-Term Effects of COVID-19Infectious Encephalopathies and EncephalitisCOVID-19 Clinical Research Studies

The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.

Brain MRI Findings in Severe COVID-19: A Retrospective Observational Study

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Kremer, Stéphane, Lersy, François, de Sèze, Jérome, Ferré, Jean-Christophe, Maamar, Adel, Carsin-Nicol, Béatrice, Collange, Olivier, Bonneville, Fabrice, Adam, Gilles, Martin-Blondel, Guillaume, Rafiq, Marie, Geeraerts, Thomas, Delamarre, Louis, Grand, Sylvie, Krainik, Alexandre, For the SFNR-COVID Group, Kremer, Stéphane, Adam, Gilles, Alleg, Manel, Anheim, Mathieu, Anxionnat, René, Ardellier, François-Daniel, Baloglu, Seyyid, Bapst, Blanche, Benzakoun, Joseph, Berge, Jérome, Bolognini, Federico, Bonneville, Fabrice, Bornet, Grégoire, Boulay, Clotilde, Boulouis, Grégoire, Boutet, Claire, Brisset, Jean Christophe, Caillard, Sophie, Carré, Sophie, Carsin-Nicol, Béatrice, Collange, Olivier, Comby, Pierre-Olivier, Constans, Jean Marc, David, Jean-Stéphane, de Beaurepaire, Isaure, de Sèze, Jérome, Delamarre, Louis, Desal, Hubert, Edjlali-Goujon, Myriam, Fabre, Xavier, Fafi-Kremer, Samira, Ferré, Jean-Christophe, Feuerstein, Philippe, Henry Feugeas, Marie-Cécile, Forestier, Géraud, Gaudemer, Augustin, Geeraerts, Thomas, Grand, Sylvie, Hansmann, Yves, Heintz, Adrien, Helms, Julie, Hemmert, Céline, Hmeydia, Ghazi, Jager, Lavinia, Kazémi, Apolline, Kerleroux, Basile, Khalil, Antoine, Krainik, Alexandre, Lacalm, Audrey, Lecler, Augustin, Lecocq, Claire, Lefèbvre, Nicolas, Lersy, François, Maamar, Adel, Martin-Blondel, Guillaume, Matthieu, Muriel, Megdiche, Imen, Mertes, Paul-Michel, Messié, Julien, Metanbou, Serge, Meyer, Nicolas, Meziani, Ferhat, Mutschler, Véronique, Nesser, Patrick, Oesterlé, Hélène, Ohana, Mickael, Oppenheim, Catherine, Pyatigorskaya, Nadya, Rafiq, Marie, Ricolfi, Frédéric, Saleme, Suzana, Schenck, Maleka, Schmitt, Emmanuelle, Schneider, Francis, Sebag, Nathan, Talla Mba, Yannick, Thouant, Pierre, Willaume, Thibault, Zhu, François, Zorn, Pierre-Emmanuel, Cotton, François·2020·Radiology
DOI 10.1148/radiol.2020202222PMC PMC7301613
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Abstract

Background Brain MRI parenchymal signal abnormalities have been associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Purpose To describe the neuroimaging findings (excluding ischemic infarcts) in patients with severe coronavirus disease 2019 (COVID-19) infection. Materials and Methods This was a retrospective study of patients evaluated from March 23, 2020, to April 27, 2020, at 16 hospitals. Inclusion criteria were (a) positive nasopharyngeal or lower respiratory tract reverse transcriptase polymerase chain reaction assays, (b) severe COVID-19 infection defined as a requirement for hospitalization and oxygen therapy, (c) neurologic manifestations, and (d) abnormal brain MRI findings. Exclusion criteria were patients with missing or noncontributory data regarding brain MRI or brain MRI showing ischemic infarcts, cerebral venous thrombosis, or chronic lesions unrelated to the current event. Categorical data were compared using the Fisher exact test. Quantitative data were compared using the Student t test or Wilcoxon test. P < .05 represented a significant difference. Results Thirty men (81%) and seven women (19%) met the inclusion criteria, with a mean age of 61 years ± 12 (standard deviation) (age range, 8–78 years). The most common neurologic manifestations were alteration of consciousness (27 of 37, 73%), abnormal wakefulness when sedation was stopped (15 of 37, 41%), confusion (12 of 37, 32%), and agitation (seven of 37, 19%). The most frequent MRI findings were signal abnormalities located in the medial temporal lobe in 16 of 37 patients (43%; 95% confidence interval [CI]: 27%, 59%), nonconfluent multifocal white matter hyperintense lesions seen with fluid-attenuated inversion recovery and diffusion-weighted sequences with variable enhancement, with associated hemorrhagic lesions in 11 of 37 patients (30%; 95% CI: 15%, 45%), and extensive and isolated white matter microhemorrhages in nine of 37 patients (24%; 95% CI: 10%, 38%). A majority of patients (20 of 37, 54%) had intracerebral hemorrhagic lesions with a more severe clinical presentation and a higher admission rate in intensive care units (20 of 20 patients [100%] vs 12 of 17 patients without hemorrhage [71%], P = .01) and development of the acute respiratory distress syndrome (20 of 20 patients [100%] vs 11 of 17 patients [65%], P = .005). Only one patient had SARS-CoV-2 RNA in the cerebrospinal fluid. Conclusion Patients with severe coronavirus disease 2019 and without ischemic infarcts had a wide range of neurologic manifestations that were associated with abnormal brain MRI scans. Eight distinctive neuroradiologic patterns were described. © RSNA, 2020

