Abstract
Background and purpose
A wide range of neuroradiological findings has been reported in patients with coronavirus disease 2019 (COVID-19), ranging from subcortical white matter changes to infarcts, haemorrhages and focal contrast media enhancement. These have been descriptively but inconsistently reported and correlations with clinical findings and biomarkers have been difficult to extract from the literature. The purpose of this study was to quantify the extents of neuroradiological findings in a cohort of patients with COVID-19 and neurological symptoms, and to investigate correlations with clinical findings, duration of intensive care and biomarkers in blood.
Material and methods
Patients with positive SARS-CoV-2 and at least one new-onset neurological symptom were included from April until July 2020. Nineteen patients were examined regarding clinical symptoms, biomarkers in blood and MRI of the brain. In order to quantify the MRI findings, a semi-quantitative neuroradiological severity scale was constructed a priori, and applied to the MR images by two specialists in neuroradiology.
Results and conclusions
The score from the severity scale correlated significantly with blood biomarkers of CNS injury (glial fibrillary acidic protein, total-tau, ubiquitin carboxyl-terminal hydrolase L1) and inflammation (C-reactive protein), Glasgow Coma Scale score, and the number of days spent in intensive care. The underlying radiological assessments had inter-rater agreements of 90.5%/86% (for assessments with 2/3 alternatives). Total intraclass correlation was 0.80.
Previously reported neuroradiological findings in COVID-19 have been diverse and heterogenous. In this study, the extent of findings in MRI examination of the brain, quantified using a structured report, shows correlation with relevant biomarkers.
【저자키워드】 COVID-19, Biomarkers, Brain, MRI, NEURORADIOLOGY, Severity scale, 【초록키워드】 coronavirus disease, SARS-CoV-2, Inflammation, Biomarker, intensive care, Clinical symptoms, severity, media, C-reactive protein, Symptom, Protein, Clinical findings, Patient, Neurological symptoms, scale, correlation, assessment, CNS, change, Blood, Injury, neurological, Clinical finding, Acidic, material, positive, heterogenous, radiological, Result, examined, significantly, reported, applied, correlated, semi-quantitative, Total, quantified, cohort of patient, subcortical, with COVID-19, 【제목키워드】 intensive care, correlation, Blood, Glasgow coma scale,