Early postmortem brain MRI findings in COVID-19 non-survivors

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered to have potential neuroinvasiveness that might lead to acute brain disorders or contribute to respiratory distress in patients with coronavirus disease 2019 (COVID-19). This study investigates the occurrence of structural...

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Veröffentlicht in:Neurology Jg. 95; H. 14; S. e2016
Hauptverfasser: Coolen, Tim, Lolli, Valentina, Sadeghi, Niloufar, Rovai, Antonin, Trotta, Nicola, Taccone, Fabio Silvio, Creteur, Jacques, Henrard, Sophie, Goffard, Jean-Christophe, Dewitte, Olivier, Naeije, Gilles, Goldman, Serge, De Tiège, Xavier
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States 06.10.2020
Schlagworte:
Aged
Aged, 80 and over
Betacoronavirus
Brain - diagnostic imaging
Brain Edema - diagnostic imaging
Cerebral Hemorrhage - diagnostic imaging
Coronavirus Infections - diagnostic imaging
COVID-19
Diffusion Magnetic Resonance Imaging
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Olfactory Bulb - diagnostic imaging
Pandemics
Pneumonia, Viral - diagnostic imaging
Posterior Leukoencephalopathy Syndrome - diagnostic imaging
Postmortem Changes
Prospective Studies
SARS-CoV-2
White Matter - diagnostic imaging
ISSN:1526-632X, 1526-632X
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Zusammenfassung:The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered to have potential neuroinvasiveness that might lead to acute brain disorders or contribute to respiratory distress in patients with coronavirus disease 2019 (COVID-19). This study investigates the occurrence of structural brain abnormalities in non-survivors of COVID-19 in a virtopsy framework. In this prospective, monocentric, case series study, consecutive patients who fulfilled the following inclusion criteria benefited from an early postmortem structural brain MRI: death <24 hours, SARS-CoV-2 detection on nasopharyngeal swab specimen, chest CT scan suggestive of COVID-19, absence of known focal brain lesion, and MRI compatibility. Among the 62 patients who died of COVID-19 from March 31, 2020, to April 24, 2020, at our institution, 19 decedents fulfilled the inclusion criteria. Parenchymal brain abnormalities were observed in 4 decedents: subcortical microbleeds and macrobleeds (2 decedents), cortico-subcortical edematous changes evocative of posterior reversible encephalopathy syndrome (PRES; 1 decedent), and nonspecific deep white matter changes (1 decedent). Asymmetric olfactory bulbs were found in 4 other decedents without downstream olfactory tract abnormalities. No brainstem MRI signal abnormality was observed. Postmortem brain MRI demonstrates hemorrhagic and PRES-related brain lesions in non-survivors of COVID-19. SARS-CoV-2-related olfactory impairment seems to be limited to olfactory bulbs. Brainstem MRI findings do not support a brain-related contribution to respiratory distress in COVID-19.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:1526-632X
1526-632X
DOI:10.1212/WNL.0000000000010116