Abstract
A variety of neurological manifestations have been attributed to COVID-19. To investigate the occurrence of neurological symptoms and neuroimaging findings in patients hospitalized in two Brazilian reference centers. We performed a retrospective cohort study of patients who had laboratory-confirmed COVID-19 presenting in two hospitals in Brazil between March 4 and July 7, 2020, who underwent brain imaging. We recorded 1,359 patients with laboratory-confirmed COVID-19. Brain imaging was performed in 250 (18.4%) patients with neurological symptoms, and nine of them (3.6%) had acute or subacute ischemic stroke neuroimaging findings. Six of the nine patients initially presented with respiratory symptoms while the other three patients presented to the emergency room with acute stroke signs. We described the neuroimaging findings of patients infected with COVID-19 who presented with neurological symptoms in two major hospitals in Brazil. We reinforce the importance of being aware of cerebrovascular complications, both in severe hospitalized patients and in patients who present to the emergency room with acute neurological symptoms, even in the elderly.
Highlights
In December 2019, an outbreak of coronavirus disease (COVID-19) began in Wuhan, China
All clinical manifestations with imaging findings were attributed to cerebrovascular disease
There was no evidence of other neurological manifestations associated to COVID-19 infection such as encephalitis, Guillain-Barre syndrome, acute disseminated encephalomyelitis, and acute necrotizing encephalopathy[9-12]
Summary
In December 2019, an outbreak of coronavirus disease (COVID-19) began in Wuhan, China. The first case of COVID-19 in Brazil was officially confirmed on February 26, 2020, and the community transmission stage occurred on March 20, 20201. This study’s objective was to investigate the neurological symptoms and neuroimaging findings in COVID-19 infection. Methods: We performed a retrospective cohort study of patients who had laboratory-confirmed COVID-19 presenting in two hospitals in Brazil between March 4 and July 7, 2020, who underwent brain imaging. Brain imaging was performed in 250 (18.4%) patients with neurological symptoms, and nine of them (3.6%) had acute or subacute ischemic stroke neuroimaging findings. Conclusions: We described the neuroimaging findings of patients infected with COVID-19 who presented with neurological symptoms in two major hospitals in Brazil. We reinforce the importance of being aware of cerebrovascular complications, both in severe hospitalized patients and in patients who present to the emergency room with acute neurological symptoms, even in the elderly
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