Correlation of neuroimaging and thorax CT findings in patients with COVID-19: A large single-center experience

Abstract

The aim of this current study was to describe the neuroimaging findings among patients with COVID-19 and to compare them with thorax CT imaging findings and clinicobiological profiles. Between the period March 11 and December 31, 2020, we evaluated brain computed tomography (CT) and magnetic resonance (MR) images of patients with COVID-19. A total of 354 patients (mean age 65.2 ± 16.6, 52% female, 42% male) who had brain imaging were included in the study. Of this total sample, 218 had thorax CT scanning (65.5%). Neuroimaging and thorax CT findings, clinical course, neurologic findings, and laboratory data were evaluated. White matter lesions (WML) and thorax CT scans were scored. Participants were divided according to whether or not they had an infarction. The neuroimaging findings indicated infarcts, parenchymal hemorrhage, encephalitis, cortical signal abnormality, posterior reversible encephalopathy syndrome (PRES), and cranial nerve involvement. WML significantly positively correlated with age (p < 0.01) but not with sex (p > 0.05). Thorax CT findings did not demonstrate significant correlations with infarcts, WML, or hemorrhages (p> 0.05). D-dimer and ferritin levels were significantly higher among patients with infarcts (p < 0.05). Immune-mediated prothrombic state and cytokine storm appear to be more responsible for etiopathogenesis than direct viral neurotropism. Neuroimaging and thorax CT findings were not correlated among patients with COVID-19 in our study. These results suggest that neurological manifestations may occur independently of pulmonary involvement and age.