Spectrum of computed tomography (Ct)-brain findings in Covid-19 patients with CNS manifestations

Abstract

Background: Infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-COV-2) results in Corona Virus Disease 2019 (COVID -19) predominantly it affects respiratory system; however it has become apparent that many other organ systems including central nervous system can also be involved. Imaging plays an essential role in diagnosis of all manifestations of the disease and its complications. Objective: To study the spectrum of neuro-imaging findings on CT in COVID-19 patients with CNS symptoms. Material and Methods: Non-contrast CT scan of brain was done in 80 patients of either gender having COVID-19, confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) with CNS manifestations. Images were assessed for presence of abnormal findings like Infarcts, hemorrhage, venous/arterial thrombosis, leukoencephalopathy, white matter disease, hypoxic ischemic injury, encephalitis and posterior reverse encephalopathy syndrome. Results: A total of 80 patients with COVID-19 were reviewed, out of which CT was abnormal in 35 patients (43.7%). findings included various types of infarcts, intra and extra axial haemorrhages, Diffuse axonal injury and PRES (Posterior Reversible Encephalopathy Syndrome). Our study demonstrated that the neurological imaging of patients with COVID-19 were variable without a specific pattern but is dominated by ischemic infarcts and intracranial haemorrhages. Conclusion: C0VID-19 is a serious public health crisis and can have neurological manifestations, therefore these patients should be evaluated early for neurological symptoms as timely analysis and management of neurological complications are key to improving the prognosis.