- Based on MRI scans, 16/37 (43%) of patients had signal abnormalities located in the medial temporal lobe

Signal abnormalities located in the medial temporal lobe

- Based on MRI scans, 11/37 patients (30%) had "non-confluent multifocal white matter hyperintense lesions on FLAIR and diffusion sequences, with variable enhancement, with associated hemorrhagic lesions".

Non-confluent multifocal white matter hyperintense lesions 

- Based on MRI scans, 9/37 patients (24%) had extensive and isolated white matter microhemorrhages 

Extensive and isolated white matter microhemorrhages

- This patient was a 57-year old man whose MRIs showed extensive and isolated white matter microhemorrhages.

Example MRI Image 

- 37 patients with severe COVID-19 met the criteria of the study
- Patients were evaluated from March 23th, 2020 to April 27th, 2020 at 16 different hospitals 

Smith College

Most researchers believe the neurological effect of the virus are an indirect result of either oxygen starvation to the brain (the “happy hypoxia” exhibited by many patients), or the byproduct of the body’s inflammatory response (the famed “cytokine storm”).  A pateints MRI brain scan showed signs of viral meningitis (inflammation of the brain), and a lumbar puncture detected Sars-CoV-2 in his cerebrospinal fluid.  Another patient had viral particals detected in the  endothelial cells lining the blood vessels of the brain itself. In fact, some scientists now suspect that the virus causes respiratory failure and death not through damage to the lungs but through damage to the brainstem.

How COVID-19 can damage the brain

Kremer, S., Lersy, F., Sèze, J. D., Ferré, J., Maamar, A., Carsin-Nicol, B., . . . Cotton, P. F. (2020). Brain MRI Findings in Severe COVID-19: A Retrospective Observational Study. Radiology, 202222. doi:10.1148/radiol.2020202222
https://pubs.rsna.org/doi/full/10.1148/radiol.2020202222

Brain MRI Findings in Severe COVID-19: A Retrospective Observational Study

Prevalence of Various Types of Brain Damage due to COVID-19

Researchers used cerebral organoids (3D in vitro models of brain tissue) to examine the potential effects that SARS-CoV-2 may have on the brain.  Choroid plexus (ChP) epithelial cells in the brain organoids were detected to contain SARS-CoV-2 entry factors, such as the receptor ACE2.  Upon incubating the organoids with SARS-CoV-2 spike protein pseudovirus and live virus, the ChP cells were infected with both the spike pseudovirus and live virus, as demonstrated by immunostaining of ACE2 on the infected cells.  Infecting the organoids with live SARS-CoV-2 appeared to further impact the ChP by breaking down the barrier of the ChP.  Because the ChP is a crucial barrier that plays a key function in stopping cytokines and immune cells from entering the brain and cerebrospinal fluid (CSF), it is important to consider potential adverse neurological effects that may arise from SARS-CoV-2 disrupting the ChP.     

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