COVID-19-associated Acute Hemorrhagic Necrotizing Encephalopathy: Imaging Features

HomeRadiologyVol. 296, No. 2 PreviousNext Reviews and CommentaryFree AccessImages in RadiologyCOVID-19–associated Acute Hemorrhagic Necrotizing Encephalopathy: Imaging FeaturesNeo Poyiadji, Gassan Shahin, Daniel Noujaim, Michael Stone, Suresh Patel, Brent Griffith Neo Poyiadji, Gassan Shahin, Daniel Noujaim, Michael Stone, Suresh Patel, Brent Griffith Author AffiliationsFrom the Department of Radiology, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI 48202.Address correspondence to B.G. (e-mail: [email protected]).Neo PoyiadjiGassan ShahinDaniel NoujaimMichael StoneSuresh PatelBrent Griffith Published Online:Mar 31 2020https://doi.org/10.1148/radiol.2020201187MoreSectionsPDF ToolsAdd to favoritesCiteTrack Citations ShareShare onFacebookXLinked In Since its introduction to the human population in December 2019, the coronavirus disease 2019 (COVID-19) pandemic has spread across the world with more than 330 000 reported cases in 190 countries, areas, or territories (1). While patients typically present with fever, shortness of breath, and cough, neurologic manifestations have been reported, although to a much lesser extent (2). Herein, we report on the first presumptive case of COVID-19–associated acute necrotizing hemorrhagic encephalopathy, a rare encephalopathy that has been associated with other viral infections but has yet to be demonstrated as a result of COVID-19 infection.A 58-year-old female airline worker presented with a 3-day history of cough, fever, and altered mental status. The initial laboratory work-up was negative for influenza, with the diagnosis of COVID-19 made by detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral nucleic acid in a nasopharyngeal swab specimen using the U.S. Centers for Disease Control and Prevention 2019 novel coronavirus real-time reverse-transcription polymerase chain reaction assay. The assay was performed using a Cobas Z 480 analyzer (Roche, Basel, Switzerland) at our institution following emergency use authorization from the U.S. Centers for Disease Control and Prevention. Cerebrospinal fluid analysis was limited due to a traumatic lumbar puncture. However, cerebrospinal fluid bacterial culture showed no growth after 3 days, and tests for herpes simplex virus 1 and 2, varicella zoster virus, and West Nile virus were negative. Testing for the presence of SARS-CoV-2 in the cerebrospinal fluid was unable to be performed. Unenhanced CT of the head demonstrated symmetric low attenuation within the bilateral medial thalami with a normal CT angiogram and CT venogram (Fig 1). Brain MRI demonstrated hemorrhagic rim-enhancing lesions within the bilateral thalami, medial temporal lobes, and subinsular regions (Fig 2). The patient was started on intravenous immunoglobulin. High-dose steroids were not initiated due to concern for respiratory compromise.Figure 1: A, Unenhanced CT scan of head demonstrates symmetric low attenuation within the bilateral medial thalami (arrows). B, Axial CT venogram demonstrates patency of the cerebral venous vasculature, including the internal cerebral veins (arrows). C, Coronal reformation of CT angiogram demonstrates normal appearance of the basilar artery and proximal posterior cerebral arteries.Figure 1:Download as PowerPointFigure 2: A, B, E, F, T2-weighted fluid-attenuated inversion recovery MRI scans demonstrate hyperintensity within the bilateral medial temporal lobes and thalami (arrows), with evidence of hemorrhage indicated by, C, G, hypointense