A review of neuroradiological abnormalities in patients with coronavirus disease 2019 (COVID-19)
- 5 July 2021
- journal article
- review article
- Published by SAGE Publications in The Neuroradiology Journal
- Vol. 35 (1), 3-24
- https://doi.org/10.1177/19714009211029177
Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to various neurological manifestations. There is an urgent need for a summary of neuroimaging findings to accelerate diagnosis and treatment plans. We reviewed prospective and retrospective studies to classify neurological abnormalities observed in patients with the SARS-CoV-2 infection. Methods: The relevant studies published in Scopus, PubMed and Clarivate Analytics databases were analysed. The search was performed for full-text articles published from 23 January 2020 to 23 February 2021. Results: In 23 studies the number of patients with SARS-CoV-2 infection was 20,850 and the number of patients with neurological manifestations was 1996 (9.5%). The total number of patients with neuroradiological abnormalities was 602 (2.8%). SARS-CoV-2 has led to various neuroimaging abnormalities which can be categorised by neuroanatomical localisation of lesions and their main probable underlying pathogenesis. Cranial nerve and spinal root abnormalities were cranial neuritis and polyradiculitis. Parenchymal abnormalities fell into four groups of: (a) thrombosis disorders, namely ischaemic stroke and sinus venous thrombosis; (b) endothelial dysfunction and damage disorders manifested as various types of intracranial haemorrhage and posterior reversible encephalopathy syndrome; (c) hypoxia/hypoperfusion disorders of leukoencephalopathy and watershed infarction; and (d) inflammatory disorders encompassing demyelinating disorders, encephalitis, vasculitis-like disorders, vasculopathy and cytotoxic lesions of the corpus callosum. Leptomeninges disorders included meningitis. Ischaemic stroke was the most frequent abnormality in these studies. Conclusion: The review study suggests that an anatomical approach to the classification of heterogeneous neuroimaging findings in patients with SARS-CoV-2 and neurological manifestations would lend itself well for use by practitioners in diagnosis and treatment planning.Keywords
This publication has 55 references indexed in Scilit:
- Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, ChinaJAMA Neurology, 2020
- Endothelial cell infection and endotheliitis in COVID-19The Lancet, 2020
- Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in ChinaJAMA, 2020
- A first case of meningitis/encephalitis associated with SARS-Coronavirus-2International Journal of Infectious Diseases, 2020
- Varicella Zoster Virus VasculopathyThe Journal of Infectious Diseases, 2018
- Histopathological and Bacteriological Analysis of Thrombus Material Extracted During Mechanical Thrombectomy in Acute Stroke PatientsCardioVascular and Interventional Radiology, 2017
- High-resolution MRI vessel wall imaging in varicella zoster virus vasculopathyJournal of the Neurological Sciences, 2015
- Characteristics and Outcomes of Patients With Multiple Cervical Artery DissectionStroke, 2014
- Neurological complications of HIV infectionThe Lancet, 1996