Routine Brain MRI Findings on the Long-Term Effects of COVID-19: A Scoping Review.

RATIONALE AND OBJECTIVES: Post-COVID condition (PCC) is associated with long-term neuropsychiatric symptoms. Magnetic resonance imaging (MRI) in PCC examines the brain metabolism, connectivity, and morphometry. Such techniques are not easily available in routine practice. We conducted a scoping review to determine what is known about the routine MRI findings in PCC patients. MATERIALS AND METHODS: The PubMed database was searched up to 11 April 2023. We included cohort, cross-sectional, and before-after studies in English. Articles with only advanced MRI sequences (DTI, fMRI, VBM, PWI, ASL), preprints, and case reports were excluded. The National Heart, Lung, and Blood Institute and PRISMA Extension tools were used for quality assurance. RESULTS: A total of 7 citations out of 167 were included. The total sample size was 451 patients (average age 51 ± 8 years; 67% female). Five studies followed a single recovering cohort, while two studies compared findings between two severity groups. The MRI findings were perivascular spaces (47%), microbleeds (27%) and white matter lesions (10%). All the studies agreed that PCC manifestations are not associated with specific MRI findings. CONCLUSION: The results of the included studies are heterogeneous due to the low agreement on the types of MRI abnormalities in PCC. Our findings indicate that the routine brain MRI protocol has little value for long COVID diagnostics.

Emergency Splenectomy in a Patient with Splenic Marginal Zone Lymphoma, Acute Portal Vein Thrombosis, and Chronic Viral Hepatitis B.

Splenic marginal zone lymphoma (SMZL) is a type of non-Hodgkin's lymphoma (NL) that occurs in 2 out of 100 cases and is more common in women aged >60 years. A sluggish, asymptomatic course of the disease does not exclude transformation into a malignant form that occurs in 25% of patients with SMZL. Another equally important sign of an NL is thrombosis that occurs in 3.6% to 17.1% of the cases. In this report, we present a case of emergency splenectomy in a patient owing to difficulties in the diagnosis of SMZL, rapid onset of acute portal vein thrombosis, and the fulminant enlargement of the spleen accompanied by an increased risk of its rupture. Chronic hepatitis B was likely the trigger for transformation of the disease to an aggressive course. Portal vein thrombosis and the aggressive course of SMZL with rapid enlargement of the spleen and threat of its rupture in the background of viral hepatitis B required emergency splenectomy followed by anticoagulant, antiviral, and antitumor therapy.