DOI: 10.5061/dryad.w9ghx3fm7
title: Data from: Neurological and neuroimaging findings in COVID-19 patients: a retrospective multicenter study

description: Objective To describe neuroimaging findings and to report the
 epidemiological and clinical characteristics of COVID-19 patients with
 neurological manifestations. Methods In this retrospective multicenter
 study (10 Hospitals), we included 64 confirmed COVID-19 patients with
 neurologic manifestations who underwent a brain MRI. Results The cohort
 included 43 men (67%), 21 women (33%), and the median age was 66 years
 (range: 20-92). 36 (56%) brain MRIs were considered abnormal, possibly
 related to SARS-CoV-2. Ischemic strokes (27%), leptomeningeal enhancements
 (17%), and encephalitis (13%) were the most frequent neuroimaging
 findings. Confusion (53%) was the most common neurological manifestation,
 following by impaired consciousness (39%), presence of clinical signs of
 corticospinal tract involvement (31%), agitation (31%), and headache
 (16%). The profile of patients experiencing ischemic stroke was different
 from the other patients with abnormal brain imaging since the former had
 less frequently acute respiratory distress syndrome (p=0·006) and more
 frequently corticospinal tract signs (p=0·02). Patients with encephalitis
 were younger (p=0·007), whereas agitation was more frequent for patients
 with leptomeningeal enhancements (p=0·009). Conclusions COVID-19 patients
 may develop a wide range of neurological symptoms, which can be associated
 with severe and fatal complications, such as ischemic stroke or
 encephalitis. Concerning the meningoencephalitis involvement, even if a
 direct effect of the virus cannot be excluded, the pathophysiology rather
 seems to involve an immune and/or inflammatory process given the presence
 of signs of inflammation in both cerebrospinal fluid and neuroimaging but
 the lack of virus in cerebrospinal fluid.
description:   Figure e-1: Ischemic stroke. Axial diffusion
 (a), SWI (b), 3D TOF MR angiography (c). Man aged 71 years: right
 fronto-insular diffusion cortico-subcortical hyperintensity (arrow)
 corresponding to middle cerebral artery acute ischemic stroke.  Middle
 cerebral artery SWI hypointensity (star) (b) corresponding to a thrombus
 inducing arterial occlusion (cross)  
 Figure e-2: Radiological acute hemorrhagic necrotizing
 encephalopathy. Man aged 66 years: axial diffusion (a) Apparent Diffusion
 Coefficient (ADC) map (b), axial SWI (c,d), axial FLAIR (e), sagittal
 FLAIR (f). Left frontal intracerebral hematoma (cross). Corpus callosum
 FLAIR and diffusion signal abnormalities with ADC decrease (star)
 corresponding to cytotoxic edema. Peri hematoma and corpus callosum,
 multiple microhemorrhage on SWI weighted MR images (arrow).
   Figure e-3: Multiple correspondence
 analysis: considering each clinical manifestation separately, subjects can
 be distinguished mainly based on a global pattern depending on their
 oxygen requirement, seizure, gender, headaches, history of autoimmune
 disease, history of seizure, age, anosmia, confusion and disturbances of
 consciousness.    References: 0=absence; 1=presence; HSt= history of
 seizures; O2= oxygen therapy; OtherH= another neurological history; Seiz=
 Seizures; CST= corticospinal tract involvement; HA= headaches; HAI=
 history of autoimmune diseases; HHM= history of hematological
 malignancies; HSeiz= history of seizures; Agit= agitation; Agueus=
 ageusia; Anos= anosmia; Conf= Confusion; Consc= disturbance of
 consciousness