Pictures of the brain in COVID-19 patients are yielding clues that may help identify the virus sooner.
A study by University of Cincinnati researchers and four Italian institutions has identified red flags for the coronavirus. The scientists reviewed neuroimaging and neurological symptoms in patients and found the most common ones are an altered mental status and stroke.
The findings are published in the journal Radiology.
"Studies have described the spectrum of chest imaging features of COVID-19, but only a few case reports have described COVID-19-associated neuroimaging findings," says lead author Abdelkader Mahammedi, MD, assistant professor of radiology at UC and a UC Health neuroradiologist. "To date, this is the largest and first study in literature that characterizes the neurological symptoms and neuroimaging features in COVID-19 patients. These newly discovered patterns could help doctors better and sooner recognize associations with COVID-19 and possibly provide earlier interventions."
Scientists Studied Italian COVID-19 Patients
Their research centered on Italy, the second epicenter of the COVID-19 spread, with more than 30,000 deaths. Scientists studied 725 patients at the University of Brescia, University of Eastern Piedmont and the University of Sassari. One-hundred-eight of them had serious neurological symptoms and underwent brain or spine imaging.
Investigators found 59% had an altered mental state and 31% experienced stroke. Smaller percentages of patients experienced headaches, seizures and dizziness. The altered mental state was more prevalent in older patients.
UC neurologist Dr. Soma Sangupta, who is working with Mahammedi, describes the altered mental state as confusion, delirium or feeling very spacey. "One of my very close friends in France who is recovering from COVID-19 and who is normally pretty sharp said, 'You know, I felt as if I were in this giant bubble and I really didn't understand what was going on around me.' "
A Third Had No Known Medical History
"Of these 108 patients, 31, or 29%, had no known past medical history. Of these, aged 16 to 62 years, 10 experienced stroke and two had brain bleeds," Mahammedi says. "Seventy-one, or 66%, of these patients had no findings on a brain CT, out of which seven of them (35%) brain MRI showed abnormalities.”
Even though researchers say an altered mental state and stroke were the most common conditions, there are other conditions to be on the lookout for in COVID-19 patients.
Mahammedi says more research is needed because there is still a poor understanding of neurological symptoms in people who have the coronavirus.
"Whether these are arising from critical illness or from direct central nervous system invasion of SARS-CoV-2, we hope further study on this subject will help in uncovering clues and providing better interventions for patients," he says.