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Molecular Imaging Findings on Acute and Long-Term Effects of COVID-19 on the Brain: A Systematic Review.
Meyer, Philipp T; Hellwig, Sabine; Blazhenets, Ganna; Hosp, Jonas A.
  • Meyer PT; Department of Nuclear Medicine, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany; philipp.meyer@uniklinik-freiburg.de.
  • Hellwig S; Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany; and.
  • Blazhenets G; Department of Nuclear Medicine, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Hosp JA; Department of Neurology and Clinical Neuroscience, Medical Center - University of Freiburg and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
J Nucl Med ; 63(7): 971-980, 2022 07.
Article in English | MEDLINE | ID: covidwho-1703536
ABSTRACT
Molecular imaging techniques such as PET and SPECT have been used to shed light on how coronavirus disease 2019 (COVID-19) affects the human brain. We provide a systematic review that summarizes the current literature according to 5 predominant topics. First, a few case reports have suggested reversible cortical and subcortical metabolic alterations in rare cases with concomitant para- or postinfectious encephalitis. Second, imaging findings in single patients with the first manifestations of parkinsonism in the context of COVID-19 resemble those in neurodegenerative parkinsonism (loss of nigrostriatal integrity), but scarceness of data and a lack of follow-up preclude further etiologic conclusions (e.g., unmasking/hastening of neurodegeneration vs. infectious or parainfectious parkinsonism). Third, several case reports and a few systematic studies have addressed focal symptoms and lesions, most notably hyposmia. The results have been variable, although some studies found regional hypometabolism of regions related to olfaction (e.g., orbitofrontal and mesiotemporal). Fourth, a case series and systematic studies in inpatients with COVID-19-related encephalopathy (acute to subacute stage) consistently found a frontoparietal-dominant neocortical dysfunction (on imaging and clinically) that proved to be grossly reversible in most cases until 6 mo. Fifth, studies on post-COVID-19 syndrome have provided controversial results. In patients with a high level of self-reported complaints (e.g., fatigue, memory impairment, hyposmia, and dyspnea), some authors found extensive areas of limbic and subcortical hypometabolism, whereas others found no metabolic alterations on PET and only minor cognitive impairments (if any) on neuropsychologic assessment. Furthermore, we provide a critical appraisal of studies with regard to frequent methodologic issues and current pathophysiologic concepts. Finally, we devised possible applications of PET and SPECT in the clinical work-up of diagnostic questions related to COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Parkinsonian Disorders / COVID-19 Type of study: Diagnostic study / Reviews / Systematic review Topics: Long Covid Limits: Humans Language: English Journal: J Nucl Med Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Parkinsonian Disorders / COVID-19 Type of study: Diagnostic study / Reviews / Systematic review Topics: Long Covid Limits: Humans Language: English Journal: J Nucl Med Year: 2022 Document Type: Article