From the Department of Radiology, New York University School of Medicine, New York, New York.
AJNR Am J Neuroradiol. 2020 Jul;41(7):1179-1183. doi: 10.3174/ajnr.A6610. Epub 2020 May 28.
Coronavirus disease 2019 (COVID-19) is a serious public health crisis and can have neurologic manifestations. This is a retrospective observational case series performed March 1-31, 2020, at New York University Langone Medical Center campuses. Clinical and imaging data were extracted, reviewed, and analyzed. Two hundred forty-two patients with COVID-19 underwent CT or MRI of the brain within 2 weeks after the positive result of viral testing (mean age, 68.7 ± 16.5 years; 150 men/92 women [62.0%/38.0%]). The 3 most common indications for imaging were altered mental status (42.1%), syncope/fall (32.6%), and focal neurologic deficit (12.4%). The most common imaging findings were nonspecific white matter microangiopathy (134/55.4%), chronic infarct (47/19.4%), acute or subacute ischemic infarct (13/5.4%), and acute hemorrhage (11/4.5%). No patients imaged for altered mental status demonstrated acute ischemic infarct or acute hemorrhage. White matter microangiopathy was associated with higher 2-week mortality ( < .001). Our data suggest that in the absence of a focal neurologic deficit, brain imaging in patients with early COVID-19 with altered mental status may not be revealing.
2019 年冠状病毒病（COVID-19）是一场严重的公共卫生危机，可引起神经系统表现。这是 2020 年 3 月 1 日至 31 日在纽约大学朗格尼医学中心进行的回顾性观察性病例系列研究。提取、审查和分析了临床和影像学数据。242 例 COVID-19 患者在病毒检测阳性后 2 周内接受了脑部 CT 或 MRI（平均年龄 68.7 ± 16.5 岁；150 名男性/92 名女性[62.0%/38.0%]）。成像的 3 个最常见指征是意识改变（42.1%）、晕厥/跌倒（32.6%）和局灶性神经功能缺损（12.4%）。最常见的影像学表现是非特异性脑白质微血管病（134/55.4%）、陈旧性梗死（47/19.4%）、急性或亚急性缺血性梗死（13/5.4%）和急性出血（11/4.5%）。未发现因意识改变而进行影像学检查的患者存在急性缺血性梗死或急性出血。脑白质微血管病与 2 周死亡率升高相关（<0.001）。我们的数据表明，在没有局灶性神经功能缺损的情况下，早期 COVID-19 伴意识改变患者的脑部成像可能无明显异常。
