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1.
J Laryngol Otol ; 135(5): 442-447, 2021 May.
Article in English | MEDLINE | ID: covidwho-1637623

ABSTRACT

OBJECTIVE: To study the possible association between invasive fungal sinusitis (mucormycosis) and coronavirus disease. METHODS: A prospective observational study was conducted at a tertiary care centre over four months, involving all patients with mucormycosis of the paranasal sinuses suffering from or having a history of coronavirus disease infection. RESULTS: Twenty-three patients presented with mucormycosis, all had an association with coronavirus disease 2019. The ethmoids (100 per cent) were the most common sinuses affected. Intra-orbital extension was seen in 43.47 per cent of cases, while intracranial extension was only seen in 8.69 per cent. Diabetes mellitus was present in 21 of 23 cases, and was uncontrolled in 12 cases. All patients had a history of steroid use during their coronavirus treatment. CONCLUSION: New manifestations of coronavirus disease 2019 are appearing over time. The association between coronavirus and mucormycosis of the paranasal sinuses must be given serious consideration. Uncontrolled diabetes and over-zealous use of steroids are two main factors aggravating the illness, and both of these must be properly checked.


Subject(s)
COVID-19/microbiology , Mucorales/isolation & purification , Mucormycosis/microbiology , Paranasal Sinuses/microbiology , Administration, Intravenous , Antifungal Agents/administration & dosage , Antifungal Agents/therapeutic use , COVID-19/complications , COVID-19/diagnosis , COVID-19/virology , Diabetes Mellitus/epidemiology , Female , Humans , India/epidemiology , Invasive Fungal Infections/diagnosis , Invasive Fungal Infections/epidemiology , Invasive Fungal Infections/microbiology , Magnetic Resonance Imaging/methods , Male , Middle Aged , Mucorales/drug effects , Mucormycosis/diagnosis , Mucormycosis/drug therapy , Mucormycosis/etiology , Pandemics , Paranasal Sinuses/diagnostic imaging , Prospective Studies , SARS-CoV-2 , Sinusitis/diagnosis , Sinusitis/microbiology , Steroids/adverse effects , Steroids/therapeutic use
2.
Radiology ; 299(2): E226-E229, 2021 05.
Article in English | MEDLINE | ID: covidwho-1613117

ABSTRACT

Coronavirus disease 2019 (COVID-19) may affect various organs. This case series reports nine patients (one of nine [11%] women and eight of nine [89%] men; mean age ± standard deviation, 56 years ± 13) with globe MRI abnormalities obtained from a multicenter cohort of 129 patients presenting with severe COVID-19 from March 4, 2020, to May 1, 2020. Nine of 129 (7%) patients had one or several nodules of the posterior pole that were hyperintense at fluid-attenuated inversion-recovery imaging. All patients had nodules in the macular region, eight of nine (89%) had bilateral nodules, and two of nine (22%) had nodules outside the macular region. Screening of these patients might improve the management of potentially severe ophthalmologic manifestations of the virus. See also the editorial by Kirsch in this issue. © RSNA, 2021 Online supplemental material is available for this article.


Subject(s)
COVID-19/complications , Eye Diseases/complications , Eye Diseases/diagnostic imaging , Magnetic Resonance Imaging/methods , SARS-CoV-2 , Cohort Studies , Eye/diagnostic imaging , Female , Humans , Male , Middle Aged , Retrospective Studies
3.
CNS Neurol Disord Drug Targets ; 20(5): 390-391, 2021.
Article in English | MEDLINE | ID: covidwho-1526729

ABSTRACT

A letter to the editor to discuss several uses of brain magnetic resonance imaging (MRI) in the investigation of neurological manifestations of covid-19. Described several situations in which the MRI is needed. Brain MRI is an important diagnostic method in the covid-19 scenario, to investigate possible neurological complications of the disease.