signal (arrows) on susceptibility-weighted images and, D, H, rim enhancement (arrows) on contrast material–enhanced images.Figure 2:Download as PowerPointAcute necrotizing encephalopathy is a rare complication of influenza and other viral infections and has been related to intracranial cytokine storms, which result in blood-brain barrier breakdown but without direct viral invasion or parainfectious demyelination (3). Accumulating evidence suggests that a subgroup of patients with severe COVID-19 might have cytokine storm syndrome (4). Although predominantly described in the pediatric population, acute necrotizing encephalopathy is known to occur in adults as well. The most characteristic imaging feature includes symmetric, multifocal lesions with invariable thalamic involvement (5). Other commonly involved locations include the brainstem, cerebral white matter, and cerebellum (5). Lesions appear hypoattenuating on CT images, and MRI demonstrates T2-weighted fluid-attenuated inversion recovery hyperintense signal with internal hemorrhage. Contrast material–enhanced images may demonstrate a ring of contrast enhancement (5).To our knowledge, this is the first reported case of COVID-19–associated acute necrotizing hemorrhagic encephalopathy. As the number of patients with COVID-19 increases worldwide, clinicians and radiologists should watch for these findings among patients presenting with COVID-19 and altered mental status.Disclosures of Conflicts of Interest: N.P. disclosed no relevant relationships. G.S. disclosed no relevant relationships. D.N. disclosed no relevant relationships. M.S. disclosed no relevant relationships. S.P. disclosed no relevant relationships. B.G. disclosed no relevant relationships.References1. Coronavirus disease (COVID-19) Pandemic. World Health Organization. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Published March 23, 2020. Accessed March 23, 2020. Google Scholar2. Filatov A, Sharma P, Hindi F, et al. Neurological complications of coronavirus (COVID-19): encephalopathy. Cureus 2020;12(3):e7352. Medline, Google Scholar3. Rossi A. Imaging of acute disseminated encephalomyelitis. Neuroimaging Clin N Am 2008;18(1):149–161, ix. Crossref, Medline, Google Scholar4. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020;395(10229):1033–1034, 20, 30628–0 https://doi.org/10.1016/S0140-6736(20)30628-0. Crossref, Medline, Google Scholar5. Wong AM, Simon EM, Zimmerman RA, Wang HS, Toh CH, Ng SH. Acute necrotizing encephalopathy of childhood: correlation of MR findings and clinical outcome. AJNR Am J Neuroradiol 2006;27(9):1919–1923. Medline, Google ScholarArticle HistoryReceived: Mar 24 2020Revision requested: Mar 26 2020Revision received: Mar 26 2020Accepted: Mar 27 2020Published online: Mar 31 2020Published in print: Aug 2020 FiguresReferencesRelatedDetailsCited BySignificance of Persistent Systemic Support in the Clinical Course of Delayed Post-hypoxic Leukoencephalopathy Following Severe Coronavirus Disease 2019JuriKawasaki, NaokoMato, HiroyukiFujii, KumikoMiura, TakafumiMashiko, ShinshuKatayama, YoshitakaYamanouchi, MikiSato, ToshikazuTakasaki, AyakoTakigami, ShuHisata, ShinNunomiya, KoichiHagiwara, MakotoMaemondo2024Apr15 | Internal Medicine, Vol. 63, No. 8Clinical characteristics and outcomes of COVID-19-associated encephalopathy in childrenLiLi, HongmeiLiao, XiaojunKuang, KeJin3 April 2024 | Journal of NeuroVirology, Vol. 269Prenatal Exposure to COVID-19 mRNA Vaccine BNT162b2 Induces Autism-Like Behaviors in Male Neonatal Rats: Insights into WNT and BDNF Signaling PerturbationsMumin