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...
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| Format: | Article |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.884449/full |
| _version_ | 1811247234197487616 |
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| author | Angela Napolitano Alberto Arrigoni Anna Caroli Mariangela Cava Andrea Remuzzi Luca Giovanni Longhi Antonino Barletta Rosalia Zangari Ferdinando Luca Lorini Maria Sessa Simonetta Gerevini |
| author_facet | Angela Napolitano Alberto Arrigoni Anna Caroli Mariangela Cava Andrea Remuzzi Luca Giovanni Longhi Antonino Barletta Rosalia Zangari Ferdinando Luca Lorini Maria Sessa Simonetta Gerevini |
| author_sort | Angela Napolitano |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-04-12T15:06:32Z |
| format | Article |
| id | doaj.art-5f01cf36e3264d918bdbed6fa0c02158 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-12T15:06:32Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj.art-5f01cf36e3264d918bdbed6fa0c021582022-12-22T03:27:56ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-05-011310.3389/fneur.2022.884449884449Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological ManifestationsAngela Napolitano0Alberto Arrigoni1Anna Caroli2Mariangela Cava3Andrea Remuzzi4Luca Giovanni Longhi5Antonino Barletta6Rosalia Zangari7Ferdinando Luca Lorini8Maria Sessa9Simonetta Gerevini10Department of Neuroradiology, ASST Papa Giovanni XXIII, Bergamo, ItalyBioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, ItalyBioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, ItalyRadiology Unit, S. Giacomo Hospital, Novi Ligure, ItalyDepartment of Management, Information and Production Engineering, University of Bergamo, Bergamo, ItalyNeurosurgical Intensive Care Unit, Department of Anesthesia and Critical Care Medicine, ASST Papa Giovanni XXIII, Bergamo, ItalyDepartment of Neuroradiology, ASST Papa Giovanni XXIII, Bergamo, ItalyResearch Foundation, ASST Papa Giovanni XXIII, Bergamo, ItalyDepartment of Emergency and Critical Care Area, ASST Papa Giovanni XXIII, Bergamo, ItalyDepartment of Neurology, ASST Papa Giovanni XXIII, Bergamo, ItalyDepartment of Neuroradiology, ASST Papa Giovanni XXIII, Bergamo, ItalyIt 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.https://www.frontiersin.org/articles/10.3389/fneur.2022.884449/fullsusceptibility-weighted imaging (SWI)neuro-COVIDinflammationMRIcerebral microbleeds (CMBs) |
| spellingShingle | Angela Napolitano Alberto Arrigoni Anna Caroli Mariangela Cava Andrea Remuzzi Luca Giovanni Longhi Antonino Barletta Rosalia Zangari Ferdinando Luca Lorini Maria Sessa Simonetta Gerevini Cerebral Microbleeds Assessment and Quantification in COVID-19 Patients With Neurological Manifestations Frontiers in Neurology susceptibility-weighted imaging (SWI) neuro-COVID inflammation MRI cerebral microbleeds (CMBs) |
| 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 | susceptibility-weighted imaging (SWI) neuro-COVID inflammation MRI cerebral microbleeds (CMBs) |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.884449/full |
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