Brain Imaging Use and Findings in COVID-19: A Single Academic Center Experience in the Epicenter of Disease in the United States

• DOI: 10.3174/ajnr.a6610
• Publication Date: 2020-05-04T19:24:42Z
• Authors: A. Radmanesh; E. Raz; E. Zan; A. Derman; M. Kaminetzky
• Keywords: Adult; Aged, 80 and over; Male; Brain Diseases; SARS-CoV-2; Pneumonia, Viral; COVID-19; Neuroimaging; Middle Aged; Magnetic Resonance Imaging; United States; 3. Good health; Betacoronavirus; 03 medical and health sciences; 0302 clinical medicine; Humans; Female; Coronavirus Infections; Pandemics; Aged; Retrospective Studies

Coronavirus disease 2019 (COVID-19) is a serious public health crisis and can have neurologic manifestations. This is a retrospective observational case series performed March 1-31, 2020, at New York University Langone Medical Center campuses. Clinical and imaging data were extracted, reviewed, and analyzed. Two hundred forty-two patients with COVID-19 underwent CT or MRI of the brain within 2 weeks after the positive result of viral testing (mean age, 68.7 ± 16.5 years; 150 men/92 women [62.0%/38.0%]). The 3 most common indications for imaging were altered mental status (42.1%), syncope/fall (32.6%), and focal neurologic deficit (12.4%). The most common imaging findings were nonspecific white matter microangiopathy (134/55.4%), chronic infarct (47/19.4%), acute or subacute ischemic infarct (13/5.4%), and acute hemorrhage (11/4.5%). No patients imaged for altered mental status demonstrated acute ischemic infarct or acute hemorrhage. White matter microangiopathy was associated with higher 2-week mortality (P < .001). Our data suggest that in the absence of a focal neurologic deficit, brain imaging in patients with early COVID-19 with altered mental status may not be revealing.