AlperErdogan, OrkunGurbuz, Mehmet FatihBozkurt, OytunErbas10 January 2024 | Neurochemical Research, Vol. 49, No. 4Insights Into MRI Neuroimaging Patterns of COVID-19 in Children: A Retrospective Comprehensive AnalysisMohamad GamalNada, Yassir EdreesAlmalki, Mohammad Abd AlkhalikBasha, Maha IbrahimMetwally, RihamDessouky, Mohamed Hesham Saleh SalehRadwan, Mohamed M.A.Zaitoun, Ahmed A. El-Hamid M.Abdalla, Ahmed A.A.Bessar, Engy FathyTantwy, Mostafa MohamadAssy, Bassant MahmoudDawoud, DianaHanna, Mahmoud M.Gohary, Sharifa KhalidAlduraibi, Alaa K.lduraibi, Diaa BakryEldib, Hamada M.Khater, Noha T.Sarhan, Dina EsmatHamed, Sara F.Saadawy, Mohammed A.Huneif, Ahmed M.Abdelkhalik Basha, Yasmin IbrahimLibda2024Apr1 | Academic Radiology, Vol. 109Brain magnetic resonance imaging findings in children with neurological complications of coronavirus disease 2019 (Omicron variant): a multicenter retrospective observational studyChunZhao, YujuanWang, JianHou, MeiyunXin, QinJiang, MingyingHan, XiaomeiLi, YelongShen, XimingWang, MoWang, YoupengJin28 March 2024 | Pediatric Radiology, Vol. 77Inhibition of the Lectin Pathway of Complement Activation Reduces Acute Respiratory Distress Syndrome Severity in a Mouse Model of SARS-CoV-2 InfectionYoussif MAli, George WCarnell, StefanoFumagalli, DomenicoMercurio, SerenaSeminara, Nicholas JLynch, PriyankaKhatri, Chanuka HArachchilage, LucaMascheroni, ClemensKaminski, Charlotte LGeorge, HazelStewart, MunehisaYabuki, GregoryDemopulos, Jonathan LHeeney, WilhelmSchwaeble25 October 2023 | The Journal of Infectious Diseases, Vol. 229, No. 3Implications of COVID-19 in Parkinson's disease: the purinergic system in a therapeutic-target perspective to diminish neurodegenerationJúlia Leão BatistaSimões, Geórgiade Carvalho Braga, Samantha WeblerEichler, Gilnei Brunoda Silva, Margarete DulceBagatini9 March 2024 | Purinergic Signalling, Vol. 6COVID-19 neuroimaging update: pathophysiology, acute findings, and post-acute developmentsAndrew C.McClelland, Steven J.Benitez, JudahBurns2024Mar1 | Seminars in Ultrasound, CT and MRI, Vol. 77Acute cerebrovascular accidents in patients with new coronavirus infection COVID-19N. A.Shamalov, L. V.Klimov, M. A.Soldatov, T. V.Kiseleva, V. N.Shamalova, N. A.Marskaya, O. V.Lyang22 February 2024 | Neurology, Neuropsychiatry, Psychosomatics, Vol. 16, No. 1SARS-CoV-2 infection and cognition in community-dwelling and nursing home residents in southern SwitzerlandGretaRizzi, DeborahPacifico, SerenaSabatini, Anna MariaAnnoni, FedericoMele, SandraJovic, LucaPiccoli, LaurieCorna, RebeccaAmati, WilliamPertoldi, MaddalenaFiordelli, FedericaSallusto, EmilianoAlbanese2024Feb1 | Brain, Behavior, & Immunity - Health, Vol. 35Special considerations and pitfalls for intracerebral bleeding followed COVID-19 case treated by ECMOWael OsmanAmer, Hussein AwadEl Gharieb, ZakariaAhmed, HossamIbrahim, AhmedAlanazi, MostafaMeshref2024Feb1 | Brain Hemorrhages, Vol. 5, No. 1Omicron variant (B.1.1.529) challenge the integrity of blood brain barrier: Evidence from protein structural analysisAbdulNasir, AbdusSamad, SamiUllah, ArifAli, Dong-QingWei, BaiQian2024Feb1 | Computers in Biology and Medicine, Vol. 169Application of in-silico drug discovery techniques to discover a novel hit for target-specific inhibition of SARS-CoV-2 Mpro's revealed allosteric binding with MAO-B receptor: A theoretical study to find a cure for post-covid neurological disorderMagdi E. A.Zaki, Sami A.AL-Hussain, Aamal A.Al-Mutairi, AbdulSamad, Vijay H.Masand, Rahul G.Ingle, Vivek DigamberRathod, Nikita MarutiGaikwad, SummyaRashid, Pravin