Modelling the Anatomical Distribution of Neurological Events in COVID-19 Patients: A Systematic Review

Abstract

Background Neuropathology caused by the coronavirus disease 2019 (COVID-19) has been reported across several studies. The characterisation of the spatial distribution of these pathology remains critical to assess long and short-term neurological sequelae of COVID-19. To this end, Mathematical models can be used to characterise the location and aetiologies underlying COVID-19-related neuropathology. Method We performed a systematic review of the literature to quantify the locations of small neurological events identified with magnetic resonance imaging (MRI) among COVID-19 patients. Neurological events were localised into the Desikan-Killiany grey and white matter atlases. A mathematical network diffusion model was then used to test whether the spatial distribution of neurological events could be explained via a linear spread through the structural connectome of the brain. Findings We identified 35 articles consisting of 123 patients that assessed the spatial distribution of small neurological events among COVID-19 patients. Of these, 91 patients had grey matter changes, 95 patients had white matter changes and 72 patients had confirmed cerebral microbleeds. White matter events were observed within 14 of 42 white matter bundles from the IIT atlas. The highest proportions (26%) of events were observed within the bilateral corticospinal tracts. The splenium and middle of the corpus callosum were affected in 14% and 9% of the cases respectively. Grey matter events were spatially distributed in the 41 brain regions within the Desikan-Killiany atlas. The highest proportions (~10%) of the events were observed in areas including the bilateral superior temporal, precentral, and lateral occipital cortices. Sub-cortical events were most frequently identified in the Pallidum. The application of a mathematical network diffusion model suggested that the spatial pattern of the small neurological events in COVID-19 can be modelled with a linear diffusion of spread from epicentres in the bilateral cerebellum and basal ganglia (Pearsons r=0.41, p<0.001, corrected). Interpretation To our knowledge, this is the first study to systematically characterise the spatial distribution of small neurological events in COVID-19 patients and test whether the spatial distribution of these events can be explained by a linear diffusion spread model. The location of neurological events is consistent with commonly identified neurological symptoms including alterations in conscious state among COVID-19 patients that require brain imaging. Given the prevalence and severity of these manifestations, clinicians should carefully monitor neurological symptoms within COVID-19 patients and their potential long-term sequelae.

The effect of COVID19 pandemic restrictions on an urban rodent population

“…Parsons et al argued that the strong association between rat sightings and cafes or restaurants, as well as the development of new rat sightings hotspots, suggested mass movements of rats had been triggered by lockdown. Moreover, they suggest that this pattern was not observed in Warsaw, Poland due to the lack of clustering of restaurants 41 . An important limitation of Parsons et al 41 was that it used public perception as a proxy for rodent abundance and movements.…”

“…Moreover, they suggest that this pattern was not observed in Warsaw, Poland due to the lack of clustering of restaurants 41 . An important limitation of Parsons et al 41 was that it used public perception as a proxy for rodent abundance and movements. Although there can be a reliable relationship between public complaints and rodent abundance 42 , this has not been validated during abnormal times such as COVID-19.…”

“…Parsons et al released a preprint in which they investigated how stay-at-home measures affected rat sightings in various urbanized environments. They analyzed rat-related public complaints in New York City and Tokyo and surveyed pest control companies in the United States, Canada, Japan and Poland 41 . They reported that the two cities displayed a different patterns of rat-related public requests, with increases in Tokyo and decreases in New York City 41 .…”

“…They analyzed rat-related public complaints in New York City and Tokyo and surveyed pest control companies in the United States, Canada, Japan and Poland 41 . They reported that the two cities displayed a different patterns of rat-related public requests, with increases in Tokyo and decreases in New York City 41 . Importantly, they reported a positive association between rat sightings and food service establishments in both cities, with the formation of new rat sighting hotspots during the lockdown period 41 .…”

“…They reported that the two cities displayed a different patterns of rat-related public requests, with increases in Tokyo and decreases in New York City 41 . Importantly, they reported a positive association between rat sightings and food service establishments in both cities, with the formation of new rat sighting hotspots during the lockdown period 41 . Parsons et al argued that the strong association between rat sightings and cafes or restaurants, as well as the development of new rat sightings hotspots, suggested mass movements of rats had been triggered by lockdown.…”