Neurologic and neuroimaging findings in patients with COVID-19: A retrospective multicenter study - Université Paris Cité Accéder directement au contenu
Article Dans Une Revue Neurology Année : 2020

Neurologic and neuroimaging findings in patients with COVID-19: A retrospective multicenter study

Stéphane Kremer
Maleka Schenck
Augustin Gaudemer
Manel Alleg
Emmanuelle Schmitt
René Anxionnat
François Zhu
Ghazi Hmeydia
Joseph Benzakoun
Claire Boutet
Géraud Forestier
Grégoire Bornet
Hubert Desal
Grégoire Boulouis
Apolline Kazémi
  • Fonction : Auteur
Suzana Saleme
Basile Kerleroux
Paul Michel Mertes
  • Fonction : Auteur
  • PersonId : 772456
  • IdRef : 075689553
Francis Schneider
Mickael Ohana
Nicolas Meyer
François Cotton

Résumé

Objective To describe neuroimaging findings and to report the epidemiologic and clinical characteristics of patients with coronavirus disease 2019 (COVID-19) with neurologic manifestations. Methods In this retrospective multicenter study (11 hospitals), we included 64 patients with confirmed COVID-19 with neurologic manifestations who underwent a brain MRI. Results The cohort included 43 men (67%) and 21 women (33%); their median age was 66 (range 20–92) years. Thirty-six (56%) brain MRIs were considered abnormal, possibly related to severe acute respiratory syndrome coronavirus. Ischemic strokes (27%), leptomeningeal enhancement (17%), and encephalitis (13%) were the most frequent neuroimaging findings. Confusion (53%) was the most common neurologic manifestation, followed by impaired consciousness (39%), presence of clinical signs of corticospinal tract involvement (31%), agitation (31%), and headache (16%). The profile of patients experiencing ischemic stroke was different from that of other patients with abnormal brain imaging: the former less frequently had acute respiratory distress syndrome ( p = 0.006) and more frequently had corticospinal tract signs ( p = 0.02). Patients with encephalitis were younger ( p = 0.007), whereas agitation was more frequent for patients with leptomeningeal enhancement ( p = 0.009). Conclusions Patients with COVID-19 may develop a wide range of neurologic symptoms, which can be associated with severe and fatal complications such as ischemic stroke or encephalitis. In terms of meningoencephalitis involvement, even if a direct effect of the virus cannot be excluded, the pathophysiology seems to involve an immune or inflammatory process given the presence of signs of inflammation in both CSF and neuroimaging but the lack of virus in CSF. ClinicalTrials.gov identifier NCT04368390.

Domaines

Neurosciences

Dates et versions

inserm-03482260 , version 1 (15-12-2021)

Identifiants

Citer

Stéphane Kremer, François Lersy, Mathieu Anheim, Hamid Merdji, Maleka Schenck, et al.. Neurologic and neuroimaging findings in patients with COVID-19: A retrospective multicenter study. Neurology, 2020, 95 (13), pp.e1868-e1882. ⟨10.1212/WNL.0000000000010112⟩. ⟨inserm-03482260⟩
45 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More