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Evolution of Neuroimaging Findings in Severe COVID-19 Patients with Initial Neurological Impairment: An Observational Study.
Lersy, François; Bund, Caroline; Anheim, Mathieu; Mondino, Mary; Noblet, Vincent; Lazzara, Shirley; Phillipps, Clelie; Collange, Olivier; Oulehri, Walid; Mertes, Paul-Michel; Helms, Julie; Merdji, Hamid; Schenck, Maleka; Schneider, Francis; Pottecher, Julien; Giraudeau, Céline; Chammas, Agathe; Ardellier, François-Daniel; Baloglu, Seyyid; Ambarki, Khalid; Namer, Izzie Jacques; Kremer, Stéphane.
  • Lersy F; Service d'Imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
  • Bund C; ICANS, Service de Médecine Nucléaire, 67000 Strasbourg, France.
  • Anheim M; Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France.
  • Mondino M; Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, CEDEX, 67200 Strasbourg, France.
  • Noblet V; Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, 67400 Illkirch, France.
  • Lazzara S; Fédération de Médecine Translationnelle de Strasbourg (FMTS), UR 3072, Université de Strasbourg, 67000 Strasbourg, France.
  • Phillipps C; Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France.
  • Collange O; Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France.
  • Oulehri W; Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, University of Strasbourg-CNRS, UMR 7357, CEDEX, 67000 Strasbourg, France.
  • Mertes PM; Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, CEDEX, 67200 Strasbourg, France.
  • Helms J; Service d'Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
  • Merdji H; Service d'Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
  • Schenck M; Service d'Anesthésie-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
  • Schneider F; Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
  • Pottecher J; INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), CRBS (Centre de Recherche en Biomédecine de Strasbourg), FMTS (Fédération de Médecine Translationnelle de Strasbourg), Faculty of Medicine, University of Strasbourg, 67000 Strasbourg, France
  • Giraudeau C; Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
  • Chammas A; Service de Médecine Intensive Réanimation, Hôpitaux Universitaires de Strasbourg, Hautepierre, 67000 Strasbourg, France.
  • Ardellier FD; Service de Médecine Intensive Réanimation, Hôpitaux Universitaires de Strasbourg, Hautepierre, 67000 Strasbourg, France.
  • Baloglu S; Fédération de Médecine Translationnelle de Strasbourg (FMTS), UR 3072, Université de Strasbourg, 67000 Strasbourg, France.
  • Ambarki K; Service d'Anesthésie-Réanimation et Médecine Péri-Opératoire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
  • Namer IJ; Department of Radiology, IHU Strasbourg, 67000 Strasbourg, France.
  • Kremer S; Service d'Imagerie 2, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67000 Strasbourg, France.
Viruses ; 14(5)2022 05 01.
Article in English | MEDLINE | ID: covidwho-1820416
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Cerebral complications related to the COVID-19 were documented by brain MRIs during the acute phase. The purpose of the present study was to describe the evolution of these neuroimaging findings (MRI and FDG-PET/CT) and describe the neurocognitive outcomes of these patients.

METHODS:

During the first wave of the COVID-19 outbreak between 1 March and 31 May 2020, 112 consecutive COVID-19 patients with neurologic manifestations underwent a brain MRI at Strasbourg University hospitals. After recovery, during follow-up, of these 112 patients, 31 (initially hospitalized in intensive care units) underwent additional imaging studies (at least one brain MRI).

RESULTS:

Twenty-three men (74%) and eight women (26%) with a mean age of 61 years (range 18-79) were included. Leptomeningeal enhancement, diffuse brain microhemorrhages, acute ischemic strokes, suspicion of cerebral vasculitis, and acute inflammatory demyelinating lesions were described on the initial brain MRIs. During follow-up, the evolution of the leptomeningeal enhancement was discordant, and the cerebral microhemorrhages were stable. We observed normalization of the vessel walls in all patients suspected of cerebral vasculitis. Four patients (13%) demonstrated new complications during follow-up (ischemic strokes, hypoglossal neuritis, marked increase in the white matter FLAIR hyperintensities with presumed vascular origin, and one suspected case of cerebral vasculitis). Concerning the grey matter volumetry, we observed a loss of volume of 3.2% during an average period of approximately five months. During follow-up, the more frequent FDG-PET/CT findings were hypometabolism in temporal and insular regions.

CONCLUSION:

A minority of initially severe COVID-19 patients demonstrated new complications on their brain MRIs during follow-up after recovery.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Vasculitis, Central Nervous System / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Year: 2022 Document Type: Article Affiliation country: V14050949

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vasculitis, Central Nervous System / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Limits: Female / Humans / Male / Middle aged Language: English Year: 2022 Document Type: Article Affiliation country: V14050949