Clinical, Laboratory and Imaging Characteristics of Hospitalized COVID-19 Patients with Neurologic Involvement; a Cross-Sectional Study
Introduction: Although neurologic involvement and neuroimaging abnormalities have been frequently identified in COVID-19 patients, the underlying factors remain unclear. In this study, we assessed the association of the neurological manifestations and neuroimaging features of hospitalized COVID-19 p...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Shahid Beheshti University of Medical Sciences
2022-01-01
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| Series: | Archives of Academic Emergency Medicine |
| Subjects: | |
| Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1507 |
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| author | Ali Zare Dehnavi Mohammadreza Salehi Mehran Arab Ahmadi Mohammad Hossein Asgardoon Farzad Ashrafi Nasrin Ahmadinejad Atefeh Behkar Ramin Hamidi Farahani Hassan Hashemi Abbas Tafakhori Hamze Shahali Mohammad Rahmani Alireza Ranjbar Naeini |
| author_facet | Ali Zare Dehnavi Mohammadreza Salehi Mehran Arab Ahmadi Mohammad Hossein Asgardoon Farzad Ashrafi Nasrin Ahmadinejad Atefeh Behkar Ramin Hamidi Farahani Hassan Hashemi Abbas Tafakhori Hamze Shahali Mohammad Rahmani Alireza Ranjbar Naeini |
| author_sort | Ali Zare Dehnavi |
| collection | DOAJ |
| description | Introduction: Although neurologic involvement and neuroimaging abnormalities have been frequently identified in COVID-19 patients, the underlying factors remain unclear. In this study, we assessed the association of the neurological manifestations and neuroimaging features of hospitalized COVID-19 patients with their clinical, laboratory, and imaging characteristics.
Methods: This multicenter cross-sectional study was conducted between September 2020 and March 2021 at two large academic hospitals in Tehran, Iran. We used census sampling from medical records to enroll hospitalized patients with a positive COVID-19 Polymerase chain reaction (PCR) test who underwent brain imaging due to presenting any acute neurologic symptom during hospital stay.
Results: Of the 4372 hospitalized patients with COVID-19, only 211 met the inclusion criteria (35.5% with severe infection). Central nervous system and psychiatric manifestations were significantly more common in severe cases (p ≤ 0.044). Approximately, 30% had a new abnormality on their neuroimaging, with ischemic (38/63) and hemorrhagic (16/63) insults being the most common. The most frequent reasons that provoked cranial imaging were headache (27%), altered consciousness (25.6%), focal neurologic signs (19.9%), and delirium (18%). Analysis revealed a positive correlation for age, neutrophilia, lymphopenia, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) with the emergence of neuroimaging abnormalities (p ≤ 0.018). In addition, patients with new neuroimaging abnormalities had a significantly higher lung CT score than those without any pathologic findings (11.1 ± 4.8 vs. 5.9 ± 4.8, p < 0.001).
Conclusion: Approximately 30% of the study population had various acute neuroimaging findings. The lung CT score, neutrophil count, and age were strong predictors of acute neuroimaging abnormalities in hospitalized COVID-19 patients. |
| first_indexed | 2024-12-13T04:35:32Z |
| format | Article |
| id | doaj.art-67e653222069408fb7e4111e49403c10 |
| institution | Directory Open Access Journal |
| issn | 2645-4904 |
| language | English |
| last_indexed | 2024-12-13T04:35:32Z |
| publishDate | 2022-01-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Archives of Academic Emergency Medicine |
| spelling | doaj.art-67e653222069408fb7e4111e49403c102022-12-21T23:59:26ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042022-01-0110110.22037/aaem.v10i1.1507Clinical, Laboratory and Imaging Characteristics of Hospitalized COVID-19 Patients with Neurologic Involvement; a Cross-Sectional StudyAli Zare Dehnavi0Mohammadreza Salehi1Mehran Arab Ahmadi2Mohammad Hossein Asgardoon3Farzad Ashrafi4Nasrin Ahmadinejad5Atefeh Behkar6Ramin Hamidi Farahani7Hassan Hashemi8Abbas Tafakhori9Hamze Shahali10Mohammad Rahmani11Alireza Ranjbar Naeini12Department of neurology, School of Medicine, AJA University of Medical Sciences, Tehran, IranInfectious Diseases and Tropical Medicines Department, Tehran University of Medical Sciences, Tehran, IranAdvanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IranSchool of Medicine, Tehran University of Medical Sciences, Tehran, IranFunctional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellence, Shahid Beheshti University of Medical Sciences, Tehran, IranAdvanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IranSchool of Medicine, Tehran University of Medical Sciences, Tehran, IranDepartment of infectious disease, AJA University of Medical Sciences, Tehran, Iran3. Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, IranDepartment of Neurology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of aerospace and sub aquatic medicine, AJA University of Medical Sciences, Tehran, Iran.Department of Neurology, School of Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.Department of neurology, School of Medicine, AJA University of Medical Sciences, Tehran, IranIntroduction: Although neurologic involvement and neuroimaging abnormalities have been frequently identified in COVID-19 patients, the underlying factors remain unclear. In this study, we assessed the association of the neurological manifestations and neuroimaging features of hospitalized COVID-19 patients with their clinical, laboratory, and imaging characteristics. Methods: This multicenter cross-sectional study was conducted between September 2020 and March 2021 at two large academic hospitals in Tehran, Iran. We used census sampling from medical records to enroll hospitalized patients with a positive COVID-19 Polymerase chain reaction (PCR) test who underwent brain imaging due to presenting any acute neurologic symptom during hospital stay. Results: Of the 4372 hospitalized patients with COVID-19, only 211 met the inclusion criteria (35.5% with severe infection). Central nervous system and psychiatric manifestations were significantly more common in severe cases (p ≤ 0.044). Approximately, 30% had a new abnormality on their neuroimaging, with ischemic (38/63) and hemorrhagic (16/63) insults being the most common. The most frequent reasons that provoked cranial imaging were headache (27%), altered consciousness (25.6%), focal neurologic signs (19.9%), and delirium (18%). Analysis revealed a positive correlation for age, neutrophilia, lymphopenia, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) with the emergence of neuroimaging abnormalities (p ≤ 0.018). In addition, patients with new neuroimaging abnormalities had a significantly higher lung CT score than those without any pathologic findings (11.1 ± 4.8 vs. 5.9 ± 4.8, p < 0.001). Conclusion: Approximately 30% of the study population had various acute neuroimaging findings. The lung CT score, neutrophil count, and age were strong predictors of acute neuroimaging abnormalities in hospitalized COVID-19 patients.https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1507COVID-19NeurologyNeuroimagingChest CTCT severity scoreNeurologic Manifestations |
| spellingShingle | Ali Zare Dehnavi Mohammadreza Salehi Mehran Arab Ahmadi Mohammad Hossein Asgardoon Farzad Ashrafi Nasrin Ahmadinejad Atefeh Behkar Ramin Hamidi Farahani Hassan Hashemi Abbas Tafakhori Hamze Shahali Mohammad Rahmani Alireza Ranjbar Naeini Clinical, Laboratory and Imaging Characteristics of Hospitalized COVID-19 Patients with Neurologic Involvement; a Cross-Sectional Study Archives of Academic Emergency Medicine COVID-19 Neurology Neuroimaging Chest CT CT severity score Neurologic Manifestations |
| title | Clinical, Laboratory and Imaging Characteristics of Hospitalized COVID-19 Patients with Neurologic Involvement; a Cross-Sectional Study |
| title_full | Clinical, Laboratory and Imaging Characteristics of Hospitalized COVID-19 Patients with Neurologic Involvement; a Cross-Sectional Study |
| title_fullStr | Clinical, Laboratory and Imaging Characteristics of Hospitalized COVID-19 Patients with Neurologic Involvement; a Cross-Sectional Study |
| title_full_unstemmed | Clinical, Laboratory and Imaging Characteristics of Hospitalized COVID-19 Patients with Neurologic Involvement; a Cross-Sectional Study |
| title_short | Clinical, Laboratory and Imaging Characteristics of Hospitalized COVID-19 Patients with Neurologic Involvement; a Cross-Sectional Study |
| title_sort | clinical laboratory and imaging characteristics of hospitalized covid 19 patients with neurologic involvement a cross sectional study |
| topic | COVID-19 Neurology Neuroimaging Chest CT CT severity score Neurologic Manifestations |
| url | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1507 |
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