Brain Mri Findings in Neurologically Symptomatic Covid-19 Patients: A Systematic Review and Meta-Analysis Publisher Pubmed



Afsahi AM¹ ; Norbash AM¹ ; Syed SF² ; Sedaghat M⁴ ; Afsahi G⁵ ; Shahidi R⁶ ; Tajabadi Z⁷ ; Bagherzadehfard M⁸ ; Karami S⁹ ; Yarahmadi P⁹ ; Shirdel S¹⁰ ; Asgarzadeh A¹¹ ; Baradaran M¹² ; Khalaj F⁷ Show All Authors
Source: Journal of Neurology Published:2023

Abstract

Background: Coronavirus disease 2019 (COVID-19) has been associated with nervous system involvement, with more than one-third of COVID-19 patients experiencing neurological manifestations. Utilizing a systematic review, this study aims to summarize brain MRI findings in COVID-19 patients presenting with neurological symptoms. Methods: Systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist. The electronic databases of PubMed/MEDLINE, Embase, Scopus, and Web of Science were systematically searched for literature addressing brain MRI findings in COVID-19 patients with neurological symptoms. Results: 25 publications containing a total number of 3118 COVID-19 patients with neurological symptoms who underwent MRI were included. The most common MRI findings and the respective pooled incidences in decreasing order were acute/subacute infarct (22%), olfactory bulb abnormalities (22%), white matter abnormalities (20%), cerebral microbleeds (17%), grey matter abnormalities (12%), leptomeningeal enhancement (10%), ADEM (Acute Disseminated Encephalomyelitis) or ADEM-like lesions (10%), non-traumatic ICH (10%), cranial neuropathy (8%), cortical gray matter signal changes compatible with encephalitis (8%), basal ganglia abnormalities (5%), PRES (Posterior Reversible Encephalopathy Syndrome) (3%), hypoxic-ischemic lesions (4%), venous thrombosis (2%), and cytotoxic lesions of the corpus callosum (2%). Conclusion: The present study revealed that a considerable proportion of patients with COVID-19 might harbor neurological abnormalities detectable by MRI. Among various findings, the most common MRI alterations are acute/subacute infarction, olfactory bulb abnormalities, white matter abnormalities, and cerebral microbleeds. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.