N.Khatale, Pramod V.Burakale, Rahul D.Jawarkar, ArabindaGhosh16 January 2024 | PLOS ONE, Vol. 19, No. 1Atypical Complications during the Course of COVID-19: A Comprehensive ReviewTauqeer HussainMallhi, AqsaSafdar, Muhammad HammadButt, MuhammadSalman, SumbalNosheen, Zia UlMustafa, Faiz UllahKhan, Yusra HabibKhan15 January 2024 | Medicina, Vol. 60, No. 1SARS-CoV-2-associated complicationsSumitKumar, VikramKhanna2024Jan1Superinfected COVID ‐19 in a young patient with posterior reversible encephalopathy syndrome: A case reportMohammad JavadNasr, Ali AlizadehKhatir, Fatemeh AbediKebria, BaharehBazooyar, SoheilEbrahimpour, AzinGooran4 January 2024 | Clinical Case Reports, Vol. 12, No. 1A Systematic Review Unraveling the Intricate Neurological Spectrum of COVID-19: Manifestations, Complications, and Transformative Insights for Patient CareAakankshaPitliya, JatinDhamecha, DeepakKumar, KVNAnusha, NeerajKancherla, LakshyaKumar, RamitSingla, AnmolPitliya29 February 2024 | Neurology India, Vol. 72, No. 1Defining the Clinicoradiologic Syndrome of SARS-CoV-2 Acute Necrotizing EncephalopathyVanessa W.Lee, Kai QianKam, Ahmad R.Mohamed, HusnaMusa, PooraniAnandakrishnan, QingtangShen, Alexander F.Palazzo, Russell C.Dale, MingLim, TerrenceThomas2024Jan1 | Neurology Neuroimmunology & Neuroinflammation, Vol. 11, No. 1Quadriplegia, Dysphagia and Ataxia Manifested in a Child With COVID-19 Related Acute Necrotizing Encephalopathy: A Case ReportYoung-SuKu, Kyung-LimJoa, Myeong-OkKim, Chang-HwanKim, Han-YoungJung1 January 2024 | Brain & Neurorehabilitation, Vol. 17, No. 1Characteristics and Pathophysiological Mechanisms of Stroke in COVID-19 PatientsSaltanatMert, DilaZafer, İbrahimAcır, ÇağrıErdim, MuratÇabalar14 January 2024 | Medical Science and Discovery, Vol. 11, No. 1Automating CT Diagnostic Image Quality Control Using Transfer LearningAnubhavGupta, Mohamed S.Shehata, W. JohnBraun, Rebecca EmilyFeldman, Thorarin AlbertBjarnason2023Dec7Altered intrinsic brain activity and functional connectivity in COVID-19 hospitalized patients at 6-month follow-upRuiliLi, GuangxueLiu, XiaodongZhang, MiaoZhang, JieLu, HongjunLi8 August 2023 | BMC Infectious Diseases, Vol. 23, No. 1Neurofilament light chain on intensive care admission is an independent predictor of mortality in COVID-19: a prospective multicenter studyTheodorSievert, IngridDidriksson, MartinSpångfors, GiselaLilja, KajBlennow, HenrikZetterberg, AttilaFrigyesi, HansFriberg28 September 2023 | Intensive Care Medicine Experimental, Vol. 11, No. 1Recurrent infection triggered encephalopathy syndrome in a pediatric patient with RANBP2 mutation and severe acute respiratory syndrome coronavirus 2 infectionJiaqiLi, FengHuo, ShuoWang, YimuFan, JieWu, ZhezheZhang, ShuangjunLiu, QuanWang19 November 2023 | Pediatric Investigation, Vol. 7, No. 4Acute haemorrhagic necrotizing encephalopathy associated with COVID-19 in a patient with liver cirrhosisSwetaSingh, Uday S.Singh21 December 2023 | Journal of Family Medicine and Primary Care, Vol. 12, No. 12Network analysis of neurosurgical literature: an increased focus on training during the COVID-19 pandemicSiddhantKumarapuram, SanjeevSreenivasan, AkankshaMathivanan, PranavManchiraju, MohammadKhuroo, SrihariSundararajan, AnilNanda, SudiptaRoychowdhury, GauravGupta19 July 2023 | Neurosurgical Review, Vol. 46, No. 1Acute Necrotizing Encephalopathy Post SARS-CoV-2 Infection in an Adult Patient: Case ReportItzel AriadnaHernández-Dehesa, José AlfonsoAlvarez-Castro, Keren MagalyAguilar-Hidalgo, José OmarSantellán-Hernández, FernandoCastro-Soto30 May 2023 | SN