Neuroimaging findings and neurological manifestations in hospitalized COVID-19 patients: Impact of cancer and ventilatory support status.
Neuroimaging findings and neurological manifestations in hospitalized COVID-19 patients: Impact of cancer and ventilatory support status.
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DOI：
10.1371/journal.pone.0283614
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
中科院分区：
文献类型：
--
作者：
已知 2019 年冠状病毒 (COVID-19) 会影响中枢神经系统。与 COVID-19 相关的神经系统发病通常归因于血栓形成和炎症过程的某些组合的后遗症。这项回顾性观察研究的目的是评估癌症与非癌症患者、有通气支持与无通气支持的患者（通气支持定义为包括插管和无创通气的患者）中具有神经系统表现的住院 COVID-19 患者的神经影像学结果。癌症患者经常处于免疫功能低下或血栓前状态，化疗和放疗的副作用可能会导致神经系统问题并增加患全身性疾病的可能性。我们想要确定患有癌症和未患癌症的患者之间的神经学和/或神经影像学结果是否存在差异。 2020 年 3 月至 2021 年 4 月期间，纽约市西奈山卫生系统住院的 80 名成年人（44 名男性，36 名女性，64.5 ±14 岁）经逆转录酶聚合酶链反应确诊为 COVID-19，在入院期间接受了磁共振成像 (MRI)。该队列根据癌症和通气支持状态由四个相等的亚组组成。采集并分析临床和影像数据。神经影像学检查结果包括非缺血性脑实质T2/FLAIR信号高信号（36.3%）、急性/亚急性梗塞（26.3%）、慢性梗塞（25.0%）、微出血（23.8%）、慢性大出血（10.0%）、急性大出血（7.5%）和脑炎样发现（7.5%）。癌症和非癌症亚组之间的神经影像学结果没有显着差异。临床神经系统表现多种多样。最常见的是脑病（77.5%），其次是反应性受损/昏迷（38.8%）和中风（26.3%）。有通气支持的患者与无通气支持的患者之间存在显着差异。接受通气支持的患者中脑病和反应性受损/昏迷更为常见 (p = 0.02)。局灶性无力在没有通气支持的患者中更为常见 (p = 0.01)。这项研究表明，COVID-19 与神经系统表现有关，这些神经系统表现可能通过 MRI 等脑成像技术可见。在我们的 COVID-19 队列中，癌症状态与神经影像学结果之间没有关联。未来的研究可能包括更多前瞻性招募的系统特征患者，以便进行更严格的统计分析。
Coronavirus 2019 (COVID-19) is known to affect the central nervous system. Neurologic morbidity associated with COVID-19 is commonly attributed to sequelae of some combination of thrombotic and inflammatory processes. The aim of this retrospective observational study was to evaluate neuroimaging findings in hospitalized COVID-19 patients with neurological manifestations in cancer versus non-cancer patients, and in patients with versus without ventilatory support (with ventilatory support defined as including patients with intubation and noninvasive ventilation). Cancer patients are frequently in an immunocompromised or prothrombotic state with side effects from chemotherapy and radiation that may cause neurological issues and increase vulnerability to systemic illness. We wanted to determine whether neurological and/or neuroimaging findings differed between patients with and without cancer. Eighty adults (44 male, 36 female, 64.5 ±14 years) hospitalized in the Mount Sinai Health System in New York City between March 2020 and April 2021 with reverse-transcriptase polymerase chain reaction-confirmed COVID-19 underwent magnetic resonance imaging (MRI) during their admissions. The cohort consisted of four equal subgroups based on cancer and ventilatory support status. Clinical and imaging data were acquired and analyzed. Neuroimaging findings included non-ischemic parenchymal T2/FLAIR signal hyperintensities (36.3%), acute/subacute infarcts (26.3%), chronic infarcts (25.0%), microhemorrhages (23.8%), chronic macrohemorrhages (10.0%), acute macrohemorrhages (7.5%), and encephalitis-like findings (7.5%). There were no significant differences in neuroimaging findings between cancer and non-cancer subgroups. Clinical neurological manifestations varied. The most common was encephalopathy (77.5%), followed by impaired responsiveness/coma (38.8%) and stroke (26.3%). There were significant differences between patients with versus without ventilatory support. Encephalopathy and impaired responsiveness/coma were more prevalent in patients with ventilatory support (p = 0.02). Focal weakness was more frequently seen in patients without ventilatory support (p = 0.01). This study suggests COVID-19 is associated with neurological manifestations that may be visible with brain imaging techniques such as MRI. In our COVID-19 cohort, there was no association between cancer status and neuroimaging findings. Future studies might include more prospectively enrolled systematically characterized patients, allowing for more rigorous statistical analysis.
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影响因子：
19.7
作者：
Kanne JP;Bai H;Bernheim A;Chung M;Haramati LB;Kallmes DF;Little BP;Rubin GD;Sverzellati N
通讯作者：
Sverzellati N
影响因子：
6
作者：
Harapan BN;Yoo HJ
通讯作者：
Yoo HJ
DOI：
10.1007/s00259-020-05178-y
发表时间：
2021-07
影响因子：
9.1
作者：
Kas A;Soret M;Pyatigoskaya N;Habert MO;Hesters A;Le Guennec L;Paccoud O;Bombois S;Delorme C;on the behalf of CoCo-Neurosciences study group and COVID SMIT PSL study group
通讯作者：
on the behalf of CoCo-Neurosciences study group and COVID SMIT PSL study group
影响因子：
3.5
作者：
Lang, M.;Li, M. D.;Buch, K.
通讯作者：
Buch, K.
影响因子：
15.1
作者：
Lu, Yiping;Li, Xuanxuan;Yin, Bo
通讯作者：
Yin, Bo