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COVID-19-associated Diffuse Leukoencephalopathy and Microhemorrhages

Alireza Radmanesh1, Anna Derman1, Yvonne W Lui1

  • 1From the Department of Radiology, New York University Grossman School of Medicine, 660 First Ave, 2nd Floor, New York, NY 10016.

Radiology
|May 22, 2020
PubMed

Insights

Critically ill patients with coronavirus disease 2019 (COVID-19) showed specific brain imaging findings. These included white matter changes and microhemorrhages, suggesting neurological complications in severe COVID-19.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to various neurological complications.
  • Brain imaging in COVID-19 patients has revealed findings like infarcts, hemorrhages, and encephalopathy.

Purpose of the Study:

  • To report and characterize specific brain imaging features in critically ill COVID-19 patients with persistent altered mental status.
  • To investigate potential pathogeneses of observed neurological findings in severe COVID-19.

Main Methods:

  • Magnetic Resonance Imaging (MRI) was performed on 11 critically ill COVID-19 patients.
  • Imaging analysis focused on white matter abnormalities and microhemorrhages.

Main Results:

  • Ten of 11 patients exhibited confluent T2 hyperintensity and mild restricted diffusion in deep and subcortical white matter.
  • Seven of 11 patients presented with multiple punctate microhemorrhages in juxtacortical and callosal white matter.

Conclusions:

  • Diffuse leukoencephalopathy and microhemorrhages are significant brain imaging findings in severe COVID-19.
  • These findings suggest a potential pattern of neurological injury associated with COVID-19.

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