Imaging Features of Acute Encephalopathy in Patients with COVID-19: A Case Series
Open accessAbstract
Coronavirus disease 2019 was declared a global pandemic by the World Health Organization on March 11, 2020. There is a scarcity of data on coronavirus disease 2019-related brain imaging features. We present 5 cases that illustrate varying imaging presentations of acute encephalopathy in patients with coronavirus disease 2019. MR features include leukoencephalopathy, diffusion restriction that involves the GM and WM, microhemorrhages, and leptomeningitis. We believe it is important for radiologists to be familiar with the neuroradiologic imaging spectrum of acute encephalopathy in the coronavirus disease 2019 population.
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Most studies on cognitive changes following SARS-CoV-2 infection focused on acute changes, mainly acute encephalopathy.
“Most studies on cognitive changes following SARS-CoV-2 infection focused on acute changes, mainly acute encephalopathy [137–139].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [139]
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Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China
Huang, C., Wang, Y., Li, X., Ren, L., Zhao, J., Hu, Y., Zhang, L., Fan, G., Xu, J., Gu, X., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30183-5 · Cited by 48,884 · see citing works
A pneumonia outbreak associated with a new coronavirus of probable bat origin
Zhou, P., Yang, X.-L., Wang, X.-G., Hu, B., Zhang, L., Zhang, W., Si, H.-R., Zhu, Y., Li, B., Huang, C.-L., et al. (2020) · Nature · doi:10.1038/s41586-020-2012-7 · Cited by 21,969 · see citing works
Lu, R., Zhao, X., Li, J., Niu, P., Yang, B., Wu, H., Wang, W., Song, H., Huang, B., Zhu, N., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30251-8 · Cited by 11,907 · see citing works
COVID-19: consider cytokine storm syndromes and immunosuppression
Mehta, P., McAuley, D. F., Brown, M., Sanchez, E., Tattersall, R. S., & Manson, J. J. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30628-0 · Cited by 9,664 · see citing works
Neurologic features in severe SARS-CoV-2 infection
Helms, J., Kremer, S., Merdji, H., Clere-Jehl, R., Schenck, M., Kummerlen, C., Collange, O., Boulay, C., Fafi-Kremer, S., Ohana, M., et al. (2020) · New England Journal of Medicine · doi:10.1056/nejmc2008597 · Cited by 2,674 · see citing works
Nervous system involvement after infection with COVID-19 and other coronaviruses
Wu, Y., Xu, X., Chen, Z., Duan, J., Hashimoto, K., Yang, L., Liu, C., & Yang, C. (2020) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2020.03.031 · Cited by 2,046 · see citing works
A first case of meningitis/encephalitis associated with SARS-Coronavirus-2
Moriguchi, T., Harii, N., Goto, J., Harada, D., Sugawara, H., Takamino, J., Ueno, M., Sakata, H., Kondo, K., Myose, N., et al. (2020) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2020.03.062 · Cited by 2,024 · see citing works
COVID-19–associated Acute Hemorrhagic Necrotizing Encephalopathy: Imaging Features
Poyiadji, N., Shahin, G., Noujaim, D., Stone, M., Patel, S., & Griffith, B. (2020) · Radiology · doi:10.1148/radiol.2020201187 · Cited by 1,505 · see citing works
Clinical course and mortality risk of severe COVID-19
Weiss, P., & Murdoch, D. R. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30633-4 · Cited by 679 · see citing works
Critical care crisis and some recommendations during the COVID-19 epidemic in China
Xie, J., Tong, Z., Guan, X., Du, B., Qiu, H., & Slutsky, A. S. (2020) · Intensive Care Medicine · doi:10.1007/s00134-020-05979-7 · Cited by 612 · see citing works
Acute disseminated encephalomyelitis: A follow-up study of 40 adult patients
Schwarz, S., Mohr, A., Knauth, M., Wildemann, B., & Storch–Hagenlocher, B. (2001) · Neurology · doi:10.1212/wnl.56.10.1313 · Cited by 511 · see citing works
Axonal Transport Enables Neuron-to-Neuron Propagation of Human Coronavirus OC43
Dubé, M., Le Coupanec, A., Wong, A. H. M., Rini, J. M., Desforges, M., & Talbot, P. J. (2018) · Journal of Virology · doi:10.1128/jvi.00404-18 · Cited by 452 · see citing works
