Evidence map›Paper›PMID 36961861›Full record

Observational studyPloS one2023

Neuroimaging findings and neurological manifestations in hospitalized COVID-19 patients: Impact of cancer and ventilatory support status.

Lily McCarthy, Oleksandr Khegai, Jonathan Goldstein, Puneet Belani, Puneet Pawha, Shingo Kihira, Brian Mathew, Kapil Gururangan, Qing Hao, Anuradha Singh and 4 more

Open access · goldFull text readObservational Study
In one paragraph

Observational study in PloS one, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Lily McCarthyIcahn School of Medicine at Mount Sinai, New York, NY, United States of America.ORCID 0000-0003-2079-0612
Oleksandr KhegaiBioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Jonathan GoldsteinDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Puneet BelaniDepartment of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Puneet PawhaDepartment of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Shingo KihiraDepartment of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Brian MathewDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Kapil GururanganDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.ORCID 0000-0001-5247-8303
Qing HaoDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Anuradha SinghDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Allison NavisDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Bradley N DelmanDepartment of Diagnostic, Molecular and Interventional Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Nathalie JetteDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Priti BalchandaniBioMedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
Icahn School of Medicine at Mount Sinai · US

Funding

7T Neurosurgical Mapping Protocol for Endoscopic Resection of Skull Base TumorsR01CA202911 · NCI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI BALCHANDANI, PRITI · 2016 to 2020
$2.1M
Identifying the Long-Term Neurological Effects of COVID-19 Using 7 Tesla Multi-Modal MRIR21NS122389 · NINDS · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI BALCHANDANI, PRITI · 2021 to 2021
$465k
NCI NIH HHS R01 CA202911NINDS NIH HHS R21 NS122389
6 · The paper itself

Abstract

introductionCoronavirus 2019 (COVID-19) is known to affect the central nervous system. Neurologic morbidity associated with COVID-19 is commonly attributed to sequelae of some combination of thrombotic and inflammatory processes. The aim of this retrospective observational study was to evaluate neuroimaging findings in hospitalized COVID-19 patients with neurological manifestations in cancer versus non-cancer patients, and in patients with versus without ventilatory support (with ventilatory support defined as including patients with intubation and noninvasive ventilation). Cancer patients are frequently in an immunocompromised or prothrombotic state with side effects from chemotherapy and radiation that may cause neurological issues and increase vulnerability to systemic illness. We wanted to determine whether neurological and/or neuroimaging findings differed between patients with and without cancer.

methodsEighty adults (44 male, 36 female, 64.5 ±14 years) hospitalized in the Mount Sinai Health System in New York City between March 2020 and April 2021 with reverse-transcriptase polymerase chain reaction-confirmed COVID-19 underwent magnetic resonance imaging (MRI) during their admissions. The cohort consisted of four equal subgroups based on cancer and ventilatory support status. Clinical and imaging data were acquired and analyzed.

resultsNeuroimaging findings included non-ischemic parenchymal T2/FLAIR signal hyperintensities (36.3%), acute/subacute infarcts (26.3%), chronic infarcts (25.0%), microhemorrhages (23.8%), chronic macrohemorrhages (10.0%), acute macrohemorrhages (7.5%), and encephalitis-like findings (7.5%). There were no significant differences in neuroimaging findings between cancer and non-cancer subgroups. Clinical neurological manifestations varied. The most common was encephalopathy (77.5%), followed by impaired responsiveness/coma (38.8%) and stroke (26.3%). There were significant differences between patients with versus without ventilatory support. Encephalopathy and impaired responsiveness/coma were more prevalent in patients with ventilatory support (p = 0.02). Focal weakness was more frequently seen in patients without ventilatory support (p = 0.01). DISCUSSION: This study suggests COVID-19 is associated with neurological manifestations that may be visible with brain imaging techniques such as MRI. In our COVID-19 cohort, there was no association between cancer status and neuroimaging findings. Future studies might include more prospectively enrolled systematically characterized patients, allowing for more rigorous statistical analysis.

Indexed as

COVID-19NeoplasmsStrokeAdultComaFemaleHumansMaleNeuroimagingSARS-CoV-2

Identifiers

PMID36961861
PMCPMC10038284
OpenAlexW4360806069

What OpenQuestion holds

Textfull text, public
LicenceCC BY
measurements read44
identifiers read4
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.