Subject(s)
COVID-19/complications , COVID-19/diagnostic imaging , Magnetic Resonance Imaging/methods , Nervous System Diseases/diagnostic imaging , Nervous System Diseases/etiology , Cerebrovascular Disorders/diagnostic imaging , Cerebrovascular Disorders/etiology , Headache/diagnostic imaging , Headache/etiology , Humans
5.
Am Heart J ; 243: 43-53, 2022 01.
Article in English | MEDLINE | ID: covidwho-1482402

ABSTRACT

BACKGROUND: The Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC) study aims to characterize the frequency and time course of acute and long-term cardiac and non-cardiac sequelae in multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C), which are currently poorly understood. METHODS: This multicenter observational cohort study will enroll at least 600 patients <21 years old who meet the Centers for Disease Control and Prevention case definition of MIS-C across multiple North American centers over 2 years. The study will collect detailed hospital and follow-up data for up to 5 years, and optional genetic testing. Cardiac imaging at specific time points includes standardized echocardiographic assessment (all participants) and cardiac magnetic resonance imaging (CMR) in those with left ventricular ejection fraction (LVEF) <45% during the acute illness. The primary outcomes are the worst LVEF and the highest coronary artery z-score of the left anterior descending or right coronary artery. Other outcomes include occurrence and course of non-cardiac organ dysfunction, inflammation, and major medical events. Independent adjudication of cases will classify participants as definite, possible, or not MIS-C. Analysis of the outcomes will include descriptive statistics and regression analysis with stratification by definite or possible MIS-C. The MUSIC study will provide phenotypic data to support basic and translational research studies. CONCLUSION: The MUSIC study, with the largest cohort of MIS-C patients and the longest follow-up period to date, will make an important contribution to our understanding of the acute cardiac and non-cardiac manifestations of MIS-C and the long-term effects of this public health emergency.


Subject(s)
COVID-19/complications , Heart/diagnostic imaging , Magnetic Resonance Imaging/methods , Systemic Inflammatory Response Syndrome , Adult , Child , Humans , National Heart, Lung, and Blood Institute (U.S.) , SARS-CoV-2 , Stroke Volume , United States , Ventricular Function, Left , Young Adult
7.
Br J Radiol ; 94(1127): 20210648, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1456034

ABSTRACT

ADVANCES IN KNOWLEDGE: Radiological findings of mucormycosis in post COVID-19 patients show varied patterns of disease involvement and spectrum of imaging features. One should not solely rely on CT imaging to detect the extent of disease. MRI helps in early and accurate detection of invasion into adjacent structures and so helpful in early intervention.


Subject(s)
COVID-19/complications , Magnetic Resonance Imaging/methods , Mucormycosis/diagnostic imaging , Mucormycosis/etiology , Paranasal Sinus Diseases/diagnostic imaging , Paranasal Sinus Diseases/etiology , Humans , Paranasal Sinuses/diagnostic imaging , SARS-CoV-2
8.
Laryngoscope ; 131(6): E1971-E1979, 2021 06.
Article in English | MEDLINE | ID: covidwho-1453618

ABSTRACT

OBJECTIVE/HYPOTHESIS: To assess the ability of ultra-short echo time (UTE)-MRI to detect subglottic stenosis (SGS) and evaluate response to balloon dilation. To correlate measurements from UTE-MRI with endotracheal-tube (ETT)-sizing and to investigate whether SGS causes change in airway dynamics. STUDY DESIGN: Animal research study. METHODS: Eight adult New-Zealand white rabbits were used as they approximate neonatal airway-size. The airways were measured using ETT-sizing and 3D UTE-MRI at baseline, 2 weeks post-cauterization induced SGS injury, and post-balloon dilation treatment. UTE-MR images were acquired to determine airway anatomy and motion. Airways were segmented from MR images. Cross-sectional area (CSA), major and minor diameters (Dmajor and Dminor ), and eccentricity were measured. RESULTS: Post-injury CSA at SGS was significantly reduced (mean 38%) compared to baseline (P = .003) using UTE-MRI. ETT-sizing correlated significantly with MRI-measured CSA at the SGS location (r = 0.6; P < .01), particularly at the post-injury timepoint (r = 0.93; P < .01). Outer diameter from ETT-sizing (OD) correlated significantly with Dmajor (r = 0.63; P < .01) from UTE-MRI at the SGS location, especially for the post-injury timepoint (r = 0.91; P < .01). Mean CSA of upper trachea did not change significantly between end-expiration and end-inspiration at any timepoint (all P > .05). Eccentricity of the upper trachea increased significantly post-balloon dilation (P < .05). CONCLUSIONS: UTE-MRI successfully detected SGS and treatment response in the rabbit model, with good correlation to ETT-sizing. Balloon dilation increased CSA at SGS, but not to baseline values. SGS did not alter dynamic motion for the trachea in this rabbit model; however, tracheas were significantly eccentric post-balloon dilation. UTE-MRI can detect SGS without sedation or ionizing radiation and may be a non-invasive alternative to ETT-sizing. LEVEL OF EVIDENCE: NA Laryngoscope, 131:E1971-E1979, 2021.