Encephalitis as a clinical manifestation of COVID-19
Ye, M., Ren, Y., & Lv, T. (2020) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2020.04.017 · Cited by 430 · see citing works
Severe neurologic syndrome associated with Middle East respiratory syndrome corona virus (MERS-CoV)
Arabi, Y. M., Alharthi, A. F., Hussein, J., Bouchama, A., Johani, S. A., Hajeer, A. H., Saeed, B. T., Wahbi, A. M. A., Saedy, A., Aldabbagh, T., et al. (2015) · Infection · doi:10.1007/s15010-015-0720-y · Cited by 385 · see citing works
Yeh, E. A., Collins, A. R., Cohen, M. E., Duffner, P. K., & Faden, H. S. (2004) · PEDIATRICS · doi:10.1542/peds.113.1.e73 · Cited by 329 · see citing works
Angiotensin‐converting enzyme 2 in the brain: properties and future directions
Xia, H., & Lazartigues, E. D. (2008) · Journal of Neurochemistry · doi:10.1111/j.1471-4159.2008.05723.x · Cited by 321 · see citing works
High-Altitude Cerebral Edema Evaluated With Magnetic Resonance Imaging
Hackett, P. H., Yarnell, P. R., Hill, R., Reynard, K., Heit, J., & McCormick, J. (1998) · JAMA · doi:10.1001/jama.280.22.1920 · Cited by 314 · see citing works
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Kandemirli, S. G., Dogan, L., Sarikaya, Z. T., Kara, S., Akinci, C., Kaya, D., Kaya, Y., Yildirim, D., Tuzuner, F., Yildirim, M. S., et al. (2020) · Radiology · doi:10.1148/radiol.2020201697 · Cited by 298 · see citing works
Molecular Methods for Diagnosis of Viral Encephalitis
DeBiasi, R. L., & Tyler, K. L. (2004) · Clinical Microbiology Reviews · doi:10.1128/cmr.17.4.903-925.2004 · Cited by 274 · see citing works
COVID-19–associated Diffuse Leukoencephalopathy and Microhemorrhages
Radmanesh, A., Derman, A. Y., Lui, Y. W., Raz, E., Loh, J. P., Hagiwara, M., Borja, M. J., Zan, E., & Fatterpekar, G. M. (2020) · Radiology · doi:10.1148/radiol.2020202040 · Cited by 267 · see citing works
Greenland, J. R., Michelow, M. D., Wang, L., & London, M. J. (2020) · Anesthesiology · doi:10.1097/aln.0000000000003303 · Cited by 208 · see citing works
Ma, J., Xia, P., Zhou, Y., Liu, Z., Zhou, X. P., Wang, J., Li, T., Yan, X., Chen, L., Zhang, S., et al. (2020) · Clinical Immunology · doi:10.1016/j.clim.2020.108408 · Cited by 171 · see citing works
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Fanou, E., Coutinho, J. M., Shannon, P. T., Kiehl, T., Levi, M. M., Wilcox, M. E., Aviv, R. I., & Mandell, D. M. (2017) · Stroke · doi:10.1161/strokeaha.116.016289 · Cited by 156 · see citing works
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Möhlenkamp, S., & Thiele, H. (2020) · Herz · doi:10.1007/s00059-020-04923-1 · Cited by 117 · see citing works
Sonneville, R., Demeret, S., Klein, I. F., Bouadma, L., Mourvillier, B., Audibert, J., Legriel, S., Bolgert, F., Regnier, B., & Wolff, M. (2007) · Intensive Care Medicine · doi:10.1007/s00134-007-0926-2 · Cited by 85 · see citing works
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- Authors
- Kihira, S., Delman, B. N., Belani, P., Stein, L., Aggarwal, A., Rigney, B., Schefflein, J., Doshi, A. H., & Pawha, P. S.
- Affiliations
- Icahn School of Medicine at Mount Sinai (US)
- ORCID
- Venue
- American Journal of Neuroradiology
- Published
- 2020-08-13
- Volume
- 41
- Issue
- 10
- Pages
- 1804-1808
- ISSN
- 0195-6108 (ISSN-L)
- 1936-959X
- PMC
- PMC7661067
- OpenAlex
- W3049537531
- Cited by
- 38
- References
- 26
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 5 · 2022: 11 · 2021: 15 · 2020: 2
- FWCI
- 3.57
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- American Journal of Neuroradiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (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 › Psychiatry and Mental health › Neurological Complications and Syndromes
- Keywords
- COVID-19 pandemic, acute encephalopathy, SARS-CoV-2, leukoencephalopathy, restricted diffusion, microhemorrhages, leptomeningitis, brain MRI findings
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Acute Disease, Adult, Brain Diseases, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pneumonia, Viral, Coronavirus Infections, Leukoencephalopathies, Pandemics
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