TY - JOUR T1 - 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 JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 1008 LP - 1016 DO - 10.3174/ajnr.A7072 VL - 42 IS - 6 AU - A. Mahammedi AU - A. Ramos AU - N. Bargalló AU - M. Gaskill AU - S. Kapur AU - L. Saba AU - H. Carrete, Jr AU - S. Sengupta AU - E. Salvador AU - A. Hilario AU - Y. Revilla AU - M. Sanchez AU - M. Perez-Nuñez AU - S. Bachir AU - B. Zhang AU - L. Oleaga AU - J. Sergio AU - L. Koren AU - P. Martin-Medina AU - L. Wang AU - M. Benegas AU - F. Ostos AU - G. Gonzalez-Ortega AU - P. Calleja AU - G. Udstuen AU - B. Williamson AU - V. Khandwala AU - S. Chadalavada AU - D. Woo AU - A. Vagal Y1 - 2021/06/01 UR - http://www.ajnr.org/content/42/6/1008.abstract N2 - 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 0–5 (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 ER -