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- Title
Brain MRI findings in neurologically symptomatic COVID-19 patients: a systematic review and meta-analysis.
- Authors
Afsahi, Amir Masoud; Norbash, Alexander M.; Syed, Shahla F.; Sedaghat, Maya; Afsahi, Ghazaleh; Shahidi, Ramin; Tajabadi, Zohreh; Bagherzadeh-Fard, Mahsa; Karami, Shaghayegh; Yarahmadi, Pourya; Shirdel, Shabnam; Asgarzadeh, Ali; Baradaran, Mansoureh; Khalaj, Fattaneh; Sadeghsalehi, Hamidreza; Fotouhi, Maryam; Habibi, Mohammad Amin; Jang, Hyungseok; Alavi, Abass; Sedaghat, Sam
- 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.
- Subjects
CEREBRAL infarction; COVID-19; POSTERIOR leukoencephalopathy syndrome; POSTVACCINAL encephalitis; MAGNETIC resonance imaging; CORPUS callosum
- Publication
Journal of Neurology, 2023, Vol 270, Issue 11, p5131
- ISSN
0340-5354
- Publication type
Article
- DOI
10.1007/s00415-023-11914-9