TY - JOUR T1 - Severity of Chest Imaging is Correlated with Risk of Acute Neuroimaging Findings among Patients with COVID-19 JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. DO - 10.3174/ajnr.A7032 AU - M. Lang AU - M.D. Li AU - K.Z. Jiang AU - B.C. Yoon AU - D.P. Mendoza AU - E.J. Flores AU - S.P. Rincon AU - W.A. Mehan, Jr AU - J. Conklin AU - S.Y. Huang AU - A.L. Lang AU - D.M. Giao AU - T.M. Leslie-Mazwi AU - J. Kalpathy-Cramer AU - B.P. Little AU - K. Buch Y1 - 2021/02/04 UR - http://www.ajnr.org/content/early/2021/02/04/ajnr.A7032.abstract N2 - BACKGROUND AND PURPOSE: Severe respiratory distress in patients with COVID-19 has been associated with higher rate of neurologic manifestations. Our aim was to investigate whether the severity of chest imaging findings among patients with coronavirus disease 2019 (COVID-19) correlates with the risk of acute neuroimaging findings.MATERIALS AND METHODS: This retrospective study included all patients with COVID-19 who received care at our hospital between March 3, 2020, and May 6, 2020, and underwent chest imaging within 10 days of neuroimaging. Chest radiographs were assessed using a previously validated automated neural network algorithm for COVID-19 (Pulmonary X-ray Severity score). Chest CTs were graded using a Chest CT Severity scoring system based on involvement of each lobe. Associations between chest imaging severity scores and acute neuroimaging findings were assessed using multivariable logistic regression.RESULTS: Twenty-four of 93 patients (26%) included in the study had positive acute neuroimaging findings, including intracranial hemorrhage (n = 7), infarction (n = 7), leukoencephalopathy (n = 6), or a combination of findings (n = 4). The average length of hospitalization, prevalence of intensive care unit admission, and proportion of patients requiring intubation were significantly greater in patients with acute neuroimaging findings than in patients without them (P < .05 for all). Compared with patients without acute neuroimaging findings, patients with acute neuroimaging findings had significantly higher mean Pulmonary X-ray Severity scores (5.0 [SD, 2.9] versus 9.2 [SD, 3.4], P < .001) and mean Chest CT Severity scores (9.0 [SD, 5.1] versus 12.1 [SD, 5.0], P = .041). The pulmonary x-ray severity score was a significant predictor of acute neuroimaging findings in patients with COVID-19.CONCLUSIONS: Patients with COVID-19 and acute neuroimaging findings had more severe findings on chest imaging on both radiographs and CT compared with patients with COVID-19 without acute neuroimaging findings. The severity of findings on chest radiography was a strong predictor of acute neuroimaging findings in patients with COVID-19.CCSChest CT SeverityCOVID-19coronavirus disease 2019ICUintensive care unitPXSPulmonary X-ray SeverityROCreceiver operating characteristicSARS-CoV-2Severe Acute Respiratory Syndrome coronavirus 2 ER -