Subject(s)
Laryngostenosis/diagnostic imaging , Magnetic Resonance Imaging/methods , Animals , Disease Models, Animal , Female , Imaging, Three-Dimensional , Intubation, Intratracheal , Laryngoscopy , Rabbits
9.
Pediatr Infect Dis J ; 41(1): e16-e18, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1447655

ABSTRACT

BACKGROUND: Coronavirus disease-2019 (COVID-19) is characterized predominantly by respiratory symptoms and has affected a small subset of children. Multisystem inflammatory syndrome in children (MIS-C) has been reported in children following COVID-19. There is increasing report that COVID-19 may also lead to neurologic manifestations. Cerebellar lesions may be observed in viral infections. CASE REPORT: We report a child with MIS-C related to severe acute respiratory syndrome coronavirus 2, who developed cerebellar lesion during the disease course. Encephalopathy was the first central nervous system symptom. His consciousness improved but he developed clinical signs of cerebellar dysfunction including ataxia, dysarthria and nystagmus. Brain magnetic resonance imaging (MRI) revealed symmetrical pathological signal changes in both cerebellar hemispheres. CONCLUSION: We demonstrated the first child with MIS-C to develop cerebellar lesion on brain MRI, suggestive of cerebellitis.


Subject(s)
Brain/diagnostic imaging , COVID-19/complications , COVID-19/diagnostic imaging , Cerebellar Diseases/diagnostic imaging , Brain Diseases/diagnostic imaging , COVID-19/physiopathology , Child, Preschool , Diagnostic Tests, Routine , Disease Progression , Humans , Magnetic Resonance Imaging/methods , Male , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
10.
Radiology ; 301(1): E353-E360, 2021 10.
Article in English | MEDLINE | ID: covidwho-1430241

ABSTRACT

Background SARS-CoV-2 targets angiotensin-converting enzyme 2-expressing cells in the respiratory tract. There are reports of breathlessness in patients many months after infection. Purpose To determine whether hyperpolarized xenon 129 MRI (XeMRI) imaging could be used to identify the possible cause of breathlessness in patients at 3 months after hospital discharge following COVID-19 infection. Materials and Methods This prospective study was undertaken between August and December of 2020, with patients and healthy control volunteers being enrolled. All patients underwent lung function tests; ventilation and dissolved-phase XeMRI, with the mean red blood cell (RBC) to tissue or plasma (TP) ratio being calculated; and a low-dose chest CT, with scans being scored for the degree of abnormalities after COVID-19. Healthy control volunteers underwent XeMRI. The intraclass correlation coefficient was calculated for volunteer and patient scans to assess repeatability. A Wilcoxon rank sum test and Cohen effect size calculation were performed to assess differences in the RBC/TP ratio between patients and control volunteers. Results Nine patients (mean age, 57 years ± 7 [standard deviation]; six male patients) and five volunteers (mean age, 29 years ± 3; five female volunteers) were enrolled. The mean time from hospital discharge for patients was 169 days (range, 116-254 days). There was a difference in the RBC/TP ratio between patients and control volunteers (0.3 ± 0.1 vs 0.5 ± 0.1, respectively; P = .001; effect size, 1.36). There was significant difference between the RBC and gas phase spectral full width at half maximum between volunteers and patients (median ± range, 567 ± 1 vs 507 ± 81 [P = .002] and 104 ± 2 vs 122 ± 17 [P = .004], respectively). Results were reproducible, with intraclass correlation coefficients of 0.82 and 0.88 being demonstrated for patients and volunteers, respectively. Participants had normal or nearly normal CT scans (mean, seven of 25; range, zero of 25 to 10 of 25). Conclusion Hyperpolarized xenon 129 MRI results showed alveolar capillary diffusion limitation in all nine patients after COVID-19 pneumonia, despite normal or nearly normal results at CT. © RSNA, 2021 See also the editorial by Dietrich in this issue.


