Brain Imaging Use and Findings in COVID-19: A Single Academic Center Experience in the Epicenter of Disease in the United States

Radmanesh, A.; Raz, E.; Zan, E.; Derman, A.; Kaminetzky, M.

Coronavirus disease 2019 (COVID-19) is a serious public health crisis and can have neurologic manifestations This is a retrospective observational case series performed March 1-31, 2020, at New York University Langone Medical Center campuses Clinical and imaging data were extracted, reviewed, and analyzed Two hundred forty-two patients with COVID-19 underwent CT or MRI of the brain within 2 weeks after the positive result of viral testing (mean age, 68 7 +/- 16 5 years;150 men/92 women [62 0%/38 0%]) The 3 most common indications for imaging were altered mental status (42 1%), syncope/fall (32 6%), and focal neurologic deficit (12 4%) The most common imaging findings were nonspecific white matter microangiopathy (134/55 4%), chronic infarct (47/19 4%), acute or subacute ischemic infarct (13/5 4%), and acute hemorrhage (11/4 5%) No patients imaged for altered mental status demonstrated acute ischemic infarct or acute hemorrhage White matter microangiopathy was associated with higher 2-week mortality (P < 001) Our data suggest that in the absence of a focal neurologic deficit, brain imaging in patients with early COVID-19 with altered mental status may not be revealing