Brain and Lung Imaging Correlation in Patients with COVID-19: Could the Severity of Lung Disease Reflect the Prevalence of Acute Abnormalities on Neuroimaging? A Global Multicenter Observational Study
Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms. In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patie...
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| Veröffentlicht in: | American journal of neuroradiology : AJNR 2021-06, Vol.42 (6), p.1008-1016 |
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| creator | Mahammedi, A Ramos, A Bargalló, N Gaskill, M Kapur, S Saba, L Carrete, Jr, H Sengupta, S Salvador, E Hilario, A Revilla, Y Sanchez, M Perez-Nuñez, M Bachir, S Zhang, B Oleaga, L Sergio, J Koren, L Martin-Medina, P Wang, L Benegas, M Ostos, F Gonzalez-Ortega, G Calleja, P Udstuen, G Williamson, B Khandwala, V Chadalavada, S Woo, D Vagal, A |
| description | Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms.
In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0-5 (0 corresponded to no involvement and 5 corresponded to >75% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement).
A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64%) patients without acute abnormal findings on neuroimaging, 49 (36%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8, |
| doi_str_mv | 10.3174/ajnr.A7072 |
| format | Article |
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In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0-5 (0 corresponded to no involvement and 5 corresponded to >75% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement).
A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64%) patients without acute abnormal findings on neuroimaging, 49 (36%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8,
< .001). These patients were more likely to present with ischemic stroke (40 [82%] versus 11 [13%],
< .0001) and were more likely to have either ground-glass opacities or consolidation (46 [94%] versus 73 [84%],
= .01) in the lungs. A threshold of the CT lung severity score of >8 was found to be 74% sensitive and 65% specific for acute abnormal findings on neuroimaging. The neuroimaging hallmarks of these patients were acute ischemic infarct (28%), intracranial hemorrhage (10%) including microhemorrhages (19%), and leukoencephalopathy with and/or without restricted diffusion (11%). The predominant CT chest findings were peripheral ground-glass opacities with or without consolidation.
The CT lung disease severity score may be predictive of acute abnormalities on neuroimaging in patients with COVID-19 with neurologic manifestations. This can be used as a predictive tool in patient management to improve clinical outcome.</description><identifier>ISSN: 0195-6108</identifier><identifier>EISSN: 1936-959X</identifier><identifier>DOI: 10.3174/ajnr.A7072</identifier><identifier>PMID: 33707278</identifier><language>eng</language><publisher>United States: American Society of Neuroradiology</publisher><subject>Adult Brain</subject><ispartof>American journal of neuroradiology : AJNR, 2021-06, Vol.42 (6), p.1008-1016</ispartof><rights>2021 by American Journal of Neuroradiology.