@article {Mahammedi1008, author = {A. Mahammedi and A. Ramos and N. Bargall{\'o} and M. Gaskill and S. Kapur and L. Saba and H. Carrete, Jr and S. Sengupta and E. Salvador and A. Hilario and Y. Revilla and M. Sanchez and M. Perez-Nu{\~n}ez and S. Bachir and B. Zhang and L. Oleaga and J. Sergio and L. Koren and P. Martin-Medina and L. Wang and M. Benegas and F. Ostos and G. Gonzalez-Ortega and P. Calleja and G. Udstuen and B. Williamson and V. Khandwala and S. Chadalavada and D. Woo and A. Vagal}, title = {Brain and Lung Imaging Correlation in Patients with COVID-19: Could the Severity of Lung Disease Reflect the Prevalence of Acute Abnormalities on Neuroimaging? A Global Multicenter Observational Study}, volume = {42}, number = {6}, pages = {1008--1016}, year = {2021}, doi = {10.3174/ajnr.A7072}, publisher = {American Journal of Neuroradiology}, abstract = {PURPOSE: Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms.MATERIALS AND METHODS: In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0{\textendash}5 (0 corresponded to no involvement and 5 corresponded to \>75\% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement).RESULTS: A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64\%) patients without acute abnormal findings on neuroimaging, 49 (36\%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8, P \< .001). These patients were more likely to present with ischemic stroke (40 [82\%] versus 11 [13\%], P \< .0001) and were more likely to have either ground-glass opacities or consolidation (46 [94\%] versus 73 [84\%], P = .01) in the lungs. A threshold of the CT lung severity score of \>8 was found to be 74\% sensitive and 65\% specific for acute abnormal findings on neuroimaging. The neuroimaging hallmarks of these patients were acute ischemic infarct (28\%), intracranial hemorrhage (10\%) including microhemorrhages (19\%), and leukoencephalopathy with and/or without restricted diffusion (11\%). The predominant CT chest findings were peripheral ground-glass opacities with or without consolidation.CONCLUSIONS: The CT lung disease severity score may be predictive of acute abnormalities on neuroimaging in patients with COVID-19 with neurologic manifestations. This can be used as a predictive tool in patient management to improve clinical outcome.COVID-19coronavirus disease 2019GGOsground-glass opacitiesPRESposterior reversible encephalopathy syndromeSARS-CoV-2Severe Acute Respiratory Syndrome coronavirus 2TIPICTransient Perivascular Inflammation of the Carotid artery syndrome}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/42/6/1008}, eprint = {https://www.ajnr.org/content/42/6/1008.full.pdf}, journal = {American Journal of Neuroradiology} }