ABSTRACT
This review article is a pictorial review of the wide variety of brain and spine CT and MR imaging findings related to coronavirus disease 2019 (COVID-19) in patients with neurologic deficits. By classifying CNS manifestations according to their pathogenesis, we provide different examples of vascular, immunologic, infectious, and miscellaneous complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We present cases encountered during the pandemic, retrieved from a large health system. Learning Objectives: To review the spectrum of common and uncommon brain and spine neuroimaging findings of COVID-19 and describe the key imaging features for each finding. © 2022, American Society of Neuroradiology. All rights reserved.
ABSTRACT
Background: Coronavirus Disease (covid 19) negatively impacted psychosocial health, health care accessibility and exercise regimen but problem's scope and potential solutions remain elusive. We conducted a patient based online survey to understand these impacts and discussed potential solutions. Objectives: Assess impact of Covid 19 on rheumatological disease status, accessibility to health care, patient anxiety and behavior and continuation of physical activity during pandemic. Methods: Google form (18-question) based questionnaire was sent via SMS/WhatsApp in Aug 2020, at height of frst pandemic and responses were collected over next month. Results: Only 339/2700 patients (12.5 %) responded to the survey. Other authors (1)(2) have observed a similar low response rate to online surveys. We recognise questionnaires with fewer questions tend to generate more responses, which should be considered critical in constructing future health-related surveys. Patients' global assessment of their disease score was 7/10, with 0 representing the worst disease status and10 representing best disease status, also 1/3 patients not felt need for rheumatological consultation during six months (March 2020-Aug 2020) of lockdown. These may imply adequate rheumatic disease control over long periods and during subsequent waves of pandemic, rheumatology patients can be shielded by avoiding non-urgent hospital follow up visits. Signifcant number of patients (20%) were unable to contact their rheumatologist, implying a signifcant impact of covid 19 and lock-down on rheumatology care, as suggested by other authors (1). As expected, there was switch to tele consultancy mode of communication, with 22 per cent of patients already using it within 3 months of its introduction, which appears to be a good indicator of future adaptability and feasibility of teleconsultation. Identifying specifc profile of patients during physical consultation who can be easily managed via teleconsultation, may reduce unnecessary hospital visits while also improving healthcare delivery. 1/3 of our patients had anxiety about disease fare, and 41 %were concerned about increased risk of covid 19 infection as they were on immunosuppressive medications as noted by other authors (3). Improving access to health care and increasing public awareness could help alleviate this anxiety. Reaching out to isolated rheumatology patients through SMS/educational video may improve the sense of health security. Contrary to our expectations, overall medication adherence was reasonable, likely due to be management of supply chains by local authorities.15% completely stopped exercising and 25% reduced their exercise regimen by 50%. Shifting to home-based exercise, educational videos on physical therapy and online teleconsulta-tion with physiotherapists could overall have positive impact. Conclusion: Covid 19 has signifcantly impacted rheumatological patients in terms of increased anxiety, decreased healthcare accessibility and decreased exercise and physical activities. Modifcations in teleconsultation methodology are needed in the future. Patients' anxiety can be alleviated by educating them through digital and social media platforms and enrolling them in online patient support groups.