• Scott H Faro, Arichena Manmatharayan, Benjamin Leiby, Neelu Jain, Feroze B Mohamed, Kiran S Talekar, Amish Doshi, Ivan Jambor, Sanders Chang, Mark Finkelstein, Stephane Kremer, Francois Lersy, Brenden Lindgren, Nathalia M Figueiredo, Simonetta Gerevini, Angela Napolitano, Rajan Jain, Siddhanth Dogra, Jay J Pillai, Dan Ryan, Rolf Jager, Francesco Carletti, Asim Mian, Artem Kaliev, Pria Anand, Courtney Takahashi, Ak Murat, Rivka Colen, Giancarlo Mansueto, and Francesca Pizzini.
• Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, United States.
• J Neuroimaging. 2023 Sep 1; 33 (5): 752763752-763.

Background And PurposeTo determine the incidence of acute neuroimaging (NI) findings and comorbidities in the coronavirus disease of 2019 (COVID-19)-infected subjects in seven U.S. and four European hospitals.MethodsThis is a retrospective study of COVID-19-positive subjects with the following inclusion criteria: age >18, lab-confirmed COVID-19 infection, and acute NI findings (NI+) attributed to COVID-19 on CT or MRI brain. NI+ and comorbidities in total hospitalized COVID-19-positive (TN) subjects were assessed.ResultsA total of 37,950 COVID-19-positive subjects were reviewed and 4342 underwent NI. NI+ incidence in subjects with NI was 10.1% (442/4342) including 7.9% (294/3701) in the United States and 22.8% (148/647) in Europe. NI+ incidence in TN was 1.16% (442/37,950). In NI (4342), incidence of ischemic stroke was 6.4% followed by intracranial hemorrhage (ICH) (3.8%), encephalitis (0.5%), sinus venous thrombosis (0.2%), and acute disseminated encephalomyelitis (ADEM) (0.2%). White matter involvement was seen in 57% of NI+. Hypertension was the most common comorbidity (54%) before cardiac disease (28.8%) and diabetes mellitus (27.7%). Cardiac disease (p < .025), diabetes (p < .014), and chronic kidney disease (p < .012) were more common in the United States.ConclusionThis multicenter, multinational study investigated the incidence and spectrum of NI+ in 37,950 hospitalized adult COVID-19 subjects including regional differences in incidences of NI+, associated comorbidities, and other demographics. NI+ incidence in TN was 1.16% including 0.95% in the United States and 2.09% in Europe. ICH, encephalitis, and ADEM were common in Europe, while ischemic strokes were more common in the United States. In this cohort, incidence and distribution of NI+ helped characterize the neurological complications of COVID-19.© 2023 American Society of Neuroimaging.

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