PDF(Pubmed)
Abstract：
OBJECTIVE: 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%).
CONCLUSIONS: 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.
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%).
CONCLUSIONS: 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.
摘要：
目的：调查未选择的COVID-19住院患者中脑血管MRI标志物的患病率（2019年冠状病毒病），我们将这些与以前没有SARS-CoV-2感染或住院的健康对照进行比较，三个月后调查患者的纵向（偶然）病变。
方法：CORONIS（CORONAvirusand缺血性卒中）是一项观察性队列研究，在2021年4月至2022年9月期间对COVID-19的成年住院患者和无COVID-19的对照组进行。在出院后不久和3个月后进行脑部MRI检查。结果包括近期缺血性（DWI阳性）病变，以前的梗塞，微出血，白质高信号（WMH）和脑出血，并进行逻辑回归分析以校正混杂因素。
结果：125例COVID-19患者和47例对照者在症状出现后中位41.5天接受了脑MRI检查。在一名患者（1％）和一名（2％）对照中发现了DWI阳性病变，临床上都沉默。WMH在患者中（78%）比对照组（62%）更普遍（校正后OR：2.95[95%CI：1.07-8.57]），其他脑血管MRI标记没有差异。ICU中标志物的患病率与非ICU患者相似.三个月后,5例患者（5%）有新的脑血管病变，包括DWI阳性病变（1例，1.0%），脑梗死（2例，2.0%)和微出血(3例，3.1%）。
结论：总体而言，我们发现,与对照组相比,在未经选择的住院COVID-19患者中,脑血管标志物的患病率并不高.少数DWI病变最有可能由小血管疾病的危险因素来解释。在一般住院的COVID-19人群中，COVID-19在住院后不久对脑血管MRI标志物的影响有限。
方法：CORONIS（CORONAvirusand缺血性卒中）是一项观察性队列研究，在2021年4月至2022年9月期间对COVID-19的成年住院患者和无COVID-19的对照组进行。在出院后不久和3个月后进行脑部MRI检查。结果包括近期缺血性（DWI阳性）病变，以前的梗塞，微出血，白质高信号（WMH）和脑出血，并进行逻辑回归分析以校正混杂因素。
结果：125例COVID-19患者和47例对照者在症状出现后中位41.5天接受了脑MRI检查。在一名患者（1％）和一名（2％）对照中发现了DWI阳性病变，临床上都沉默。WMH在患者中（78%）比对照组（62%）更普遍（校正后OR：2.95[95%CI：1.07-8.57]），其他脑血管MRI标记没有差异。ICU中标志物的患病率与非ICU患者相似.三个月后,5例患者（5%）有新的脑血管病变，包括DWI阳性病变（1例，1.0%），脑梗死（2例，2.0%)和微出血(3例，3.1%）。
结论：总体而言，我们发现,与对照组相比,在未经选择的住院COVID-19患者中,脑血管标志物的患病率并不高.少数DWI病变最有可能由小血管疾病的危险因素来解释。在一般住院的COVID-19人群中，COVID-19在住院后不久对脑血管MRI标志物的影响有限。