Comprehensive Clinical Medicine, Vol. 5, No. 1Acute necrotizing encephalopathy associated with COVID-19: case series and systematic reviewChangGeng, WeiliZhao, ZhijunWang, JinWu, DongxiaoJiang, NanJiang, MangeLiu, MingYao, HongzhiGuan11 September 2023 | Journal of Neurology, Vol. 270, No. 11Hydrogen sulfide: From a toxic gas to a potential therapy for COVID-19 and inflammatory disordersMohitKumar2023Nov1 | Nitric Oxide, Vol. 140-141Gray Matter Thickness and Subcortical Nuclear Volume in Men After SARS-CoV-2 Omicron InfectionYanyaoDu, WeiZhao, SihongHuang, ChuxinHuang, ChangLi, YanjingChen, YijieHuang, LongtaoYang, CongLi, HuitingZhang, HuGuo, JunLiu30 November 2023 | JAMA Network Open, Vol. 6, No. 11Effects of the COVID-19 Pandemic on the Occurrence and Course of Mental Disorders in Elderly PeopleO. B.Yakovleva, T. P.Safarova, D. A.Tsvetaeva27 December 2023 | Neuroscience and Behavioral Physiology, Vol. 53, No. 9From Emergence to Endemicity: A Comprehensive Review of COVID-19RoopaNaik, SreekantAvula, Sujith KPalleti, JyotsnaGummadi, RajarajeshwariRamachandran, DeepakChandramohan, GagandeepDhillon, Angad SGill, KapilPaiwal, BushraShaik, MalavikaBalachandran, BhumikaPatel, SimhachalamGurugubelli, Abhishek KumarMariswamy Arun Kumar, AthmanandaNanjundappa, MahitaBellamkonda, KanikaRathi, Pavana LalithyaSakhamuri, MahmoudNassar, AtulBali2023Oct31 | Cureus, Vol. 382Coronavirus disease 2019-associated acute necrotizing encephalopathy in a 9-year-old boyOck-BinIm, Min-JeeKim, Mi-SunYum, Won KyoungJhang2023Oct30 | Pediatric Emergency Medicine Journal, Vol. 10, No. 4Emerging Landscape of Preclinical Models for Studying COVID-19 Neurologic DiseasesJasonLi, JingWang, HuWang6 September 2023 | ACS Pharmacology & Translational Science, Vol. 6, No. 10SARS-CoV-2 and Brain Health: New Challenges in the Era of the PandemicWaqasAhmed, JiaFeng, YifanZhang, LukuiChen8 October 2023 | Microorganisms, Vol. 11, No. 10SARS coronavirus 2 and central nervous system manifestations: causation, relation, or coexistence? a case series study and literature reviewSeyed AbdolhadiDaneshi, MortezaTaheri, ArashFattahi21 December 2020 | British Journal of Neurosurgery, Vol. 37, No. 5Central nervous system complications in SARS-CoV-2-infected patientsZhongguiLi, DanyuLin, XiaoshuangXu, XiaohuanLiu, JieliZhang, KaixunHuang, FeiyifanWang, JianfengLiu, ZhiZhang, EnxiangTao13 August 2023 | Journal of Neurology, Vol. 382Fetal brain vulnerability to SARS-CoV-2 infectionCourtney L.McMahon, JoshuaCastro, JesusSilvas, AranisMuniz Perez, ManuelEstrada, RicardoCarrion, JennyHsieh2023Aug1 | Brain, Behavior, and Immunity, Vol. 112Acute neurological symptoms in multisystem inflammatory syndrome in children: A case seriesAminDehghan, RanaSaleh, HamidRahimi, ZahraPourmoghaddas, AtefehSadeghizadeh, NiloofarJavadi2023Aug1 | Heliyon, Vol. 9, No. 8Pathogenesis and Management of Acute Necrotizing EncephalopathyNingxiangQin, JingWang, XiPeng, LiangWang13 June 2023 | Expert Review of Neurotherapeutics, Vol. 23, No. 7Mild sensory symptoms during SARS-CoV-2 infection among healthcare professionalsD.Gayoso Cantero, E.Cantador Pavón, E.Pérez Fernández, M.E.Novillo López2023Apr1 | Neurología (English Edition), Vol. 14Risk factors for mortality in fulminant acute necrotizing encephalopathy following influenza A in an adolescent boyNahidehKhosroshahi, DaryaRezaei, FarnooshEmami, KambizEftekhari23 April 2023 | Clinical Case Reports, Vol. 11, No. 4Neurological complications of COVID-19XDai, XCao, QJiang, BWu, TLou, YShao, YHu, QLan9 December 2022 | QJM: An International Journal of