Neuroimaging findings in conjunction with severe COVID-19 infection

Background & Purpose: COVID-19 has a variable, but well-described course Some patients additionally present with neurological symptoms Recent studies also suggest neurological complications such as encephalitis The purpose of this study was to investigate whether neuroimaging findings can be detected on CT and MRI in SARS-CoV-2 positive patients and whether they are direct sequelae of viral central nervous system infection or secondary to critical illness and intensive care therapy Methods: We retrospectively analyzed brain CT and MRI scans of 34 hospitalized COVID-19 patients at our Level I Center between March 15 and April 24 with regard to pathological neuroimaging findings In addition, clinical parameters such as neurological symptoms, comorbidities, and type of ventilation therapy were documented A descriptive statistical analysis was performed Results: Pathological findings were detected in 38 2 % of patients of the study cohort Based on the weekly institutional SARS-CoV-2 report of all positively tested patients in our clinic at the time of data collection, neuroimaging findings could be found in 6 % of all patients (34/565) The most common findings were microbleeds (20 6 %) and signs of hypoxic brain injury (11 8 %) Furthermore, cortical subarachnoid hemorrhage, typical and atypical cerebral hematomas, ischemic strokes, and generalized brain edema were documented All neuroimaging findings occurred in patients who were either intubated or treated by ECMO Conclusion: A broad range of pathological neuroimaging findings can be seen in critically ill SARS-CoV-2 positive patients The majority of neuroimaging findings are probably critical illness and therapy-associated, although direct and indirect viral effects cannot be excluded