MRI Alteration of the Brain in a Patient With COVID-19 and A
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The neurotropism of human coronaviruses has already been demonstrated in small animals, and in autoptic studies the SARS-CoV, which was responsible for the SARS outbreak during 2002 to 2003, was found in the brains of patients with infection. It has been proposed that the neuroinvasive potential of the novel SARS-CoV-2, responsible for COVID-19, may be at least partially responsible for the respiratory failure of patients with COVID-19. This article shares the MRI evidence of in vivo brain alteration presumably due to SARS-CoV-2 and demonstrate that anosmia can represent the predominant symptom in COVID-19.

A 25-year-old female radiographer with no significant medical history who had been working in a COVID-19 ward presented with a mild dry cough that lasted for 1 day, followed by persistent severe anosmia and dysgeusia. She did not have a fever. She had no trauma, seizure, or hypoglycemic event. Three days later, nasal fibroscopic evaluation results were unremarkable, and noncontrast chest and maxillofacial computed tomography results were negative.

On the same day, a brain MRI was also performed. On 3-dimensional and 2-dimensional fluid-attenuated inversion recovery images, a cortical hyperintensity was evident in the right gyrus rectus and a subtle hyperintensity was present in the olfactory bulbs. Because many patients in Italy are this is the first report of in vivo human brain involvement in a patient with COVID-19 showing a signal alteration compatible with viral brain invasion in a cortical region (ie, posterior gyrus rectus) that is associated with olfaction. experiencing anosmia and the cortical signal alteration was suggestive of viral infection, a swab test was performed and RT-PCR analysis yielded positive results for SARS-CoV-2.

This is the first report of in vivo human brain involvement in a patient with COVID-19 showing a signal alteration compatible with viral brain invasion in a cortical region that is associated with olfaction.

Source: https://jamanetwork.com/journals/jamaneurology/fullarticle/2766765
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