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COVID-19-associated cerebral microbleeds in the general population

Sagar et al., Brain Communications, doi:10.1093/braincomms/fcae127
Apr 2024  
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Retrospective 73 COVID-19 outpatients and 219 matched controls showing a significantly higher rate of cerebral microbleeds on MRI in COVID-19 patients (12%) compared to controls (5%). The increased occurrence of microbleeds persisted when excluding patients with dementia and critical illness. The results suggest COVID-19 may be associated with an increased risk of cerebral microbleeds, even in non-hospitalized patients.
Immediate treatment recommended. SARS-CoV-2 infection primarily begins in the upper respiratory tract and may progress to the lower respiratory tract, other tissues, and the nervous and cardiovascular systems, which may lead to cytokine storm, pneumonia, ARDS, neurological injury1-12 and cognitive deficits4, cardiovascular complications13, organ failure, and death. Minimizing replication as early as possible is recommended.
Sagar et al., 15 Apr 2024, retrospective, Denmark, peer-reviewed, 7 authors. Contact: ckruuse@dadlnet.dk.
This PaperMiscellaneousAll
COVID-19-associated cerebral microbleeds in the general population
Malini V Sagar, Neus R Ferrer, Mostafa Mehdipour Ghazi, Kiril V Klein, Espen Jimenez-Solem, Mads Nielsen, Christina Kruuse
Brain Communications, doi:10.1093/braincomms/fcae127
Cerebral microbleeds are frequent incidental findings on brain MRI and have previously been shown to occur in Coronavirus Disease 2019 (COVID-19) cohorts of critically ill patients. We aimed to determine the risk of having microbleeds on medically indicated brain MRI and compare non-hospitalized COVID-19-infected patients with non-infected controls. In this retrospective case-control study, we included patients over 18 years of age, having an MRI with a susceptibility-weighted sequence, between 1 January 2019 and 1 July 2021. Cases were identified based on a positive reverse transcriptase polymerase chain reaction test for SARS-CoV-2 and matched with three non-exposed controls, based on age, sex, body mass index and comorbidities. The number of cerebral microbleeds on each scan was determined using artificial intelligence. We included 73 cases and 219 matched non-exposed controls. COVID-19 was associated with significantly greater odds of having cerebral microbleeds on MRI [odds ratio 2.66 (1.23-5.76, 95% confidence interval)], increasingly so when patients with dementia and hospitalized patients were excluded. Our findings indicate that cerebral microbleeds may be associated with COVID-19 infections. This finding may add to the pathophysiological considerations of cerebral microbleeds and help explain cases of incidental cerebral microbleeds in patients with previous COVID-19.
Competing interests C.K., M.V.S., N.R.F., K.V.K., M.M.G. and M.N. have all received support from Innovation Fund Denmark; M.
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