In this retrospective, multicentre study, the author systematically characterised neurological symptoms and neuroimaging features in hospitalised COVID-19 patients from multiple institutions in Italy. A total of 725 consecutive hospitalised COVID-19 patients were reviewed. Out of these, 108 (15%) met eligibility criteria. Of the 108 patients, 107 (99%) were examined with non-contrast brain CT, 17 (16%) head and neck CT angiography (CTA) and 20 (18%) brain MRI. The most common neurological symptoms were altered mental status in 64 (59%) patients and ischaemic stroke in 34 (31%) patients. The main neuroimaging hallmark was acute ischaemic infarcts in 34 (31%) [30 (28%) on CT and 4 (20%) on MRI]. Of these infarcts, 19 (18%) were large (15, 2, and 2 in middle , posterior and anterior territories, respectively), 11 (10%) were small, 3 (3%) were cardioembolic and 1 (1%) of hypoxic-ischaemic encephalopathy pattern. Out of 6 (6%) intracranial hemorrhages, subarachnoid hemorrhage was the commonest 3 (3%). The authors concluded that the neuroimaging features of hospitalised COVID-19 patients were variable, without a specific pattern, but dominated by acute ischaemic infarcts and intracranial hemorrhages.
by Marialuisa Zedde and Francesco Cavallieri