"There should probably be a low threshold to order brain imaging for patients with COVID-19," lead investigator Dr. Scott Faro of Thomas Jefferson University, in Philadelphia, said in a statement from the Radiological Society of North America (RSNA) annual meeting, where he presented the study.
It's become clear that COVID-19 symptoms extend "well beyond the flu-like symptoms and devastating pulmonary involvement" and now include central nervous system (CNS) complications, he told attendees.
To get a better handle on CNS complications of COVID-19, he and his colleagues did a retrospective review of 37,950 patients (mean age, 66 years) who were hospitalized with COVID-19 at seven U.S. and four Western European university hospitals.
A total of 4,342 patients (11%) underwent neuroimaging and acute neuroimaging findings most likely associated with the viral infection were present in 442 patients (10%). The overall incidence of CNS complications was 1.2%.
Ischemic stroke was the most common finding (62.4%), followed by intracranial hemorrhage (37.1%), encephalitis (5.2%), sinus venous thrombosis (2.3%), acute demyelinating encephalomeningitis (1.8%), posterior reversible encephalopathy (1.6%) and vasculitis (0.5%).
Most patients had lesions on only one side of the brain (59.7%) and involving the frontal and parietal lobes (roughly 52%), with an equal distribution of white matter, cortical and subcortical involvement (about 55%).
"Much has been written about the overall pulmonary problems related to COVID-19, but we do not often talk about the other organs that can be affected. Our study shows that central nervous system complications represent a significant cause of morbidity and mortality in this devastating pandemic," Dr. Faro said in the statement.
SOURCE: https://bit.ly/3lifM9T Radiological Society of North America annual meeting, November 28 to December 2, 2021.
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