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oai:docta.ucm.es:20.500.14352/1162782025-01-28T01:08:50Zcom_20.500.14352_14col_20.500.14352_15

00925njm 22002777a 4500 dc Mahammedi, A author Ramos González, Ana author Salvador Álvarez, Elena author Hilario Barrio, Amaya author Revilla Ostolaza, Teresa Yolanda author Vagal, A. author 2021-06 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. Mahammedi A, Ramos A, Bargalló N, Gaskill M, Kapur S, Saba L, Carrete H Jr, Sengupta S, Salvador E, Hilario A, Revilla Y, Sanchez M, Perez-Nuñez M, Bachir S, Zhang B, Oleaga L, Sergio J, Koren L, Martin-Medina P, Wang L, Benegas M, Ostos F, Gonzalez-Ortega G, Calleja P, Udstuen G, Williamson B, Khandwala V, Chadalavada S, Woo D, Vagal A. 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. AJNR Am J Neuroradiol. 2021 Jun;42(6):1008-1016. 0195-6108 10.3174/ajnr.A7072 https://hdl.handle.net/20.500.14352/116278 1936-959X http://dx.doi.org/10.3174/ajnr.A7072 33707278 https://www.ajnr.org/content/42/6/1008.long https://pubmed.ncbi.nlm.nih.gov/33707278/ 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