Medicine, Vol. 116, No. 3Neurological infection and complications of SARS-CoV-2: A reviewSantoshSingh, NikitaMeher, ArifullahMohammed, Mohammad Khairul Azhar AbdulRazab, L.V.K.S.Bhaskar, Norazlina MatNawi2023Feb3 | Medicine, Vol. 102, No. 5Appearance of extrapyramidal symptoms in adolescent psychiatry patients during COVID‐19 infectionAysegulTonyali, GulKaracetin, CelalYesilkaya, Feyza Nur TasArik, BinayKayan Ocakoglu14 February 2023 | Journal of Medical Virology, Vol. 95, No. 2Pathogenic Coronaviruses of Humans and AnimalsLisa A.Beltz2023The Changing Epidemiology of Central Nervous System InfectionBrenda Sze PengAng, ThirugnanamUmapathi, TchoyosonLim2023 | Neuroimaging Clinics of North America, Vol. 33, No. 1Case report: Bilateral globus pallidus lesions and delayed progressive leukoencephalopathy in COVID-19: Effects of hypoxia alone or combination of hypoxia and inflammation?Ahmad A.Ballout, MichaelKolesnik, YunaChoi, Marc S.Ayoub, AsaffHarel, SouhelNajjar2023 | Frontiers in Neurology, Vol. 13Consensus Clinical Guidance for Diagnosis and Management of Adult COVID-19 Encephalopathy PatientsBenedict D.Michael, DeanWalton, EricaWestenberg, DavidGarcía-Azorín, BhagteshwarSingh, Arina A.Tamborska, M.Netravathi, MashinaChomba, Greta K.Wood, AvaEaston, Omar K.Siddiqi, Thomas A.Jackson, Thomas A.Pollak, Timothy R.Nicholson, ShaliniNair, GeromeBreen, KameshwarPrasad, Kiran T.Thakur, Sherry H.-Y.Chou, ErichSchmutzhard, Jennifer A.Frontera, RaimundHelbok, AlessandroPadovani, David K.Menon, TomSolomon, Andrea S.Winkler2023 | The Journal of Neuropsychiatry and Clinical Neurosciences, Vol. 35, No. 1An online observational study assessing clinical characteristics and impacts of the COVID-19 pandemic on mental health: a perspective study from BangladeshFahmida BegumMina, MutasimBillah, SumonKarmakar, SabujDas, Md. SiddikurRahman, Md. FarukHasan, Uzzal KumarAcharjee2023 | Journal of Public Health, Vol. 31, No. 2Prognosis value of pupillometry in COVID-19 patients admitted in intensive care unitMatthieuDaniel, DavidCharier, BrunoPereira, MathildePachcinski, TarekSharshar, SergeMolliex2023 | Autonomic Neuroscience, Vol. 245Autoimmunity, COVID-19, Post-COVID19 Syndrome and COVID-19 VaccinationPolinaSobolevskaia, AndreiKolobov, LeonidP. Churilov2023Pediatric recurrent acute necrotizing encephalomyelitis, RANBP2 genotype and Sars-CoV-2 infection: Diagnosis, pathogenesis and targeted treatments from a case studyCristinaForest, MicheleLaudisi, CristinaMalaventura, ValeriaTugnoli, GiudittaPellino, ElisabettaMarangoni, EleonoraBaldi, LucaBorgatti, MauraPugliatti, AgneseSuppiej2023 | European Journal of Paediatric Neurology, Vol. 42Clinical Profile of COVID-19 Patients Admitted at a Private Hospital During Three Surges in Mandalay, MyanmarKyuKyu, Tin KoKo, Zin MarLwin, May KyiSoe, Kyaw WinMaw, Aung MyoThant, KyiShin, MoeKyaw Myint2023 | CureusAmyloidogenic proteins in the SARS-CoV and SARS-CoV-2 proteomesTaniyaBhardwaj, KundlikGadhave, Shivani K.Kapuganti, PrateekKumar, Zacharias FaidonBrotzakis, Kumar UditSaumya, NamyashreeNayak, AnkurKumar, RichaJoshi, BodhidipraMukherjee, AparnaBhardwaj, Krishan GopalThakur, NehaGarg, MicheleVendruscolo, RajanishGiri2023 | Nature Communications, Vol. 14, No. 1Action of the Purinergic and Cholinergic Anti-inflammatory Pathways on Oxidative Stress in Patients with Alzheimer's Disease in the Context of the COVID-19 PandemicJúlia L.B.Simões, Leilane D.Sobierai, Inayá F.Leal, Miriam V.R.Dos Santos, João VictorCoiado, Margarete D.Bagatini2023 | Neuroscience, Vol. 512COVID-опосередковані цереброваскулярні