Subject(s)
COVID-19/physiopathology , Dyspnea/physiopathology , Lung/diagnostic imaging , Lung/physiopathology , Magnetic Resonance Imaging/methods , Xenon Isotopes , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , SARS-CoV-2
11.
Radiology ; 301(2): 263-277, 2021 11.
Article in English | MEDLINE | ID: covidwho-1398732

ABSTRACT

Despite the global coronavirus pandemic, cardiovascular imaging continued to evolve throughout 2020. It was an important year for cardiac CT and MRI, with increasing prominence in cardiovascular research, use in clinical decision making, and in guidelines. This review summarizes key publications in 2020 relevant to current and future clinical practice. In cardiac CT, these have again predominated in assessment of patients with chest pain and structural heart diseases, although more refined CT techniques, such as quantitative plaque analysis and CT perfusion, are also maturing. In cardiac MRI, the major developments have been in patients with cardiomyopathy and myocarditis, although coronary artery disease applications remain well represented. Deep learning applications in cardiovascular imaging have continued to advance in both CT and MRI, and these are now closer than ever to routine clinical adoption. Perhaps most important has been the rapid deployment of MRI in enhancing understanding of the impact of COVID-19 infection on the heart. Although this review focuses primarily on articles published in Radiology, attention is paid to other leading journals where published CT and MRI studies will have the most clinical and scientific value to the practicing cardiovascular imaging specialist.


Subject(s)
Cardiovascular Diseases/diagnostic imaging , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Cardiovascular System/diagnostic imaging , Humans
12.
Clin Res Cardiol ; 110(11): 1832-1840, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1375633

ABSTRACT

OBJECTIVES: We assessed possible myocardial involvement in previously cardiac healthy post-COVID patients referred for persisting symptoms with suspected myocarditis. BACKGROUND: Prior studies suggested myocardial inflammation in patients with coronavirus-induced disease 2019 (COVID-19). However, the prevalence of cardiac involvement among COVID patients varied between 1.4 and 78%. METHODS: A total of 56 post-COVID patients without previous heart diseases were included consecutively into this study. All patients had positive antibody titers against SARS-CoV-2. Patients were referred for persistent symptoms such as chest pain/discomfort, shortness of breath, or intolerance to activity. All patients underwent standardized cardiac assessment including electrocardiogram (ECG), cardiac biomarkers, echocardiography, and cardiac magnetic resonance (CMR). RESULTS: 56 Patients (46 ± 12 years, 54% females) presented 71 ± 66 days after their COVID-19 disease. In most patients, the course of COVID-19 was mild, with hospital treatment being necessary in five (9%). At presentation, patients most often reported persistent fatigue (75%), chest pain (71%), and shortness of breath (66%). Acute myocarditis was confirmed by T1/T2-weighed CMR and elevated NTpro-BNP levels in a single patient (2%). Left ventricular ejection fraction was 56% in this patient. Additional eight patients (14%) showed suspicious CMR findings, including myocardial edema without fibrosis (n = 3), or non-ischemic myocardial injury suggesting previous inflammation (n = 5). However, myocarditis could ultimately not be confirmed according to 2018 Lake Louise criteria; ECG, echo and lab findings were inconspicuous in all eight patients. CONCLUSIONS: Among 56 post-COVID patients with persistent thoracic complaints final diagnosis of myocarditis could be confirmed in a single patient using CMR.


Subject(s)
COVID-19/complications , Heart/virology , Magnetic Resonance Imaging/methods , Myocarditis/virology , Adult , COVID-19/diagnosis , Echocardiography , Electrocardiography , Female , Heart/diagnostic imaging , Humans , Male , Middle Aged , Myocarditis/diagnostic imaging , Stroke Volume , Ventricular Function, Left
14.
AJR Am J Roentgenol ; 217(4): 959-974, 2021 10.
Article in English | MEDLINE | ID: covidwho-1365501

