Coronavirus (COVID-19)

Allan Klotsche

1H-MR spectra of 3 consecutive patients with COVID-19. Upper row: Axial FLAIR images at the corona radiata level show representative MRS voxels (black squares) from sampled periventricular regions. Lower row: Corresponding spectrum (black) and LCModel fit (red) from each patient acquired at TE = 30 ms (upper row) and TE = 288 ms (lower row). A, A patient with COVID-19-associated multifocal necrotizing leukoencephalopathy shows diffuse patchy WM lesions with markedly increased Cho and decreased NAA, as well as elevated Lac. B, A patient with COVID-19 after recent PEA cardiac arrest with subtle FLAIR hyperintense white matter changes also shows elevated Cho/Cr and decreased NAA/Cr ratios. However, these derangements are less severe than in the patient in A. There is no clear elevation of Lac. C, A patient with COVID-19 without encephalopathy or recent severe hypoxia has normal Cho/Cr, with mildly decreased NAA/Cr and no lactate elevation. Cho, Choline; NAA, N-Acetyl-Aspartate; mI, Myo-Inositol; Lac, Lactate; Glx, Glutamate + Glutamine. Image courtesy of AJNR

Kaplan-Meier curves for all-cause mortality in patients with versus without myocardial injury (Panel A) and in patients with versus without myocardial injury according to the presence or absence of major echocardiographic abnormalities (Panel B). *Includes wall motion abnormalities, global left ventricular dysfunction, diastolic dysfunction, right ventricular dysfunction and presence of pericardial effusion. Event rates are censored at 20 days from hospital admission. Images courtesy of Mount Sinai Health System