Brain MR Spectroscopic Findings in 3 Consecutive Patients with COVID-19: Preliminary Observations
O Rapalino1, A Weerasekera2,3, S J Moum4
1From the Departments of Radiology (O.R., A.W., K.E.-H., M.L.L., P.W.S., R.G.G., M.H.L., E.R.) orapalino@mgh.harvard.edu.
AJNR. American Journal of Neuroradiology
|October 30, 2020
Summary
Magnetic Resonance (MR) spectroscopic imaging reveals distinct brain metabolite changes in patients with coronavirus disease 2019 (COVID-19). These findings, including reduced N-acetylaspartate and elevated choline, suggest white matter injury patterns similar to hypoxic brain damage.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) can cause neurological complications.
- White matter changes have been observed in some COVID-19 patients.
- The specific neurochemical alterations in COVID-19-related brain injury are not fully understood.
Purpose of the Study:
- To investigate brain metabolite changes using multivoxel MR spectroscopic imaging in patients with COVID-19.
- To compare these findings with non-COVID-19 white matter pathology and healthy controls.
- To characterize the pattern of neurochemical alterations in COVID-19-associated neurological complications.
Main Methods:
- Multivoxel MR spectroscopic imaging was performed on three patients with COVID-19.
- Patients included those with necrotizing leukoencephalopathy, post-cardiac arrest with white matter changes, and mild symptoms.
- Findings were compared to two patients with non-SARS-CoV-2 white matter disease and one healthy control.
Main Results:
- The patient with COVID-19-associated necrotizing leukoencephalopathy showed significant N-acetylaspartate reduction, choline elevation, and glutamate/glutamine elevation.
- Similar, though less pronounced, metabolite changes were observed in the COVID-19 patient with a history of cardiac arrest.
- Lactate elevation was most prominent in the necrotizing leukoencephalopathy case.
- These patterns resembled those seen in delayed posthypoxic leukoencephalopathy.
Conclusions:
- MR spectroscopic imaging can detect specific neurochemical alterations in the brains of COVID-19 patients.
- COVID-19-associated white matter injury may share metabolic similarities with hypoxic brain injury.
- Further research is warranted to understand the long-term neurological implications of these findings.
