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Comparative Study - The Impact and Profile of COVID-19 Patients Who Are Indicated for Neuroimaging: Vascular Phenomena Are Been Found in the Brain and Olfactory Bulbs
medRxiv - Neurology Pub Date : 2021-01-04 , DOI: 10.1101/2020.12.28.20248957
Maria de Fatima Viana Vasco Aragao , Mariana de Carvalho Leal , Ocelio Queiroga Cartaxo Filho , Tatiana Moreira Fonseca , Lucas Vasco Aragao , Maria Regina Vendas Carneiro Leao , Marcelo Andrade Valenca , Pedro Henrique Pereira de Andrade , Joao Pedro Vasco Aragao , Silvio da Silva Caldas Neto , Marcelo Moraes Valenca

Objective: To verify the impact and findings of the COVID-19 patients group that underwent brain scans in comparison to the group which only chest CT was performed. Method: 876 suspected COVID-19 patients and a subsample of 232 cases with confirmed COVID-19 who underwent brain CT/MRI scan (n=35) or only chest CT (n=197) in two radiology departments, were evaluated. Results: 5.59% of all suspected COVID-19 patients found had brain scans and 98.74% chest CT. There was a statistically significant difference with associations regarding the COVID-19 brain scan group for: admission to ICU, greater severity of lung injuries, the use of mechanical ventilator, seizure, sepsis, and stroke and statistical tendency for chronic renal failure and systemic arterial hypertension. 40.0% of COVID-19 patients from the brain scan group were abnormal on brain CT and/or brain MRI. 22.9% cases with any kind of bleeding or microbleeding, 8.6% with restricted diffusion lesions. One ischemic stroke case was associated with irregularity at M1 segment of the right middle cerebral artery. There was a case of left facial nerve palsy with enhancement of left geniculate ganglia. An analyse of the olfactory bulbs was possible in 12 brain MRIs and 100% had enhancement and/or microbleeding. There was no statistical difference regarding death (9.1% versus 5.2%). In conclusion: the COVID-19 patients group on which brain CT and/or MRI needed to be performed was statically associated with the more severe COVID-19 disease. Less than half of patients had abnormal imaging scans with all of them showing vascular brain injury lesion, being more frequently microbleeding or bleeding, followed by restricted diffusion lesions. All the olfactory bulbs evaluated showed injury by vascular phenomenon, probably methahemoglobine by microbleeding and/or abnormal enhancement

中文翻译:

比较研究-神经影像学指征的COVID-19患者的影响和概况:在脑和嗅球中发现了血管现象

目的:与仅进行胸部CT检查的组相比,验证接受脑部扫描的COVID-19患者组的影响和发现。方法:评估了876名疑似COVID-19患者和232例确诊的COVID-19患者的子样本,分别在两个放射科进行了脑部CT / MRI扫描(n = 35)或仅进行了胸部CT(n = 197)。结果:发现的所有可疑COVID-19患者中有5.59%进行了脑部扫描,而胸部CT达到了98.74%。COVID-19脑扫描组的相关性在统计学上有显着差异:入住ICU,肺损伤严重程度更高,使用机械呼吸机,癫痫发作,败血症和中风,以及慢性肾功能衰竭和全身动脉的统计趋势高血压。40 来自脑部扫描组的COVID-19患者中有0%的脑部CT和/或脑部MRI异常。22.9%的病例有任何形式的出血或微出血,8.6%的病例具有弥散性病变。1例缺血性中风病例与右中脑动脉M1段不规则有关。有一例左面部神经麻痹伴左膝状神经节增强。可以在12例脑部MRI中分析嗅球,并且100%具有嗅觉增强和/或微出血。死亡无统计学差异(9.1%对5.2%)。结论:需要进行脑部CT和/或MRI检查的COVID-19患者组与更严重的COVID-19疾病静态相关。不到一半的患者影像学扫描异常,所有患者均显示血管脑损伤病变,经常出现微出血或出血,然后扩散受限。评估的所有嗅球均显示出血管现象造成的损伤,可能是甲闪血球蛋白因微出血和/或异常增强所致
更新日期:2021-01-04
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