Neuroimaging findings of COVID-19: a systematic review on longitudinal studies

Abstract

Background: There is high number of evidence regarding the involvement of the central nervous system (CNS) in patients with severe acute respiratory syndrome coronavirus-2 (SARS-COV-2). The aim of our systematic review study is to evaluate the current state of knowledge regarding neuroimaging findings after COVID-19 by focusing on longitudinal studies. By limiting our review to this type of study design, we aimed to provide a more comprehensive and detailed picture of the long-term effects of COVID-19 on the brain. Methods: Three electronic databases (PubMed, Scopus, and Web of Science) were searched for relevant studies. We included studies that investigated longitudinal brain changes in patients with COVID-19 with available neuroimaging findings at least two different times. Results: After a two-step review, 10 studies were included in our qualitative synthesis. Brain MRI was the only imaging modality in seven studies, whereas one used only FDG-PET, one used CT/MRI, and one used CT/MRI/FDG-PET. Our results demonstrated consistent evidence of lesions, white matter microstructural, grey matter, metabolism, and blood flow alterations in comparison with healthy controls. Conclusion: Our systematic review provides evidence of widespread microstructural, grey matter, metabolism, and blood flow alterations in patients afflicted with COVID-19. The longitudinal nature of the included studies highlights the importance of ongoing monitoring and follow-up imaging in patients after COVID-19 infection.

A Comprehensive Review on Navigating the Neurological Landscape of COVID-19: Insights Into Etiopathogenesis and Clinical Management

“…Neuroimaging modalities play a crucial role in diagnosing and managing neurological manifestations in COVID-19 patients, with brain MRI being the most commonly utilized modality in clinical practice. According to a systematic review, brain MRI was employed in seven of ten studies [50]. The recommended MRI protocol typically includes a combination of T2-weighted, FLAIR (preferably 3D), and diffusionweighted images, along with hemorrhage-sensitive sequences (preferably SWI) and pre-and post-contrast T1 weighted-images for the initial investigation [51].…”