Brain MRI findings in patients with post COVID-19 condition: frequency and longitudinal changes in a nationwide cohort study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Prolonged neurological symptoms following COVID-19 are common, yet few longitudinal studies describe brain MRI findings in this patient group. The use of contrast enhanced sequences is particularly lacking. We address this knowledge gap by reporting the frequency and longitudinal changes in brain MRI findings among patients with post COVID-19 condition exhibiting neurological symptoms. Methods: This prospective multicenter study included 140 adult patients referred for persistent neurological symptoms following COVID-19. Brain MRI was performed at both 6 and 12 months after infection onset, reporting white matter hyperintensities, cerebral microbleeds, and additional pathological findings including contrast enhancement. White matter hyperintensities were compared with a healthy control group. Results: The prevalence of white matter hyperintensities was comparable to healthy controls, and microbleeds were found at rates comparable to population studies, with longitudinal changes being infrequent. Lesions consistent with inflammation or demyelination were present in 4% (5/120) of patients at 6 months. Cranial nerve enhancement was found in 7% (7/94) of patients, persisting up to 12 months, predominantly affecting the oculomotor nerve. However, enhancement occurred without clinically detected ocular muscle paresis. Conclusion: Our findings indicate that brain MRI primarily serves to exclude differential diagnoses in post COVID-19 condition, with limited clinical benefit of repeated imaging in the absence of new symptoms. However, signs of long-term inflammatory processes can be observed, and detection is improved by contrast enhanced sequences.
Source: Frontiers in Neurology
Authors: Liv Lygre Furevik, Oksana Lapina, Elisabeth Stokke Lindland, Einar August Høgestøl, Oliver Marcel Geier, Kristina Devik, Anette Huuse Farmen, Heidi Øyen Flemmen, Hanne Flinstad Harbo, Åse Hagen Morsund, Vojtech Novotny, Hilde Karen Ofte, Kenneth Ottesen Pedersen, Trine Haug Popperud, Barbara Ratajczak-Tretel, Christian Samsonsen, Per Selnes, Øivind Torkildsen, Ragnhild Marie Undseth, Anne Hege Aamodt, Mona Kristiansen Beyer, Marion Ingeborg Boldingh
Institutions: Oslo University Hospital, University of Oslo, Sørlandet Hospital Arendal, Namsos Hospital, Innlandet Hospital Trust, Telemark Hospital, Molde Hospital, Nordland Hospital Trust, Østfold Hospital Trust, Norwegian University of Science and Technology, St Olav's University Hospital, Akershus University Hospital, Haukeland University Hospital, University of Bergen, University of Liverpool
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
Funder: Universitetet i Oslo
OpenAlex ID: W4416166609