</rights><rights>2021 by American Journal of Neuroradiology 2021 American Journal of Neuroradiology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c378t-a67507b5bfeccc7302e7578ab4a62876968e299f5b64a6a19f83228f7ffb28c53</citedby><cites>FETCH-LOGICAL-c378t-a67507b5bfeccc7302e7578ab4a62876968e299f5b64a6a19f83228f7ffb28c53</cites><orcidid>0000-0002-1398-8308 ; 0000-0002-5754-7723 ; 0000-0001-6284-5402 ; 0000-0002-4748-8010 ; 0000-0001-6428-6499 ; 0000-0003-0585-5609 ; 0000-0003-1540-9303 ; 0000-0002-7432-6922 ; 0000-0002-8591-6848 ; 0000-0002-8324-6502 ; 0000-0002-1161-402X ; 0000-0003-4577-1397 ; 0000-0002-6076-2395 ; 0000-0003-4858-1927 ; 0000-0003-2870-3771 ; 0000-0002-8726-9269 ; 0000-0002-5107-438X ; 0000-0002-8020-3435 ; 0000-0001-9702-0451 ; 0000-0003-0607-1806 ; 0000-0002-4763-3265 ; 0000-0003-0393-0126 ; 0000-0002-2671-5157 ; 0000-0003-2972-163X ; 0000-0002-8618-313X ; 0000-0002-2466-7155 ; 0000-0002-8744-264X ; 0000-0002-3778-174X ; 0000-0001-5143-603X ; 0000-0001-7362-8569</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191655/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191655/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33707278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mahammedi, A</creatorcontrib><creatorcontrib>Ramos, A</creatorcontrib><creatorcontrib>Bargalló, N</creatorcontrib><creatorcontrib>Gaskill, M</creatorcontrib><creatorcontrib>Kapur, S</creatorcontrib><creatorcontrib>Saba, L</creatorcontrib><creatorcontrib>Carrete, Jr, H</creatorcontrib><creatorcontrib>Sengupta, S</creatorcontrib><creatorcontrib>Salvador, E</creatorcontrib><creatorcontrib>Hilario, A</creatorcontrib><creatorcontrib>Revilla, Y</creatorcontrib><creatorcontrib>Sanchez, M</creatorcontrib><creatorcontrib>Perez-Nuñez, M</creatorcontrib><creatorcontrib>Bachir, S</creatorcontrib><creatorcontrib>Zhang, B</creatorcontrib><creatorcontrib>Oleaga, L</creatorcontrib><creatorcontrib>Sergio, J</creatorcontrib><creatorcontrib>Koren, L</creatorcontrib><creatorcontrib>Martin-Medina, P</creatorcontrib><creatorcontrib>Wang, L</creatorcontrib><creatorcontrib>Benegas, M</creatorcontrib><creatorcontrib>Ostos, F</creatorcontrib><creatorcontrib>Gonzalez-Ortega, G</creatorcontrib><creatorcontrib>Calleja, P</creatorcontrib><creatorcontrib>Udstuen, G</creatorcontrib><creatorcontrib>Williamson, B</creatorcontrib><creatorcontrib>Khandwala, V</creatorcontrib><creatorcontrib>Chadalavada, S</creatorcontrib><creatorcontrib>Woo, D</creatorcontrib><creatorcontrib>Vagal, A</creatorcontrib><title>Brain and Lung Imaging Correlation in Patients with COVID-19: Could the Severity of Lung Disease Reflect the Prevalence of Acute Abnormalities on Neuroimaging? A Global Multicenter Observational Study</title><title>American journal of neuroradiology : AJNR</title><addtitle>AJNR Am J Neuroradiol</addtitle><description>Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms.
In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0-5 (0 corresponded to no involvement and 5 corresponded to >75% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement).
A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64%) patients without acute abnormal findings on neuroimaging, 49 (36%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8,
< .001). These patients were more likely to present with ischemic stroke (40 [82%] versus 11 [13%],
< .0001) and were more likely to have either ground-glass opacities or consolidation (46 [94%] versus 73 [84%],
= .01) in the lungs. A threshold of the CT lung severity score of >8 was found to be 74% sensitive and 65% specific for acute abnormal findings on neuroimaging. The neuroimaging hallmarks of these patients were acute ischemic infarct (28%), intracranial hemorrhage (10%) including microhemorrhages (19%), and leukoencephalopathy with and/or without restricted diffusion (11%). The predominant CT chest findings were peripheral ground-glass opacities with or without consolidation.
