Neuroimaging and neurologic findings in COVID-19 and other coronavirus infections: A systematic review in 116 patients

Abstract

Various neurologic syndromes have been described in patients with COVID-19 and other coronavirus infections. In this paper, we systematically reviewed the available imaging findings of patients diagnosed with neurological symptoms associated with coronavirus infections. Diverse radiologic results in the context of different neurologic presentations have been demonstrated using CT and MRI. While many patients have normal imaging evaluations, some patients present with intra-axial and extra-axial abnormalities. Stroke (both ischemic and hemorrhagic), encephalomyelitis, meningitis, demyelinating disorders such as acute disseminated encephalomyelitis (ADEM), and encephalopathy have been reported. Familiarity with these radiologic patterns will guide radiologists and referring clinicians to consider coronavirus infections in patients with worsening or progressive neurologic findings, particularly during the current COVID-19 pandemic. As data on this topic is very limited, further research and investigation are required.

Keywords: Acute disseminated encephalomyelitis (ADEM); Brain; CNS; COVID-19; CT; Encephalitis; Encephalopathy; HCoV; MRI; Meningitis; Middle East Respiratory Syndrome Coronavirus (MERS-CoV); Neurologic sequelae; SARS; SARS-CoV-2; Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV); Stroke.

Fig. 1

Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram of the study.