Prevalence and 3-month follow-up of cerebrovascular MRI markers in hospitalized COVID-19 patients: the CORONIS study

Neuroradiology. 2024 Sep;66(9):1565-1575. doi: 10.1007/s00234-024-03411-1. Epub 2024 Jul 2.

Abstract

Purpose: To investigate the prevalence of cerebrovascular MRI markers in unselected patients hospitalized for COVID-19 (Coronavirus disease 2019), we compared these with healthy controls without previous SARS-CoV-2 infection or hospitalization and subsequently, investigated longitudinal (incidental) lesions in patients after three months.

Methods: CORONIS (CORONavirus and Ischemic Stroke) was an observational cohort study in adult hospitalized patients for COVID-19 and controls without COVID-19, conducted between April 2021 and September 2022. Brain MRI was performed shortly after discharge and after 3 months. Outcomes included recent ischemic (DWI-positive) lesions, previous infarction, microbleeds, white matter hyperintensities (WMH) and intracerebral hemorrhage and were analysed with logistic regression to adjust for confounders.

Results: 125 patients with COVID-19 and 47 controls underwent brain MRI a median of 41.5 days after symptom onset. DWI-positive lesions were found in one patient (1%) and in one (2%) control, both clinically silent. WMH were more prevalent in patients (78%) than in controls (62%) (adjusted OR: 2.95 [95% CI: 1.07-8.57]), other cerebrovascular MRI markers did not differ. Prevalence of markers in ICU vs. non-ICU patients was similar. After three months, five patients (5%) had new cerebrovascular lesions, including DWI-positive lesions (1 patient, 1.0%), cerebral infarction (2 patients, 2.0%) and microbleeds (3 patients, 3.1%).

Conclusion: Overall, we found no higher prevalence of cerebrovascular markers in unselected hospitalized COVID-19 patients compared to controls. The few incident DWI-lesions were most likely to be explained by risk-factors of small vessel disease. In the general hospitalized COVID-19 population, COVID-19 shows limited impact on cerebrovascular MRI markers shortly after hospitalization.

Keywords: Brain ischemia; COVID-19; Cerebrovascular disorders; MRI; SARS-CoV-2; WMH.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • COVID-19* / diagnostic imaging
  • COVID-19* / epidemiology
  • Case-Control Studies
  • Cerebrovascular Disorders / diagnostic imaging
  • Cerebrovascular Disorders / epidemiology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hospitalization
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Prevalence
  • SARS-CoV-2