The CT lung disease severity score may be predictive of acute abnormalities on neuroimaging in patients with COVID-19 with neurologic manifestations. 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A Global Multicenter Observational Study</title><author>Mahammedi, A ; Ramos, A ; Bargalló, N ; Gaskill, M ; Kapur, S ; Saba, L ; Carrete, Jr, H ; Sengupta, S ; Salvador, E ; Hilario, A ; Revilla, Y ; Sanchez, M ; Perez-Nuñez, M ; Bachir, S ; Zhang, B ; Oleaga, L ; Sergio, J ; Koren, L ; Martin-Medina, P ; Wang, L ; Benegas, M ; Ostos, F ; Gonzalez-Ortega, G ; Calleja, P ; Udstuen, G ; Williamson, B ; Khandwala, V ; Chadalavada, S ; Woo, D ; Vagal, A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c378t-a67507b5bfeccc7302e7578ab4a62876968e299f5b64a6a19f83228f7ffb28c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult Brain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mahammedi, A</creatorcontrib><creatorcontrib>Ramos, A</creatorcontrib><creatorcontrib>Bargalló, N</creatorcontrib><creatorcontrib>Gaskill, M</creatorcontrib><creatorcontrib>Kapur, S</creatorcontrib><creatorcontrib>Saba, L</creatorcontrib><creatorcontrib>Carrete, Jr, H</creatorcontrib><creatorcontrib>Sengupta, S</creatorcontrib><creatorcontrib>Salvador, E</creatorcontrib><creatorcontrib>Hilario, A</creatorcontrib><creatorcontrib>Revilla, Y</creatorcontrib><creatorcontrib>Sanchez, M</creatorcontrib><creatorcontrib>Perez-Nuñez, M</creatorcontrib><creatorcontrib>Bachir, S</creatorcontrib><creatorcontrib>Zhang, B</creatorcontrib><creatorcontrib>Oleaga, L</creatorcontrib><creatorcontrib>Sergio, J</creatorcontrib><creatorcontrib>Koren, L</creatorcontrib><creatorcontrib>Martin-Medina, P</creatorcontrib><creatorcontrib>Wang, L</creatorcontrib><creatorcontrib>Benegas, M</creatorcontrib><creatorcontrib>Ostos, F</creatorcontrib><creatorcontrib>Gonzalez-Ortega, G</creatorcontrib><creatorcontrib>Calleja, P</creatorcontrib><creatorcontrib>Udstuen, G</creatorcontrib><creatorcontrib>Williamson, B</creatorcontrib><creatorcontrib>Khandwala, V</creatorcontrib><creatorcontrib>Chadalavada, S</creatorcontrib><creatorcontrib>Woo, D</creatorcontrib><creatorcontrib>Vagal, A</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of neuroradiology : AJNR</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mahammedi, A</au><au>Ramos, A</au><au>Bargalló, N</au><au>Gaskill, M</au><au>Kapur, S</au><au>Saba, L</au><au>Carrete, Jr, H</au><au>Sengupta, S</au><au>Salvador, E</au><au>Hilario, A</au><au>Revilla, Y</au><au>Sanchez, M</au><au>Perez-Nuñez, M</au><au>Bachir, S</au><au>Zhang, B</au><au>Oleaga, L</au><au>Sergio, J</au><au>Koren, L</au><au>Martin-Medina, P</au><au>Wang, L</au><au>Benegas, M</au><au>Ostos, F</au><au>Gonzalez-Ortega, G</au><au>Calleja, P</au><au>Udstuen, G</au><au>Williamson, B</au><au>Khandwala, V</au><au>Chadalavada, S</au><au>Woo, D</au><au>Vagal, A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Brain and Lung Imaging Correlation in Patients with COVID-19: Could the Severity of Lung Disease Reflect the Prevalence of Acute Abnormalities on Neuroimaging? A Global Multicenter Observational Study</atitle><jtitle>American journal of neuroradiology : AJNR</jtitle><addtitle>AJNR Am J Neuroradiol</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>42</volume><issue>6</issue><spage>1008</spage><epage>1016</epage><pages>1008-1016</pages><issn>0195-6108</issn><eissn>1936-959X</eissn><abstract>Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms.
In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0-5 (0 corresponded to no involvement and 5 corresponded to >75% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement).
A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64%) patients without acute abnormal findings on neuroimaging, 49 (36%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8,
< .001). These patients were more likely to present with ischemic stroke (40 [82%] versus 11 [13%],
< .0001) and were more likely to have either ground-glass opacities or consolidation (46 [94%] versus 73 [84%],
= .01) in the lungs. A threshold of the CT lung severity score of >8 was found to be 74% sensitive and 65% specific for acute abnormal findings on neuroimaging. The neuroimaging hallmarks of these patients were acute ischemic infarct (28%), intracranial hemorrhage (10%) including microhemorrhages (19%), and leukoencephalopathy with and/or without restricted diffusion (11%). The predominant CT chest findings were peripheral ground-glass opacities with or without consolidation.
