PT  - JOURNAL ARTICLE
AU  - Mahammedi, A.
AU  - Ramos, A.
AU  - Bargalló, N.
AU  - Gaskill, M.
AU  - Kapur, S.
AU  - Saba, L.
AU  - Carrete, H.
AU  - Sengupta, S.
AU  - Salvador, E.
AU  - Hilario, A.
AU  - Revilla, Y.
AU  - Sanchez, M.
AU  - Perez-Nuñez, M.
AU  - Bachir, S.
AU  - Zhang, B.
AU  - Oleaga, L.
AU  - Sergio, J.
AU  - Koren, L.
AU  - Martin-Medina, P.
AU  - Wang, L.
AU  - Benegas, M.
AU  - Ostos, F.
AU  - Gonzalez-Ortega, G.
AU  - Calleja, P.
AU  - Udstuen, G.
AU  - Williamson, B.
AU  - Khandwala, V.
AU  - Chadalavada, S.
AU  - Woo, D.
AU  - Vagal, A.
TI  - 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
AID  - 10.3174/ajnr.A7072
DP  - 2021 Jun 01
TA  - American Journal of Neuroradiology
PG  - 1008--1016
VI  - 42
IP  - 6
4099  - http://www.ajnr.org/content/42/6/1008.short
4100  - http://www.ajnr.org/content/42/6/1008.full
SO  - Am. J. Neuroradiol.2021 Jun 01; 42
AB  - 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