• Lydia Chougar, Natalia Shor, Nicolas Weiss, Damien Galanaud, Delphine Leclercq, Bertrand Mathon, Samia Belkacem, Sebastian Ströer, Sonia Burrel, David Boutolleau, Alexandre Demoule, Charlotte Rosso, Cécile Delorme, Danielle Seilhean, Didier Dormont, Elise Morawiec, Mathieu Raux, Sophie Demeret, Sophie Gerber, Stéphanie Trunet, Thomas Similowski, Vincent Degos, Pierre Rufat, Jean-Christophe Corvol, Stéphane Lehéricy, Nadya Pyatigorskaya, and CoCo Neurosciences Study Group.
• From the Sorbonne Université, Inserm, CNRS, Institut du Cerveau-Paris Brain Institute (ICM), F-75013 Paris, France (L.C., D.G., B.M., C.R., D.D., J.C.C., S.L., N.P.); Sorbonne Université, INSERM 75013 Paris, France (L.C., N.S., N.W., D.G., B.M., S. Burrel, D.B., A.D., C.R., D.S., D.D., E.M., M.R., T.S., V.D., J.C.C., S.L., N.P.); Paris Brain Institute - ICM, Movement Investigations and Therapeutics Team (MOV'IT), Paris, France (L.C., S.L., N.P.); ICM, Centre de NeuroImagerie de Recherche-CENIR, Paris, France (L.C., D.G., S.L., N.P.); Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Service de Neuroradiologie (L.C., N.S., D.G., D.L., S. Belkacem, S.S., D.D., S.G., S.T., S.L., N.P.), Médecine Intensive Réanimation Neurologique (N.W.), Service de Neurochirurgie (B.M.), Service de Virologie, Centre d'Investigation Clinique Neurosciences (S. Burrel, D.B.), Service de Pneumologie, Médecine Intensive et Réanimation (A.D., E.M., T.S.), Urgences Cérébro-Vasculaires (C.R.), Département de Neurologie, Centre d'Investigation Clinique Neurosciences (C.D., J.C.C.), Département de Neuropathologie (D.S.), Department of Anesthesia, Critical Care and Peri-Operative Medicine (M.R., V.D.), Paris, France; Brain Liver Pitié-Salpêtrière Study Group, INSERM UMR S 938, Centre de Recherche Saint-Antoine, Maladies Métaboliques, biliaires et fibro-inflammatoire du foie, Institute of Cardiometabolism and Nutrition (N.W., S.D.); CNR Herpèsvirus (laboratoire associé HSV), SU-INSERM UMR_S 1136 Team 3 THERAVIR IPLESP (S. Burrel, D.B.); ICM, Stroke Network, STAR Team, Paris, France (C.R.); Assistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpêtrière,; ICM, INRIA, ARAMIS project-team, Paris, France (D.D., M.R.); Clinical Research Group ARPE, Sorbonne University, Paris, France (V.D.); INSERM UMR 1141, Paris France (V.D.); and Assistance Publique Hôpitaux de Paris, DMU ESPRIT, Paris, France (P.R.).
• Radiology. 2020 Dec 1; 297 (3): E313-E323.

AbstractBackground This study provides a detailed imaging assessment in a large series of patients infected with coronavirus disease 2019 (COVID-19) and presenting with neurologic manifestations. Purpose To review the MRI findings associated with acute neurologic manifestations in patients with COVID-19. Materials and Methods This was a cross-sectional study conducted between March 23 and May 7, 2020, at the Pitié-Salpêtrière Hospital, a reference center for COVID-19 in the Paris area. Adult patients were included if they had a diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and referral for brain MRI. Patients with a prior history of neurologic disease were excluded. The characteristics and frequency of different MRI features were investigated. The findings were analyzed separately in patients in intensive care units (ICUs) and other departments (non-ICU). Results During the inclusion period, 1176 patients suspected of having COVID-19 were hospitalized. Of 308 patients with acute neurologic symptoms, 73 met the inclusion criteria and were included (23.7%): thirty-five patients were in the ICU (47.9%) and 38 were not (52.1%). The mean age was 58.5 years ± 15.6 [standard deviation], with a male predominance (65.8% vs 34.2%). Forty-three patients had abnormal MRI findings 2-4 weeks after symptom onset (58.9%), including 17 with acute ischemic infarct (23.3%), one with a deep venous thrombosis (1.4%), eight with multiple microhemorrhages (11.3%), 22 with perfusion abnormalities (47.7%), and three with restricted diffusion foci within the corpus callosum consistent with cytotoxic lesions of the corpus callosum (4.1%). Multifocal white matter-enhancing lesions were seen in four patients in the ICU (5%). Basal ganglia abnormalities were seen in four other patients (5%). Cerebrospinal fluid analyses were negative for SARS-CoV-2 in all patients tested (n = 39). Conclusion In addition to cerebrovascular lesions, perfusion abnormalities, cytotoxic lesions of the corpus callosum, and intensive care unit-related complications, we identified two patterns including white matter-enhancing lesions and basal ganglia abnormalities that could be related to severe acute respiratory syndrome coronavirus 2 infection. © RSNA, 2020 Online supplemental material is available for this article.

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