Boparai Montek S, Musheyev Benjamin, Hou Wei, Mehler Mark F, Duong Tim Q
Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States.
Department of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY, United States.
Front Neurol. 2023 Oct 12;14:1258352. doi: 10.3389/fneur.2023.1258352. eCollection 2023.
Neurocognitive symptoms and dysfunction of various severities have become increasingly recognized as potential consequences of SARS-CoV-2 infection. Although there are numerous observational and subjective survey-reporting studies of neurological symptoms, by contrast, those studies describing imaging abnormalities are fewer in number.
This study conducted a metanalysis of 32 studies to determine the incidence of the common neurological abnormalities using magnetic resonance imaging (MRI) in patients with COVID-19.
We also present the common clinical findings associated with MRI abnormalities. We report the incidence of any MRI abnormality to be 55% in COVID-19 patients with perfusion abnormalities (53%) and SWI abnormalities (44%) being the most commonly reported injuries. Cognitive impairment, ICU admission and/or mechanical ventilation status, older age, and hospitalization or longer length of hospital stay were the most common clinical findings associated with brain injury in COVID-19 patients.
Overall, the presentation of brain injury in this study was diverse with no substantial pattern of injury emerging, yet most injuries appear to be of vascular origin. Moreover, analysis of the association between MRI abnormalities and clinical findings suggests that there are likely many mechanisms, both direct and indirect, by which brain injury occurs in COVID-19 patients.
各种严重程度的神经认知症状和功能障碍已越来越被认为是SARS-CoV-2感染的潜在后果。相比之下，尽管有大量关于神经症状的观察性和主观调查报告研究，但描述影像学异常的研究数量较少。
本研究对32项研究进行了荟萃分析，以确定使用磁共振成像（MRI）检测COVID-19患者常见神经异常的发生率。
我们还展示了与MRI异常相关的常见临床发现。我们报告，在COVID-19患者中，任何MRI异常的发生率为55%，灌注异常（53%）和磁敏感加权成像（SWI）异常（44%）是最常报告的损伤。认知障碍、入住重症监护病房（ICU）和/或机械通气状态、年龄较大以及住院或住院时间较长是COVID-19患者中与脑损伤相关的最常见临床发现。
总体而言，本研究中脑损伤的表现多种多样，没有出现实质性的损伤模式，但大多数损伤似乎起源于血管。此外，对MRI异常与临床发现之间关联的分析表明，COVID-19患者脑损伤的发生可能有许多直接和间接机制。