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  1. World Health Organization, Protocol: Real-time RT-PCR assays for the detection of SARS-CoV-2
  2. Nabi S, 2016, BMJ Case Rep, 2016
  3. Katyal N, 2018, Cureus, 10

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Authors
Kremer, S., Lersy, F., de Sèze, J., Ferré, J.-C., Maamar, A., Carsin-Nicol, B., Collange, O., Bonneville, F., Adam, G., Martin-Blondel, G., Rafiq, M., Geeraerts, T., Delamarre, L., Grand, S., Krainik, A., For the SFNR-COVID Group, Kremer, S., Adam, G., Alleg, M., Anheim, M., Anxionnat, R., Ardellier, F.-D., Baloglu, S., Bapst, B., Benzakoun, J., Berge, J., Bolognini, F., Bonneville, F., Bornet, G., Boulay, C., Boulouis, G., Boutet, C., Brisset, J. C., Caillard, S., Carré, S., Carsin-Nicol, B., Collange, O., Comby, P.-O., Constans, J. M., David, J.-S., de Beaurepaire, I., de Sèze, J., Delamarre, L., Desal, H., Edjlali-Goujon, M., Fabre, X., Fafi-Kremer, S., Ferré, J.-C., Feuerstein, P., Henry Feugeas, M.-C., Forestier, G., Gaudemer, A., Geeraerts, T., Grand, S., Hansmann, Y., Heintz, A., Helms, J., Hemmert, C., Hmeydia, G., Jager, L., Kazémi, A., Kerleroux, B., Khalil, A., Krainik, A., Lacalm, A., Lecler, A., Lecocq, C., Lefèbvre, N., Lersy, F., Maamar, A., Martin-Blondel, G., Matthieu, M., Megdiche, I., Mertes, P.-M., Messié, J., Metanbou, S., Meyer, N., Meziani, F., Mutschler, V., Nesser, P., Oesterlé, H., Ohana, M., Oppenheim, C., Pyatigorskaya, N., Rafiq, M., Ricolfi, F., Saleme, S., Schenck, M., Schmitt, E., Schneider, F., Sebag, N., Talla Mba, Y., Thouant, P., Willaume, T., Zhu, F., Zorn, P.-E., & Cotton, F.
Affiliations
  • Hôpitaux Universitaires de Strasbourg (FR)
  • Centre National de la Recherche Scientifique (FR)
ORCID
Venue
Radiology
Publisher
Radiological Society of North America (RSNA)
Published
2020-11
Volume
297
Issue
2
Pages
E242-E251
ISSN
  • 0033-8419 (ISSN-L)
  • 1527-1315
DOI
10.1148/radiol.2020202222
PMC
PMC7301613
OpenAlex
W3035517854
Cited by
460
References
28
Citations by year
2026: 9 · 2025: 17 · 2024: 35 · 2023: 64 · 2022: 80 · 2021: 163 · 2020: 89
FWCI
42.87
Type
journal article
Language
en
Open access
Locations
  • Radiology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • HAL (submittedVersion)
Funders
Agence Nationale de la Recherche (ANR-10-EQPX-0001)
Topics
  • Health Sciences › Medicine › Clinical 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 MRI findings, neurologic manifestations, altered states of consciousness, white matter hyperintensities, intracerebral hemorrhage, diffusion-weighted imaging, FLAIR, cerebral venous thrombosis, cerebral edema, brain hypometabolism
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Aged, Brain, Child, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pneumonia, Viral, Retrospective Studies, Cohort Studies, Coronavirus Infections, Young Adult, Pandemics

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