ABSTRACT

Neurologic involvement is well-recognized in COVID-19. This article reviews the neuroimaging manifestations of COVID-19 on CT and MRI, presenting cases from the New York City metropolitan region encountered by the authors during the first surge of the pandemic. The most common neuroimaging manifestations are acute infarcts with large clot burden and intracranial hemorrhage, including microhemorrhages. However, a wide range of additional imaging patterns occur, including leukoencephalopathy, global hypoxic injury, acute disseminated encephalomyelitis, cytotoxic lesions of the corpus callosum, olfactory bulb involvement, cranial nerve enhancement, and Guillain-Barré syndrome. The described CNS abnormalities largely represent secondary involvement from immune activation that leads to a prothrombotic state and cytokine storm; evidence for direct neuroinvasion is scant. Comorbidities such as hypertension, complications of prolonged illness and hospitalization, and associated supportive treatments also contribute to the CNS involvement in COVID-19. Routine long-term neurologic follow-up may be warranted, given emerging evidence of long-term microstructural and functional changes on brain imaging after COVID-19 recovery.


Subject(s)
Brain Diseases/complications , Brain Diseases/diagnostic imaging , COVID-19/complications , Magnetic Resonance Imaging/methods , Neuroimaging/methods , Tomography, X-Ray Computed/methods , Adult , Brain/diagnostic imaging , Humans , Pandemics , SARS-CoV-2
15.
Hamostaseologie ; 41(5): 366-370, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1356592

ABSTRACT

Diagnosing myocarditis is still challenging due to its varying presentation ranging from none or mild symptoms to sudden cardiac death. Clinical presentation, electrocardiography, and cardiac biomarkers seem not to be sufficient for a reliable diagnosis. In fact, an unequivocal myocardial characterization is needed, applying endomyocardial biopsy (EMB) and cardiac magnetic resonance (CMR), a technique which demonstrates high accuracy to histology. Besides the assessment of functional parameters (volumes, ejection fraction), established late gadolinium enhancement and recent T1 and T2 mapping techniques including the calculation of extracellular volume fraction allow distinct myocardial tissue analysis by a noninvasive approach without the need of radiation. However, EMB is the only method which allows the identification of the underlying etiology of cardiac inflammation. Since myocardial damage and inflammation seem to be prevalent in a considerable number of patients even in the mid-term range after COVID-19, CMR and EMB seem to be adequate tools to further investigate these findings. In this article, we will (1) review current knowledge about the role of CMR in the COVID-19 pandemic and (2) report about our own EMB findings in COVID-19 patients in the Cardiopathology Center of our University Hospital.


Subject(s)
COVID-19/complications , Myocarditis/diagnosis , Myocarditis/etiology , SARS-CoV-2 , Adolescent , Adult , Aged , Aged, 80 and over , Biopsy/methods , Endocardium/pathology , Female , Heart Disease Risk Factors , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Myocarditis/diagnostic imaging , Myocardium/pathology , Pandemics , SARS-CoV-2/pathogenicity , Young Adult
16.
AJR Am J Roentgenol ; 217(4): 831-834, 2021 10.
Article in English | MEDLINE | ID: covidwho-1352774

ABSTRACT

Early clinical experience with COVID-19 vaccination suggests that approved COVID-19 vaccines cause a notably higher incidence of axillary lymphadenopathy on breast MRI compared with other vaccines. Guidelines are needed to appropriately manage unilateral axillary lymphadenopathy detected by MRI in the era of COVID-19 vaccination and to avoid biopsies of benign reactive nodes. This article examines the available data on vaccine-related lymphadenopathy and offers a basic strategy for assessing axillary lymphadenopathy on MRI and guiding management. At our institution, we are adding questions regarding the date(s) and laterality of administration of COVID-19 vaccination to the intake form given to patients before all breast imaging examinations. We consider MRI-detected isolated unilateral axillary lymphadenopathy ipsilateral to the vaccination arm to most likely be related to the COVID-19 vaccine if it develops within 4 weeks of administration of either dose. In these cases, we assess the lymphadenopathy as BI-RADS 3 and recommend that follow-up ultrasound be performed within 6-8 weeks after administration of the second dose. These guidelines may be refined as we acquire further data on the expected time course of axillary lymphadenopathy after COVID-19 vaccination. Until that time, this management pathway will help avoid unnecessary biopsies of benign vaccine-related reactive lymphadenopathy.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Lymphadenopathy/diagnostic imaging , Lymphadenopathy/etiology , Magnetic Resonance Imaging/methods , Adult , Axilla , COVID-19 Vaccines/therapeutic use , Female , Humans , Lymph Nodes/diagnostic imaging , Middle Aged , SARS-CoV-2
19.
Nat Commun ; 12(1): 4663, 2021 08 02.
Article in English | MEDLINE | ID: covidwho-1338537