The CT lung disease severity score may be predictive of acute abnormalities on neuroimaging in patients with COVID-19 with neurologic manifestations. This can be used as a predictive tool in patient management to improve clinical outcome.</abstract><cop>United States</cop><pub>American Society of Neuroradiology</pub><pmid>33707278</pmid><doi>10.3174/ajnr.A7072</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-1398-8308</orcidid><orcidid>https://orcid.org/0000-0002-5754-7723</orcidid><orcidid>https://orcid.org/0000-0001-6284-5402</orcidid><orcidid>https://orcid.org/0000-0002-4748-8010</orcidid><orcidid>https://orcid.org/0000-0001-6428-6499</orcidid><orcidid>https://orcid.org/0000-0003-0585-5609</orcidid><orcidid>https://orcid.org/0000-0003-1540-9303</orcidid><orcidid>https://orcid.org/0000-0002-7432-6922</orcidid><orcidid>https://orcid.org/0000-0002-8591-6848</orcidid><orcidid>https://orcid.org/0000-0002-8324-6502</orcidid><orcidid>https://orcid.org/0000-0002-1161-402X</orcidid><orcidid>https://orcid.org/0000-0003-4577-1397</orcidid><orcidid>https://orcid.org/0000-0002-6076-2395</orcidid><orcidid>https://orcid.org/0000-0003-4858-1927</orcidid><orcidid>https://orcid.org/0000-0003-2870-3771</orcidid><orcidid>https://orcid.org/0000-0002-8726-9269</orcidid><orcidid>https://orcid.org/0000-0002-5107-438X</orcidid><orcidid>https://orcid.org/0000-0002-8020-3435</orcidid><orcidid>https://orcid.org/0000-0001-9702-0451</orcidid><orcidid>https://orcid.org/0000-0003-0607-1806</orcidid><orcidid>https://orcid.org/0000-0002-4763-3265</orcidid><orcidid>https://orcid.org/0000-0003-0393-0126</orcidid><orcidid>https://orcid.org/0000-0002-2671-5157</orcidid><orcidid>https://orcid.org/0000-0003-2972-163X</orcidid><orcidid>https://orcid.org/0000-0002-8618-313X</orcidid><orcidid>https://orcid.org/0000-0002-2466-7155</orcidid><orcidid>https://orcid.org/0000-0002-8744-264X</orcidid><orcidid>https://orcid.org/0000-0002-3778-174X</orcidid><orcidid>https://orcid.org/0000-0001-5143-603X</orcidid><orcidid>https://orcid.org/0000-0001-7362-8569</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0195-6108 |
| ispartof | American journal of neuroradiology : AJNR, 2021-06, Vol.42 (6), p.1008-1016 |
| issn | 0195-6108 1936-959X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8191655 |
| source | EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adult Brain |
| title | Brain and Lung Imaging Correlation in Patients with COVID-19: Could the Severity of Lung Disease Reflect the Prevalence of Acute Abnormalities on Neuroimaging? A Global Multicenter Observational Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T22%3A14%3A19IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Brain%20and%20Lung%20Imaging%20Correlation%20in%20Patients%20with%20COVID-19:%20Could%20the%20Severity%20of%20Lung%20Disease%20Reflect%20the%20Prevalence%20of%20Acute%20Abnormalities%20on%20Neuroimaging?%20A%20Global%20Multicenter%20Observational%20Study&rft.jtitle=American%20journal%20of%20neuroradiology%20:%20AJNR&rft.au=Mahammedi,%20A&rft.date=2021-06-01&rft.volume=42&rft.issue=6&rft.spage=1008&rft.epage=1016&rft.pages=1008-1016&rft.issn=0195-6108&rft.eissn=1936-959X&rft_id=info:doi/10.3174/ajnr.A7072&rft_dat=%3Cproquest_pubme%3E2501262595%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2501262595&rft_id=info:pmid/33707278&rfr_iscdi=true |