Abstract
We review the wide variety of common neuroimaging manifestations related to coronavirus
disease 2019 (COVID-19) and COVID therapies, grouping the entities by likely pathophysiology,
recognizing that the etiology of many entities remains uncertain. Direct viral invasion
likely contributes to olfactory bulb abnormalities. COVID meningoencephalitis may
represent direct viral infection and/or autoimmune inflammation. Para-infectious inflammation
and inflammatory demyelination at the time of infection are likely primary contributors
to acute necrotizing encephalopathy, cytotoxic lesion of the corpus callosum, and
diffuse white matter abnormality. Later postinfectious inflammation and demyelination
may manifest as acute demyelinating encephalomyelitis, Guillain–Barré syndrome, or
transverse myelitis. The hallmark vascular inflammation and coagulopathy of COVID-19
may produce acute ischemic infarction, microinfarction contributing to white matter
abnormality, space-occupying hemorrhage or microhemorrhage, venous thrombosis, and
posterior reversible encephalopathy syndrome. Adverse effects of therapies including
zinc, chloroquine/hydroxychloroquine, antivirals, and vaccines, and current evidence
regarding “long COVID” is briefly reviewed. Finally, we present a case of bacterial
and fungal superinfection related to immune dysregulation from COVID.
Keywords
neuroimaging - COVID - MRI
