Article ; Online: Clinical, Imaging, and Lab Correlates of Severe COVID-19 Leukoencephalopathy.
AJNR. American journal of neuroradiology
2021 Volume 42, Issue 4, Page(s) 632–638
Abstract: ... of variable severity. Our aim was to characterize imaging, lab, and clinical correlates of severe coronavirus ... Conclusions: Our findings highlight notable correlations between severe COVID-19 leukoencephalopathy ... disease 2019 (COVID-19) leukoencephalopathy, which may provide insight into the SARS-CoV-2 pathophysiology ...
| Abstract | Background and purpose: Patients infected with the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) can develop a spectrum of neurological disorders, including a leukoencephalopathy of variable severity. Our aim was to characterize imaging, lab, and clinical correlates of severe coronavirus disease 2019 (COVID-19) leukoencephalopathy, which may provide insight into the SARS-CoV-2 pathophysiology. Materials and methods: Twenty-seven consecutive patients positive for SARS-CoV-2 who had brain MR imaging following intensive care unit admission were included. Seven (7/27, 26%) developed an unusual pattern of "leukoencephalopathy with reduced diffusivity" on diffusion-weighted MR imaging. The remaining patients did not exhibit this pattern. Clinical and laboratory indices, as well as neuroimaging findings, were compared between groups. Results: The reduced-diffusivity group had a significantly higher body mass index (36 versus 28 kg/m Conclusions: Our findings highlight notable correlations between severe COVID-19 leukoencephalopathy with reduced diffusivity and obesity, acute renal failure, mild hypernatremia, anemia, and an unusual brain MR imaging white matter lesion distribution pattern. Together, these observations may shed light on possible SARS-CoV-2 pathophysiologic mechanisms associated with leukoencephalopathy, including borderzone ischemic changes, electrolyte transport disturbances, and silent hypoxia in the setting of the known cytokine storm syndrome that accompanies severe COVID-19. |
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| MeSH term(s) | Acute Kidney Injury/complications ; Acute Kidney Injury/diagnostic imaging ; Adult ; COVID-19/complications ; Diffusion Magnetic Resonance Imaging ; Humans ; Intensive Care Units ; Leukoencephalopathies/complications ; Leukoencephalopathies/diagnostic imaging ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; SARS-CoV-2 ; White Matter/diagnostic imaging | |||||
| Language | English | |||||
| Publishing date | 2021-01-07 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 603808-6 | |||||
| ISSN | 1936-959X ; 0195-6108 | |||||
| ISSN (online) | 1936-959X | |||||
| ISSN | 0195-6108 | |||||
| DOI | 10.3174/ajnr.A6966 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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