ABSTRACT
With an increasing number of cases of Coronavirus disease 2019 (COVID-19), various neurological complications have been reported; however, some of these have not been fully elucidated. We herein report on 2 cases in which lesions at the bilateral globus pallidus and substantia nigra were observed. The patients were a 27-year-old male and a 61-year-old female. They underwent ventilation management due to COVID-19 pneumonia with hypoxemia. However, even after the sedative had weakened, the state of consciousness disturbance was found to have continued. Brain magnetic resonance imaging was performed for both patients. From the bilateral globus pallidus to the substantia nigra of both, the fluid attenuated inversion recovery images and T2-weighted images indicated high intensity, while the diffusion-weighted image resulted in high intensity and low apparent diffusion coefficient. Regarding the 61-year-old female patient, head computed tomography also indicated low density at the bilateral globus pallidus. The patients did not show any improvement in their neurological findings while hospitalized. Although COVID-19 associated with bilateral globus pallidus and substantia nigra lesions are rare, the neurological prognosis may be poor. We believe that attention should be paid to these imaging findings at the onset of consciousness disturbance.
ABSTRACT
OBJECTIVES: The symptoms of Coronavirus disease 2019 (COVID-19) vary among patients. The aim of this study was to investigate the clinical manifestation and disease duration in young versus elderly patients. METHODS: We retrospectively analyzed 187 patients (87 elderly and 100 young patients) with confirmed COVID-19. The clinical characteristics and chest computed tomography (CT) extent as defined by a score were compared between the two groups. RESULTS: The numbers of asymptomatic cases and severe cases were significantly higher in the elderly group (elderly group vs. young group; asymptomatic cases, 31 [35.6%] vs. 10 [10%], p < 0.0001; severe cases, 25 [28.7%] vs. 8 [8.0%], p = 0.0002). The proportion of asymptomatic patients and severe patients increased across the 10-year age groups. There was no significant difference in the total CT score and number of abnormal cases. A significant positive correlation between the disease duration and patient age was observed in asymptomatic patients (ρ = 0.4570, 95% CI 0.1198-0.6491, p = 0.0034). CONCLUSIONS: Although the extent of lung involvement did not have a significant difference between the young and elderly patients, elderly patients were more likely to have severe clinical manifestations. Elderly patients were also more likely to be asymptomatic and a source of COVID-19 viral shedding.