катастрофиГаннаРусіна, ЯрославЖулего, АнастасіяРусіна2023 | InterConf, No. 30(143)Neuroimaging findings and neurological manifestations in hospitalized COVID-19 patients: Impact of cancer and ventilatory support statusLilyMcCarthy, OleksandrKhegai, JonathanGoldstein, PuneetBelani, PuneetPawha, ShingoKihira, BrianMathew, KapilGururangan, QingHao, AnuradhaSingh, AllisonNavis, Bradley N.Delman, NathalieJette, PritiBalchandani, YiminChen2023 | PLOS ONE, Vol. 18, No. 3Acute Neurological Complications of Coronavirus DiseaseSandersChang, MichaelSchecht, RajanJain, PuneetBelani2023 | Neuroimaging Clinics of North America, Vol. 33, No. 1Radiology of Infectious and Inflammatory Diseases - Volume 1LiLi, YinglinGuo, DanZhang, JunLiu, WenxiaoJia, LonglinYin, MeijiRen, NuerbiyemuAbulikemu, XueningZhang2023HeadacheMügeAyhan, BelginCoşkun, RahmetGüner2023Systemic Inflammatory Biomarkers in DSM-5–Defined Disorders and COVID-19: Evidence From Published Meta-analysesAngelaDuong, HyunjinJeong, DanaEl Soufi El Sabbagh, Ana C.Andreazza2023 | Biological Psychiatry Global Open Science, Vol. 3, No. 2Acute necrotizing encephalopathy associated with RANBP2 mutation: value of MRI findings for diagnosis and interventionEsraSarigecili, Habibe KocUcar, CengizHavali, AliCansu, KursadAydin2023 | Acta Neurologica Belgica, Vol. 123, No. 2Review of Neurological Manifestations of SARS-CoV-2Priyal., VineetSehgal, SaniyaKapila, RishabhTaneja, PrachiMehmi, NihalGulati2023 | CureusPathological Effects of COVID-19 on Body OrgansSaberehAhmadzadeh, MehrnooshSedighi, AminTorkashvand, PejmanHashemzadeh, FatemeShafiei, MohammadTorkashvand, AtefehHasan-Zadeh2023 | Journal of Medical Microbiology and Infectious Diseases, Vol. 11, No. 1Crosstalk between SARS-CoV-2 Infection and Neurological Disorders: A ReviewAsimAzhar, Mohammad AkramWali, QudsiaRashid, Wajihul HasanKhan, KhaledAl-hosaini, MohammadOwais, Mohammad AmjadKamal2023 | CNS & Neurological Disorders - Drug Targets, Vol. 22, No. 5Neonatal Encephalitis and White Matter Injury in an Early Neonate: Cause or Association With COVID-19 Infection?AnilkumarKhamkar, PradeepSuryawanshi, P. D.Pote, Georgeena ElsaJose2023 | Journal of Neonatology, Vol. 37, No. 2Evaluation of abdominal computed tomography findings in patients with COVID-19: a multicenter studyMehmet RuhiOnur, YakupÖzbay, İlkayİdilman, Ali DevrimKaraosmanoğlu, SelmaUysal Ramadan, FundaBarlık, SonayAydın, HüseyinOdaman, CananAltay, IşılBaşara Akın, OğuzDicle, ÖzgürAppak, BaşakGülpınar, AyşeErden, SezerKula, AyşegülGürsöy Çoruh, DiğdemKuru Öz, MelahatKul, ÇağlarUzun, ErdalKaravaş, AkınLevent, HakanArtaş, HasanEryeşil, OnurSolmaz, TürkkanÖztürk Kaygusuz, MustafaFaraşat, Ahmet BurakKale, FatihDüzgün, GökhanPekindil, F. DemirApaydın, MeltemNass Duce, YükselBalcı, KaanEsen, AyşegülSağır Kahraman, LeylaKaraca, ZeynepMaraş Özdemir, BayramKahraman, MesudeTosun, Mehmet SelimNural, İlkayÇamlıdağ, Mustafa ArdaOnar, KaanBallı, EzgiGüler, MustafaHarman, Nevra ZehraElmas, CansuÖztürk, ÖzlemGüngör, DuyguHerek, Ahmet BakiYağcı, CengizErol, MehmetŞeker, İremİşlek, YusufCan, SerdarAslan, M. YaseminKaradeniz Bilgili, AlperGöncüoğlu, HaticeKeleş, Pelin ZeynepBekin Sarıkaya, BarışBakır, Merve GülbizDağoğlu Kartal, GörkemDurak, GülşenYücel Oğuzdoğan, FatihAlper, AhmetYalçın, SafiyeGürel, BircanAlan, ElifGündoğdu, NevinAydın, AyşegülCansu, CeydaCivan Kuş, ElifOfluoğlu Tuncer, Ferhat CanPişkin, HaleÇolakoğlu Er, BuminDeğirmenci, Mustafa NasuhÖzmen, MecitKantarcı, MuşturayKarçaaltıncaba2023 | Diagnostic and Interventional Radiology, Vol. 29, No. 3Practical Guide to Simulation in