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 6 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.

CT: Computed tomography CTPA: Computed tomography pulmonary angiography DDU: D-dimer units DVT: Deep venous thrombosis PCR: Polymerase chain reaction ROC: Receiver operator characteristic Key results: 1. CTPA was positive for pulmonary embolism in 37% of COVID-19 patients. 2. D-dimer levels directly correlate with the presence and extent of pulmonary embolism as indicated by the Mastora index and can be used to risk stratify patients for pulmonary embolism workup. Summary Statement Patients with confirmed COVID-19 had pulmonary embolism diagnosed in 37% of CTPA examinations with D-dimer levels associated with the presence of pulmonary embolism and the degree of pulmonary artery obstruction.

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