Brain MRI findings in COVID-19 patients with PRES: A systematic review

Clin Imaging. 2022 Jan:81:107-113. doi: 10.1016/j.clinimag.2021.10.003. Epub 2021 Oct 16.

Abstract

Background: Numerous case reports and case series have described brain Magnetic Resonance Imaging (MRI) findings in Coronavirus disease 2019 (COVID-19) patients with concurrent posterior reversible encephalopathy syndrome (PRES).

Purpose: We aim to compile and analyze brain MRI findings in patients with COVID-19 disease and PRES.

Methods: PubMed and Embase were searched on April 5th, 2021 using the terms "COVID-19", "PRES", "SARS-CoV-2" for peer-reviewed publications describing brain MRI findings in patients 21 years of age or older with evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and PRES.

Results: Twenty manuscripts were included in the analysis, which included descriptions of 30 patients. The average age was 57 years old. Twenty-four patients (80%) required mechanical ventilation. On brain MRI examinations, 15 (50%) and 7 (23%) of patients exhibited superimposed foci of hemorrhage and restricted diffusion respectively.

Conclusions: PRES is a potential neurological complication of COVID-19 related disease. COVID-19 patients with PRES may exhibit similar to mildly greater rates of superimposed hemorrhage compared to non-COVID-19 PRES patients.

Keywords: COVID-19; MRI brain; PRES.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Brain / diagnostic imaging
  • COVID-19*
  • Humans
  • Magnetic Resonance Imaging
  • Middle Aged
  • Posterior Leukoencephalopathy Syndrome*
  • SARS-CoV-2