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Neuroimaging Findings in Patients with COVID-19: A Systematic Review and Meta-Analysis

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Abstract
Objective
Central nervous system involvement in coronavirus disease 2019 (COVID-19) has been increasingly reported. We performed a systematic review and meta-analysis to evaluate the incidence of radiologically demonstrated neurologic complications and detailed neuroimaging findings associated with COVID-19.

Materials and Methods
A systematic literature search of MEDLINE/PubMed and EMBASE databases was performed up to September 17, 2020, and studies evaluating neuroimaging findings of COVID-19 using brain CT or MRI were included. Several cohort-based outcomes, including the proportion of patients with abnormal neuroimaging findings related to COVID-19 were evaluated. The proportion of patients showing specific neuroimaging findings was also assessed. Subgroup analyses were also conducted focusing on critically ill COVID-19 patients and results from studies that used MRI as the only imaging modality.

Results
A total of 1394 COVID-19 patients who underwent neuroimaging from 17 studies were included; among them, 3.4% of the patients demonstrated COVID-19-related neuroimaging findings. Olfactory bulb abnormalities were the most commonly observed (23.1%). The predominant cerebral neuroimaging finding was white matter abnormality (17.6%), followed by acute/subacute ischemic infarction (16.0%), and encephalopathy (13.0%). Significantly more critically ill patients had COVID-19-related neuroimaging findings than other patients (9.1% vs. 1.6%; p = 0.029). The type of imaging modality used did not significantly affect the proportion of COVID-19-related neuroimaging findings.

Conclusion
Abnormal neuroimaging findings were occasionally observed in COVID-19 patients. Olfactory bulb abnormalities were the most commonly observed finding. Critically ill patients showed abnormal neuroimaging findings more frequently than the other patient groups. White matter abnormalities, ischemic infarctions, and encephalopathies were the common cerebral neuroimaging findings.
Author(s)
김평화김민재서종현정새롬박지은김수진최영준이정현김호성백정환최충곤김상준
Issued Date
2021
Type
Article
Keyword
Brain - diagnostic imagingCOVID - 19HumansMagnetic Resonance ImagingNeuroimagingSARS-CoV-2방사선과학
DOI
10.3348/kjr.2021.0127
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7416
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9872910&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Neuroimaging%20Findings%20in%20Patients%20with%20COVID-19:%20A%20Systematic%20Review%20and%20Meta-Analysis&offset=0&pcAvailability=true
Publisher
KOREAN JOURNAL OF RADIOLOGY
Location
대한민국
Language
영어
ISSN
1229-6929
Citation Volume
22
Citation Number
11
Citation Start Page
1875
Citation End Page
1885
Appears in Collections:
Medicine > Medicine
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