Brain MRI Of Covid 19 Patients Related To Presence Of Virus
Get authentic, real-time news that helps you fight COVID-19 better.
Install PlexusMD App for doctors. It's free.
The presence of CNS hyperintense lesions or leptomeningeal enhancement on neuroimaging from patients with COVID19 is associated with an increased likelihood of a positive CSF SARS-CoV-2 PCR, suggests findings from a recent study. However, the research team further elaborated that a positive CSF SARS-CoV 2 PCR is uncommon in patients with these neuroimaging findings, suggesting they are often related to other etiologies.

Researchers reviewed the literature to evaluate cerebrospinal fluid (CSF) results from patients with COVID-19 who had neurological symptoms and had an MRI that showed (1) central nervous system hyperintense lesions not attributed to ischemia and/or (2) leptomeningeal enhancement. The team sought to determine if these findings were associated with a positive CSF SARS-CoV-2 polymerase chain reaction (PCR).

They performed a systematic review of Medline and Embase from December 1, 2019, to November 18, 2020. CSF results were evaluated based on the presence/absence of (1) Greater than or equal to 1 CNS hyperintense lesion and (2) leptomeningeal enhancement.

Results highlighted the following facts.
• In 117 publications, we identified 193 patients with COVID-19 who had an MRI of the CNS and CSF testing.

• There were 125 (65%) patients with CNS hyperintense lesions. Patients with CNS hyperintense lesions were significantly more likely to have a positive CSF SARS-CoV-2 PCR.

• Of 75 patients who had a contrast MRI, there were 20 (27%) patients who had leptomeningeal enhancement.

• Patients with leptomeningeal enhancement were significantly more likely to have a positive CSF SARS-CoV-2 PCR.

Based on this meta-analysis of data obtained from 193 patients with COVID-19 described in the literature who had an MRI brain and/or spine and CSF testing as a workup for neurologic symptoms, we found that the presence of CNS hyperintense lesions or leptomeningeal enhancement on neuroimaging is associated with increased likelihood of a positive CSF SARS-CoV-2 PCR.

However, most patients with COVID-19 who have CNS hyperintense lesions or leptomeningeal enhancement do not have evidence of SARS-CoV-2 in the CSF, suggesting that these findings are the result of other processes, such as inflammation, hypoxia, or ischemia. The etiology for these imaging findings should be explored further via neuropathology studies, the team concluded.

Source:
https://onlinelibrary.wiley.com/doi/10.1111/jon.12880
Dr. T●●●●z H●●●●●●i and 1 others like this2 shares
Like
Comment
Share