Brain MRI Imaging in Patients With SARS-Cov2 (COVID-19) Infection With or Without Anosmia

Study Overview
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Brief Summary
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To date there is no brain imaging and olfactory data available in COVID-19 positive patients with anosmia. By describing the pathophysiological characteristics underlying the olfactory symptoms and clinical characteristics of COVID-19 infection, the study investigators wish to compare the MRI aspects obtained in COVID-19 patients with and without anosmia, in the absence of other underlying neurological disorders.

Detailed Description
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Brain mapping of COVID-19 patients with or without anosmia will allow better understanding of the mechanisms leading to the onset of these symptoms and will provide a pathophysiological basis for the therapeutic interventions to improve the clinical prognosis of affected patients. The study investigators hypothesize that in COVID-19 patients witch anosmia the brain mapping objectified by an MRI examination is modified and that there are functional abnormalities in the brain in these patients.

Official Title
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Descriptive Pilot Study of Brain MRI Imaging in Patients With SARS-Cov2 (COVID-19) Infection With or Without Anosmia

Conditions
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Covid-19, Anosmia

Intervention / Treatment
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* Other: Brain MRI scan


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Consecutive adult patients consulting the CAREB or hospitalized at the Nîmes teaching hospital due to COVID-19 infection (fever, persistent cough, tiredness, shortness of breath, diarrhea, abdominal pain, chest pain, sore throat, loss of smell or taste) COVID-19 confirmed by RT-PCR and / or chest CT or clinical characteristics (i.e an epidemic history and 2 clinical manifestations or at least 3 clinical manifestations) The patient must have given their free and informed consent and signed the consent form The patient must be a member or beneficiary of a health insurance plan with anosmia group: scoring < 30 on a VAS 0-100 for olfactory ability Responding yes to question have you lost your sense of smell in the last few days? Negative result to olfactory test with n-Butanol diluted to 1/1000. without anosmia group: scoring < 80 on a VAS 0-100 for olfactory ability Responding no to question have you lost your sense of smell in the last few days? Positive result to olfactory test with n-Butanol diluted to 1/16000. Exclusion Criteria: Patient suffering from serious medical problems or hospitalized in an intensive care unit for invasive ventilation or severe dyspnea. Patient with neurological (motor, sensitive or cognitive), neuropsychiatric or vascular disorders. Patient with a contraindication to MRI (pace maker, claustrophobic patient, metallic heart valve, etc.). Patient with a history of rhinological pathology or a sense of smell problem. Patient with known neurological, psychiatric or neuroradiological manifestation.The subject is participating in a category 1 interventional study, or is in a period of exclusion determined by a previous study The subject is unable to express consent It is impossible to give the subject informed information The patient is under safeguard of justice or state guardianship Patient is pregnant, parturient or breastfeeding

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| COVID-19 patients with anosmia<br>Patients reporting loss of smell and scoring < 30 on a VAS 0-100 for ability to detect n-Butanol diluted 1/1000 | Other: Brain MRI scan<br>* Resting state, functional, structural and morphometric MRI; diffusion tensor imaging on a 3-Tesla MRI scanner<br>|
| COVID-19 patients without anosmia<br>Patients reporting no loss of smell and scoring > 80 on a VAS 0-100 for ability to detect n-Butanol diluted 1/16000 | Other: Brain MRI scan<br>* Resting state, functional, structural and morphometric MRI; diffusion tensor imaging on a 3-Tesla MRI scanner<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brain regional homogeneity between COVID-19 patients with and without anosmia | MRI; Voxels | Day 0 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brain regional homogeneity between COVID-19 patients with and without anosmia | MRI; Voxels | Month 3 | 
| Topography of supra- or sub-tentorial lesions between COVID-19 patients with and without anosmia | MRI; Voxels | Day 0 | 
| Fractional anisotropy between COVID-19 patients with and without anosmia | MRI; voxels, value between 0-1 | Day 0 | 
| Fractional anisotropy between COVID-19 patients with and without anosmia | MRI; voxels, value between 0-1 | Month 3 | 
| Mean diffusivity between COVID-19 patients with and without anosmia | MRI; mm2/s | Day 0 | 
| Mean diffusivity between COVID-19 patients with and without anosmia | MRI; mm2/s | Month 3 | 
| Radial diffusivity between COVID-19 patients with and without anosmia | MRI; mm2/s | Day 0 | 
| Radial diffusivity between COVID-19 patients with and without anosmia | MRI; mm2/s | Month 3 | 
| Self-assessed olfactory and gustatory test | Four questions measured by 0-100 visual analogue scale: how do you rate the quality of your sense of smell/taste normally/today | Day 0 | 
| Self-assessed olfactory and gustatory test | Four questions measured by 0-100 visual analogue scale: how do you rate the quality of your sense of smell/taste normally/today | Day 8 | 
| Self-assessed olfactory and gustatory test | Four questions measured by 0-100 visual analogue scale: how do you rate the quality of your sense of smell/taste normally/today | Month 1 | 
| Self-assessed olfactory and gustatory test | Four questions measured by 0-100 visual analogue scale: how do you rate the quality of your sense of smell/taste normally/today | Month 2 | 
| Ability to detect odor | Ability to smell 1.5ml air freshner on a 0-100 VAS scale (cut-offs: strang (>80), moderate (40-80), attenuated (<40) | Day 0 | 
| Ability to taste a pinch of sugar | Patient asked to describe whether a pinch of sugar on their tongue taste sweet or salty | Day 0 | 
| Presence of thrombotic and hemorrhagic lesions | MRI: absence/presence | Day 0 | 
| Presence of thrombotic and hemorrhagic lesions | MRI: absence/presence | Month 3 | 
| Presence of lesions with hyperintensity | Short Ti Inversion Recovery (STIR); presence/absence | Day 0 | 
| Presence of lesions with hyperintensity | Short Ti Inversion Recovery (STIR); presence/absence | Month 3 | 
| Projection network analysis of all patients | beta voxels | Day 0 | 
| Projection network analysis of all patients | beta voxels | Month 3 | 
| Blinded independent component analysis of all patients | beta voxels | Day 0 | 
| Blinded independent component analysis of all patients | beta voxels | Month 3 | 
| default mode network analysis of all patients | beta voxels | Day 0 | 
| default mode network analysis of all patients | beta voxels | Month 3 | 
| executive control network analysis of all patients | beta voxels | Day 0 | 
| executive control network analysis of all patients | beta voxels | Month 3 |