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

Abstract

\n Background\n 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).\n \n Purpose\n We aim to compile and analyze brain MRI findings in patients with COVID-19 disease and PRES.\n \n Methods\n 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\u202fyears of age or older with evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and PRES.\n \n Results\n Twenty manuscripts were included in the analysis, which included descriptions of 30 patients. The average age was 57\u202fyears 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.\n \n Conclusions\n 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.\n