Delivery Room EmergenciesMatteoLoverro, NicolaLaforgia, Maria TeresaLoverro, AntonioMalvasi, EdoardoDi Naro2023An impact of the COVID-19 pandemia on the onset and course of mental disorders in elderlyO.B.Yakovleva, T.P.Safarova, D.A.Tsvetaeva2023 | Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova, Vol. 123, No. 5Encephalomyelitis associated with Covid-19 infection: case reportGuldenDemirci Otluoglu, UlasYener, Mustafa KemalDemir, BaranYilmaz2023 | British Journal of Neurosurgery, Vol. 37, No. 3Neuroimaging of COVID-19JisooKim, Geoffrey S.Young2023 | Seminars in Neurology, Vol. 43, No. 02COVID-19 related acute necrotizing encephalopathy presenting in the early postoperative periodElissavetSymeonidou, AndronikiDimitriadou, AntoniosMorsi-Yeroyannis2023 | Archive of Clinical Cases, Vol. 10, No. 2Biological correlates of the neuropsychiatric symptoms in SARS-CoV-2 infection: an updated reviewSrinageshMannekote Thippaiah, ShabbirAmanullah, Zi HuaiHuang, EdwardGoldschmidt, BasantPradhan2023 | The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, Vol. 59, No. 1Covid-19 : manifestations et complications neurologiques à la phase aiguë de la maladieThomasde Broucker2023 | Bulletin de l'Académie Nationale de Médecine, Vol. 207, No. 7Volume mismatch indicates tumors in paramedial bithalamic diseases: a retrospective studyLuSu, PeiyiGao2023 | Frontiers in Neurology, Vol. 14COVID-19 and Neurological ManifestationsKathleenForero, RaghadBuqaileh, ClareSunderman, WissamAbouAlaiwi2023 | Brain Sciences, Vol. 13, No. 8Thromboembolic Disorder in COVID-19 InfectionShawnLee, JosephGunderson, RazaMushtaq2023 | Current Medical Imaging Formerly Current Medical Imaging Reviews, Vol. 19, No. 14Gravitational search algorithm‐extreme learning machine for COVID‐19 active cases forecastingBoyuHuang, YouyiSong, ZhihanCui, HaowenDou, DazhiJiang, TengZhou, JingQin2023 | IET Software, Vol. 17, No. 4Neurological post‐acute sequelae of SARS‐CoV‐2 infectionMasakiTakao, MasayukiOhira2023 | Psychiatry and Clinical Neurosciences, Vol. 77, No. 2Coronavirus Disease 2019 (COVID‐19)KiandokhtKeyhanian, Raffaella PizzolatoUmeton, BabakMohit, BrookeMcNeilly, MehdiGhasemi2023Neurological manifestations in SARS‐CoV‐2 infection: A single‐center cross‐sectional study in MalaysiaHui JanTan, Cheon HanGoh, Ching SoongKhoo, Chen FeiNg, Juen KiemTan, Wan AsyrafWan Zaidi, Zhe KangLaw, Muhamad DanialZulkifli, Shahrul AzminMd Rani, Wan Nur NafisahWan Yahya, RabaniRemli, NorlinahMohamed Ibrahim, RozitaHod, Shahizon AzuraMohamed Mukari, Aida‐Widure MustaphaMohd Mustapha, NajmaKori, PetrickPeriyasamy2023 | Neurology and Clinical Neuroscience, Vol. 11, No. 1Central Diabetes Insipidus: An Acute Manifestation of COVID-19 InfectionSharanyaSuresh Kumar, KiranKumar, SnehaVenkataramani, Naail MohammedGhazi2023 | CureusDiffusion Restriction in Bilateral Thalami: Beyond Artery of Percheron InfarctReshmaSShaik, SandhyaManorenj, SravanKMarupaka, TasneemAra2023 | Neurology India, Vol. 71, No. 4Cerebrospinal fluid cytochemical analysis from COVID-19 patients with neurological disordersDavidQuispe-Aranda, GloriaCruz-Gonzales, VíctorRojas-Zumaran, ArístidesHurtado-Concha, WilliamCruz-Gonzales, JeelMoya-Salazar, EderWalttuoni-Picón18 October 2023 | F1000Research, Vol. 12Acute Necrotizing Encephalopathy in Adult Patients With COVID-19: A Systematic Review of Case Reports and Case SeriesShaghayeghKarami, FattanehKhalaj, HoumanSotoudeh, ZohrehTajabadi, RaminShahidi, Mohammad AminHabibi, Mahsa ShirforoushSattari, AmirAzimi, Seyed AliForouzannia, RominaRafiei, HamidReihani, RezaNemati, Sora