Cargando…
Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations
It is increasingly acknowledged that Coronavirus Disease 2019 (COVID-19) can have neurological manifestations, and cerebral microbleeds (CMBs) have been observed in this setting. The aim of this study was to characterize CMBs patterns on susceptibility-weighted imaging (SWI) in hospitalized patients...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9168977/ https://www.ncbi.nlm.nih.gov/pubmed/35677326 http://dx.doi.org/10.3389/fneur.2022.884449 |
_version_ | 1784721114401865728 |
---|---|
author | Napolitano, Angela Arrigoni, Alberto Caroli, Anna Cava, Mariangela Remuzzi, Andrea Longhi, Luca Giovanni Barletta, Antonino Zangari, Rosalia Lorini, Ferdinando Luca Sessa, Maria Gerevini, Simonetta |
author_facet | Napolitano, Angela Arrigoni, Alberto Caroli, Anna Cava, Mariangela Remuzzi, Andrea Longhi, Luca Giovanni Barletta, Antonino Zangari, Rosalia Lorini, Ferdinando Luca Sessa, Maria Gerevini, Simonetta |
author_sort | Napolitano, Angela |
collection | PubMed |
description | It is increasingly acknowledged that Coronavirus Disease 2019 (COVID-19) can have neurological manifestations, and cerebral microbleeds (CMBs) have been observed in this setting. The aim of this study was to characterize CMBs patterns on susceptibility-weighted imaging (SWI) in hospitalized patients with COVID-19 with neurological manifestations. CMBs volume was quantified and correlated with clinical and laboratory parameters. The study included patients who were hospitalized due to COVID-19, exhibited neurological manifestations, and underwent a brain MRI between March and May 2020. Neurological, clinical, and biochemical variables were reported. The MRI was acquired using a 3T scanner, with a standardized protocol including SWI. Patients were divided based on radiological evidence of CMBs or their absence. The CMBs burden was also assessed with a semi-automatic SWI processing procedure specifically developed for the purpose of this study. Odds ratios (OR) for CMBs were calculated using age, sex, clinical, and laboratory data by logistic regression analysis. Of the 1,760 patients with COVID-19 admitted to the ASST Papa Giovanni XXIII Hospital between 1 March and 31 May 2020, 116 exhibited neurological symptoms requiring neuroimaging evaluation. Of these, 63 patients underwent brain MRI and were therefore included in the study. A total of 14 patients had radiological evidence of CMBs (CMBs+ group). CMBs+ patients had a higher prevalence of CSF inflammation (p = 0.020), a higher white blood cell count (p = 0.020), and lower lymphocytes (p = 0.010); the D-dimer (p = 0.026), LDH (p = 0.004), procalcitonin (p = 0.002), and CRP concentration (p < 0.001) were higher than in the CMBs- group. In multivariable logistic regression analysis, CRP (OR = 1.16, p = 0.011) indicated an association with CMBs. Estimated CMBs volume was higher in females than in males and decreased with age (Rho = −0.38; p = 0.18); it was positively associated with CRP (Rho = 0.36; p = 0.22), and negatively associated with lymphocytes (Rho = −0.52; p = 0.07). CMBs are a frequent imaging finding in hospitalized patients with COVID-19 with neurological manifestations and seem to be related to pro-inflammatory status. |
format | Online Article Text |
id | pubmed-9168977 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-91689772022-06-07 Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations Napolitano, Angela Arrigoni, Alberto Caroli, Anna Cava, Mariangela Remuzzi, Andrea Longhi, Luca Giovanni Barletta, Antonino Zangari, Rosalia Lorini, Ferdinando Luca Sessa, Maria Gerevini, Simonetta Front Neurol Neurology It is increasingly acknowledged that Coronavirus Disease 2019 (COVID-19) can have neurological manifestations, and cerebral microbleeds (CMBs) have been observed in this setting. The aim of this study was to characterize CMBs patterns on susceptibility-weighted imaging (SWI) in hospitalized patients with COVID-19 with neurological manifestations. CMBs volume was quantified and correlated with clinical and laboratory parameters. The study included patients who were hospitalized due to COVID-19, exhibited neurological manifestations, and underwent a brain MRI between March and May 2020. Neurological, clinical, and biochemical variables were reported. The MRI was acquired using a 3T scanner, with a standardized protocol including SWI. Patients were divided based on radiological evidence of CMBs or their absence. The CMBs burden was also assessed with a semi-automatic SWI processing procedure specifically developed for the purpose of this study. Odds ratios (OR) for CMBs were calculated using age, sex, clinical, and laboratory data by logistic regression analysis. Of the 1,760 patients with COVID-19 admitted to the ASST Papa Giovanni XXIII Hospital between 1 March and 31 May 2020, 116 exhibited neurological symptoms requiring neuroimaging evaluation. Of these, 63 patients underwent brain MRI and were therefore included in the study. A total of 14 patients had radiological evidence of CMBs (CMBs+ group). CMBs+ patients had a higher prevalence of CSF inflammation (p = 0.020), a higher white blood cell count (p = 0.020), and lower lymphocytes (p = 0.010); the D-dimer (p = 0.026), LDH (p = 0.004), procalcitonin (p = 0.002), and CRP concentration (p < 0.001) were higher than in the CMBs- group. In multivariable logistic regression analysis, CRP (OR = 1.16, p = 0.011) indicated an association with CMBs. Estimated CMBs volume was higher in females than in males and decreased with age (Rho = −0.38; p = 0.18); it was positively associated with CRP (Rho = 0.36; p = 0.22), and negatively associated with lymphocytes (Rho = −0.52; p = 0.07). CMBs are a frequent imaging finding in hospitalized patients with COVID-19 with neurological manifestations and seem to be related to pro-inflammatory status. Frontiers Media S.A. 2022-05-23 /pmc/articles/PMC9168977/ /pubmed/35677326 http://dx.doi.org/10.3389/fneur.2022.884449 Text en Copyright © 2022 Napolitano, Arrigoni, Caroli, Cava, Remuzzi, Longhi, Barletta, Zangari, Lorini, Sessa and Gerevini. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Napolitano, Angela Arrigoni, Alberto Caroli, Anna Cava, Mariangela Remuzzi, Andrea Longhi, Luca Giovanni Barletta, Antonino Zangari, Rosalia Lorini, Ferdinando Luca Sessa, Maria Gerevini, Simonetta Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations |
title | Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations |
title_full | Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations |
title_fullStr | Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations |
title_full_unstemmed | Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations |
title_short | Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations |
title_sort | cerebral microbleeds assessment and quantification in covid-19 patients with neurological manifestations |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9168977/ https://www.ncbi.nlm.nih.gov/pubmed/35677326 http://dx.doi.org/10.3389/fneur.2022.884449 |
work_keys_str_mv | AT napolitanoangela cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT arrigonialberto cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT carolianna cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT cavamariangela cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT remuzziandrea cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT longhilucagiovanni cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT barlettaantonino cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT zangarirosalia cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT loriniferdinandoluca cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT sessamaria cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations AT gerevinisimonetta cerebralmicrobleedsassessmentandquantificationincovid19patientswithneurologicalmanifestations |