Prevalence and 3-month follow-up of cerebrovascular MRI markers in hospitalized COVID-19 patients: the CORONIS study.

IF 2.4 3区医学 Q2 CLINICAL NEUROLOGY Neuroradiology Pub Date : 2024-09-01 Epub Date: 2024-07-02 DOI:10.1007/s00234-024-03411-1

Theresa J van Lith, Wouter M Sluis, Naomi T Wijers, Frederick J A Meijer, Karin Kamphuis-van Ulzen, Jeroen de Bresser, Jan Willem Dankbaar, Quirijn de Mast, Frederikus A Klok, Suzanne C Cannegieter, Marieke J H Wermer, Menno V Huisman, Anil M Tuladhar, H Bart van der Worp, Frank-Erik de Leeuw

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Abstract

Purpose: To investigate the prevalence of cerebrovascular MRI markers in unselected patients hospitalized for COVID-19 (Coronavirus disease 2019), we compared these with healthy controls without previous SARS-CoV-2 infection or hospitalization and subsequently, investigated longitudinal (incidental) lesions in patients after three months.

Methods: CORONIS (CORONavirus and Ischemic Stroke) was an observational cohort study in adult hospitalized patients for COVID-19 and controls without COVID-19, conducted between April 2021 and September 2022. Brain MRI was performed shortly after discharge and after 3 months. Outcomes included recent ischemic (DWI-positive) lesions, previous infarction, microbleeds, white matter hyperintensities (WMH) and intracerebral hemorrhage and were analysed with logistic regression to adjust for confounders.

Results: 125 patients with COVID-19 and 47 controls underwent brain MRI a median of 41.5 days after symptom onset. DWI-positive lesions were found in one patient (1%) and in one (2%) control, both clinically silent. WMH were more prevalent in patients (78%) than in controls (62%) (adjusted OR: 2.95 [95% CI: 1.07-8.57]), other cerebrovascular MRI markers did not differ. Prevalence of markers in ICU vs. non-ICU patients was similar. After three months, five patients (5%) had new cerebrovascular lesions, including DWI-positive lesions (1 patient, 1.0%), cerebral infarction (2 patients, 2.0%) and microbleeds (3 patients, 3.1%).

Conclusion: Overall, we found no higher prevalence of cerebrovascular markers in unselected hospitalized COVID-19 patients compared to controls. The few incident DWI-lesions were most likely to be explained by risk-factors of small vessel disease. In the general hospitalized COVID-19 population, COVID-19 shows limited impact on cerebrovascular MRI markers shortly after hospitalization.

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COVID-19住院患者脑血管磁共振成像标记物的流行率和3个月随访：CORONIS研究。

目的：为了调查未经选择的COVID-19（2019年冠状病毒病）住院患者的脑血管MRI标志物的流行情况，我们将这些患者与既往未感染SARS-CoV-2或未住院的健康对照组进行了比较，随后调查了患者三个月后的纵向（偶然）病变：CORONIS（CORONavirus and Ischemic Stroke）是一项观察性队列研究，在2021年4月至2022年9月期间对因COVID-19住院的成人患者和未感染COVID-19的对照组进行了研究。患者出院后不久和 3 个月后均进行了脑磁共振成像检查。研究结果包括近期缺血性（DWI阳性）病变、既往脑梗塞、微出血、白质高密度（WMH）和脑内出血，并通过逻辑回归进行分析，以调整混杂因素：125名COVID-19患者和47名对照组患者在症状出现后中位41.5天接受了脑磁共振成像检查。在一名患者（1%）和一名对照组患者（2%）中发现了 DWI 阳性病灶，这两名患者均无临床症状。患者（78%）的WMH发生率高于对照组（62%）（调整后OR：2.95 [95% CI：1.07-8.57]），其他脑血管MRI标记物没有差异。重症监护病房与非重症监护病房患者的标记物流行率相似。三个月后，五名患者（5%）出现了新的脑血管病灶，包括 DWI 阳性病灶（1 名患者，1.0%）、脑梗塞（2 名患者，2.0%）和微出血（3 名患者，3.1%）：总体而言，与对照组相比，我们在未经选择的 COVID-19 住院患者中没有发现更高的脑血管标记物发病率。小血管疾病的风险因素很可能是造成少数 DWI 病变的原因。在 COVID-19 的一般住院人群中，COVID-19 对住院后不久的脑血管 MRI 标志物的影响有限。

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来源期刊

Neuroradiology 医学-核医学

CiteScore

5.30

自引率

3.60%

发文量

214

审稿时长

4-8 weeks

期刊介绍： Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.