Patients with coronavirus disease 2019 (COVID-19) may have symptoms of anosmia or partial loss of the sense of smell, often accompanied by changes in taste. We report 5 cases (3 with anosmia) of adult patients with COVID-19 in whom injury to the olfactory bulbs was interpreted as microbleeding or abnormal enhancement on MR imaging. The patients had persistent headache (n ¼ 4) or motor deficits (n ¼ 1). This olfactory bulb injury may be the mechanism by which the Severe Acute Respiratory Syndrome coronavirus 2 causes olfactory dysfunction. ABBREVIATIONS: COVID-19 ¼ coronavirus disease 2019; SARS-CoV-2 ¼ Severe Acute Respiratory Syndrome coronavirus 2 C oronavirus has the human respiratory system as its main target but also has neuroinvasive capabilities and can spread from the respiratory tract to the CNS. 1-3 Therefore, patients with coronavirus disease 19 (COVID-19) may present with neurologic symptomatology with repercussions on imaging examinations, 4-18 and these have been described in association with ischemic infarct, 8,9 hemorrhage, 11 acute hemorrhagic necrotizing encephalopathy, 10 cerebral venous thrombosis, 13 and diffuse leukoencephalopathy with microhemorrhage. 15 Transmission from person to person occurs mainly by direct contact or droplets spread by coughing or sneezing by an infected individual with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). 5,19 Symptoms of COVID-19 usually appear after an incubation period of about 5 days. The most common symptoms are fever, cough, fatigue, headache, and dyspnea. 5,19,20 In the most severe cases, patients may develop pneumonia, acute respiratory failure, distress syndrome, and acute heart problems. 5,19,20 Anosmia or partial loss of the sense of smell, usually accompanied by changes in taste, is a frequent symptom that helps in the diagnosis of COVID-19. 21-28 It is often a transitory

No abstract

ObjectiveTo 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.Method876 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.Results5.59% 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 conclusionthe 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, an indication to ICU, a more severe form of lung disease, use of mechanical ventilator, seizure, sepsis and stroke. Less than half of patients had abnormal brain 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 or microthrombus and/or abnormal enhancement