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10.3174/ajnr.A6966 http://scihub22266oqcxt.onion/10.3174/ajnr.A6966 33414226!8040983!33414226     free     free     free Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 235.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       AJNR+Am+J+Neuroradiol 2021 ; 42 (4): 632-638 Nephropedia Template TP {{tp|p=33414226|t=2021. Clinical, Imaging, and Lab Correlates of Severe COVID-19 Leukoencephalopathy |pdf=|usr=}}{{33414226}} gab.com Text Clinical, Imaging, and Lab Correlates of Severe COVID-19 Leukoencephalopathy JO: AJNR Am J Neuroradiol http://www.kidney.de/pget.php?&tw=1&pmid=33414226 #FOAvip BACKGROUND AND PURPOSE: Patients infected with the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) can develop a spectrum of neurological disorders, including a leukoencephalopathy of variable severity. Our aim was to characterize imaging, lab, and clinical correlates of severe coronavirus disease 2019 (COVID-19) leukoencephalopathy, which may provide insight into the SARS-CoV-2 pathophysiology. MATERIALS AND METHODS: Twenty-seven consecutive patients positive for SARS-CoV-2 who had brain MR imaging following intensive care unit admission were included. Seven (7/27, 26%) developed an unusual pattern of "leukoencephalopathy with reduced diffusivity" on diffusion-weighted MR imaging. The remaining patients did not exhibit this pattern. Clinical and laboratory indices, as well as neuroimaging findings, were compared between groups. RESULTS: The reduced-diffusivity group had a significantly higher body mass index (36 versus 28 kg/m(2), P < .01). Patients with reduced diffusivity trended toward more frequent acute renal failure (7/7, 100% versus 9/20, 45%; P = .06) and lower estimated glomerular filtration rate values (49 versus 85 mL/min; P = .06) at the time of MRI. Patients with reduced diffusivity also showed lesser mean values of the lowest hemoglobin levels (8.1 versus 10.2 g/dL, P < .05) and higher serum sodium levels (147 versus 139 mmol/L, P = .04) within 24 hours before MR imaging. The reduced-diffusivity group showed a striking and highly reproducible distribution of confluent, predominantly symmetric, supratentorial, and middle cerebellar peduncular white matter lesions (P < .001). CONCLUSIONS: Our findings highlight notable correlations between severe COVID-19 leukoencephalopathy with reduced diffusivity and obesity, acute renal failure, mild hypernatremia, anemia, and an unusual brain MR imaging white matter lesion distribution pattern. Together, these observations may shed light on possible SARS-CoV-2 pathophysiologic mechanisms associated with leukoencephalopathy, including borderzone ischemic changes, electrolyte transport disturbances, and silent hypoxia in the setting of the known cytokine storm syndrome that accompanies severe COVID-19. Twit Text FOAVip Clinical, Imaging, and Lab Correlates of Severe COVID-19 Leukoencephalopathy ????AJNR Am J Neuroradiol http://www.kidney.de/pget.php?&tw=1&pmid=33414226 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=33414226 #FOAvip English Wikipedia <ref>{{Cite pmid|33414226}}</ref> Clinical, Imaging, and Lab Correlates of Severe COVID-19 Leukoencephalopathy #MMPMID33414226 Rapalino O; Pourvaziri A; Maher M; Jaramillo-Cardoso A; Edlow BL; Conklin J; Huang S; Westover B; Romero JM; Halpern E; Gupta R; Pomerantz S; Schaefer P; Gonzalez RG; Mukerji SS; Lev MH AJNR Am J Neuroradiol 2021[Apr]; 42 (4): 632-638 PMID33414226show ga BACKGROUND AND PURPOSE: Patients infected with the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) can develop a spectrum of neurological disorders, including a leukoencephalopathy of variable severity. Our aim was to characterize imaging, lab, and clinical correlates of severe coronavirus disease 2019 (COVID-19) leukoencephalopathy, which may provide insight into the SARS-CoV-2 pathophysiology. MATERIALS AND METHODS: Twenty-seven consecutive patients positive for SARS-CoV-2 who had brain MR imaging following intensive care unit admission were included. Seven (7/27, 26%) developed an unusual pattern of "leukoencephalopathy with reduced diffusivity" on diffusion-weighted MR imaging. The remaining patients did not exhibit this pattern. Clinical and laboratory indices, as well as neuroimaging findings, were compared between groups. RESULTS: The reduced-diffusivity group had a significantly higher body mass index (36 versus 28 kg/m(2), P < .01). Patients with reduced diffusivity trended toward more frequent acute renal failure (7/7, 100% versus 9/20, 45%; P = .06) and lower estimated glomerular filtration rate values (49 versus 85 mL/min; P = .06) at the time of MRI. Patients with reduced diffusivity also showed lesser mean values of the lowest hemoglobin levels (8.1 versus 10.2 g/dL, P < .05) and higher serum sodium levels (147 versus 139 mmol/L, P = .04) within 24 hours before MR imaging. The reduced-diffusivity group showed a striking and highly reproducible distribution of confluent, predominantly symmetric, supratentorial, and middle cerebellar peduncular white matter lesions (P < .001). CONCLUSIONS: Our findings highlight notable correlations between severe COVID-19 leukoencephalopathy with reduced diffusivity and obesity, acute renal failure, mild hypernatremia, anemia, and an unusual brain MR imaging white matter lesion distribution pattern. Together, these observations may shed light on possible SARS-CoV-2 pathophysiologic mechanisms associated with leukoencephalopathy, including borderzone ischemic changes, electrolyte transport disturbances, and silent hypoxia in the setting of the known cytokine storm syndrome that accompanies severe COVID-19. |*Intensive Care Units[MESH] |Acute Kidney Injury/complications/*diagnostic imaging[MESH] |Adult[MESH] |COVID-19/*complications[MESH] |Diffusion Magnetic Resonance Imaging[MESH] |Humans[MESH] |Leukoencephalopathies/*complications/diagnostic imaging[MESH] |Magnetic Resonance Imaging/methods[MESH] |Male[MESH] |Middle Aged[MESH] |SARS-CoV-2[MESH]Clinical, Imaging, and Lab Correlates of Severe COVID-19 Leukoencephal(epmc).pdf DeepDyve Pubget Overpricing