Brain imaging utilization and findings in COVID-19: A single academic center experience in the epicenter of disease in the united states

Abstract

Coronavirus disease 2019 (COVID-19) is a serious public health crisis and can have neurologic manifestations. This is a retrospective observational case series performed from March 1-31, 2020 at New York University Langone Medical Center campuses. Clinical and imaging data were extracted, reviewed and analyzed. 242 COVID-19 patients underwent CT or MRI of brain within 2 weeks of positive testing (mean [SD] age: 68.7[16.5] years, 150 men/92 females[62.0%/38.0%]). The 3 most common indications for imaging were altered mental status(42.1%), syncope/fall(32.6%), and focal neurologic deficit(12.4%). The most common imaging findings were nonspecific white matter microangiopathy(123/50.8%), chronic infarct(47/19.4%), acute or subacute ischemic infarct(13/5.4%) and acute hemorrhage(11/4.5%). No patients imaged for altered mental status demonstrated acute ischemic infarct or acute hemorrhage. White matter microangiopathy was associated with higher two-week mortality(p=0.0001). Our data suggest that in the absence of focal neurologic deficit, brain imaging in COVID-19 patients with altered mental status may not be revealing.