ABSTRACT

Vaccine-induced thrombotic thrombocytopenia with cerebral venous thrombosis is a syndrome recently described in young adults within two weeks from the first dose of the ChAdOx1 nCoV-19 vaccine. Here we report two cases of malignant middle cerebral artery (MCA) infarct and thrombocytopenia 9-10 days following ChAdOx1 nCoV-19 vaccination. The two cases arrived in our facility around the same time but from different geographical areas, potentially excluding epidemiological links; meanwhile, no abnormality was found in the respective vaccine batches. Patient 1 was a 57-year-old woman who underwent decompressive craniectomy despite two prior, successful mechanical thrombectomies. Patient 2 was a 55-year-old woman who developed a fatal bilateral malignant MCA infarct. Both patients manifested pulmonary and portal vein thrombosis and high level of antibodies to platelet factor 4-polyanion complexes. None of the patients had ever received heparin in the past before stroke onset. Our observations of rare arterial thrombosis may contribute to assessment of possible adverse effects associated with COVID-19 vaccination.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/immunology , Cerebral Infarction/chemically induced , Purpura, Thrombocytopenic, Idiopathic/chemically induced , SARS-CoV-2/immunology , Thrombosis/chemically induced , Autoantibodies/blood , Autoantibodies/immunology , COVID-19/virology , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/immunology , Cerebral Infarction/diagnostic imaging , Computed Tomography Angiography/methods , Female , Humans , Magnetic Resonance Imaging/methods , Middle Aged , Platelet Factor 4/immunology , Purpura, Thrombocytopenic, Idiopathic/diagnostic imaging , SARS-CoV-2/physiology , Thrombosis/diagnostic imaging , Tomography, X-Ray Computed/methods , Vaccination/adverse effects , Venous Thrombosis/chemically induced , Venous Thrombosis/diagnostic imaging
20.
Clin Radiol ; 76(11): 812-819, 2021 11.
Article in English | MEDLINE | ID: covidwho-1330728

ABSTRACT

A subset of diabetic COVID-19 patients treated with steroids, oxygen, and/or prolonged intensive care admission develop rhino-orbito-cerebral mucormycosis. Radiologists must have a high index of suspicion for early diagnosis, which prompts immediate institution of antifungal therapy that limits morbidity and mortality. Assessment of disease extent by imaging is crucial for planning surgical debridement. Complete debridement of necrotic tissue improves survival. Imaging features reflect the angioinvasive behaviour of fungal hyphae from the Mucoraceae family, which cause necrotising vasculitis and thrombosis resulting in extensive tissue infarction. Contrast-enhanced magnetic resonance imaging (MRI) is the imaging technique of choice. The classic "black turbinate" on contrast-enhanced imaging represents localised invasive fungal rhinosinusitis (IFRS). A striking radiological feature of disseminated craniofacial disease is non-enhancing devitalised and necrotic soft tissue at the orbits and central skull base. Sinonasal and extrasinonasal non-enhancing lesions in IFRS are secondary to coagulative necrosis induced by fungal elements. Multicompartmental and extrasinonasal tissue infarction is possible without overt bone involvement and caused by the propensity of fungal elements to disseminate from the nasal cavity via perineural and perivascular routes. Fungal vasculitis can result in internal carotid artery occlusion and cerebral infarction. Remnant non-enhancing lesions after surgical debridement portend a poor prognosis. Assessment for the non-enhancing MRI lesion is crucial, as it is a sole independent prognostic factor for IFRS-specific mortality. In this review, we describe common and uncommon imaging presentations of biopsy-proven rhino-orbito-cerebral mucormycosis in a cohort of nearly 40 COVID-19 patients.


Subject(s)
Brain Diseases/diagnostic imaging , COVID-19/complications , Magnetic Resonance Imaging/methods , Mucormycosis/complications , Mucormycosis/diagnostic imaging , Orbital Diseases/diagnostic imaging , Tomography, X-Ray Computed/methods , Brain/diagnostic imaging , Brain/microbiology , Brain Diseases/microbiology , Humans , Orbit/diagnostic imaging , Orbit/microbiology , Orbital Diseases/microbiology , SARS-CoV-2
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