Neuroimaging Findings in Patients with Covid-19 in Indonesia


  • Cindy Sadikin RS Premier Surabaya, Indonesia
  • Meryana Meryana Department of Neurology, Premier Surabaya Hospital, Surabaya, Indonesia, Indonesia
  • Valentinus Besin Department of Neurology, Premier Surabaya Hospital, Surabaya, Indonesia, Indonesia
  • Yanna Saelan Department of Neurology, Premier Surabaya Hospital, Surabaya, Indonesia, Indonesia



Covid-19, neurological, manifestation, neuroimaging


Background: Covid-19 caused by the SARS-CoV-2 virus has spread worldwide, including Indonesia. Neurological manifestations has also been reported in Covid-19 positive patients. Yet documentation of their neuroimaging findings are lacking, especially in Indonesia.
Objective: To understand neuroimaging findings in Covid-19 positive patients

Methods: An observational study from medical record of Covid-19 positive patients in our hospital who developed abnormal neurologic manifestations and were followed up by neuroimaging examination from May to August 2020. Covid-19 positive diagnosis was confirmed from nasopharyngeal swab using the Real Time Polymerase Chain Reaction (RT-PCR). Neurological examination was performed by a neurologist, who then referred patients for neuroimaging examination using CT or MRI. Radiological expertise was performed by a radiologist.

Results: A total of 288 patients who are Covid-19 positive from nasopharyngeal RT-PCR swab admitted to our hospital from May to August 2020. Ten patients (3.5%) had abnormal neurologic manifestations and further neuroimaging examination follow up. Range of age 33-72 years old and slight male predominance (60%). Frequent clinical symptoms were decreased consciousness (40%), altered mental status (30%) and tremors (20%). Neuroimaging findings were large vessel occlusion (30%), vasculitis (20%), post hipoxic leucoencephalopathy (10%), basal ganglia encephalopathy (10%), non specific small vessel ischemia changes and negative findings (30%). Most patients were discharged with clinical improvement (60%), while 40% mortality rate were seen in patient with large vessel occlusion (30%) and vasculitis (10%).

Conclusion: Neuroimaging findings in Covid-19 positive patients were large vessel occlusion (LVO), vasculitis, post hipoxic leucoencephalopathy and basal ganglia encephalopathy
Keywords: Covid-19, neurological, manifestation, neuroimaging


Download data is not yet available.


1. Kemenkes RI. Pedoman Pencegahan dan Pengendalian Coronavirus Disease (COVID-19), Germas; 2020. pp. 0–115
2. Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: what we know. International Journal of Infectious Diseases. 2020.
3. Behzad S, Aghaghazvini l, Radmard A, Gholamrezanezhad A. Extrapulmonarymanifestations of COVID-19: radiological and clinical overview. Clinical imag-ing. 2020
4. Mao L., et al. Neurologic manifestation of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurology; 2020.
5. Vollono C, Rollo E, Romozzi M, et al. Focal status epilepticus as unique clinical
feature of COVID-19: a case report. Seizure. 2020.
5. Vu D, Ruggiero M, Choi WS, et al. Three unsuspected CT diagnoses of COVID-19. Emergency Radiology. 2020:1–4.
6. Singhania N, Bansal S, Singhania G. An Atypical Presentation of Novel Coronavirus Disease 2019 (COVID-19). The American Journal of Medicine. 2020.
7. Amit A, Marco P, Karuna R, et al. Neurological emergencies associated with COVID-19: stroke and beyond. Emergency Radiology. 2020.
8. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 2020;395(10229):1033–4.
9. Conde Cardona G, Quintana Pajaro LD, Quintero Marzola ID, et al. Neurotropism of SARS-CoV 2: mechanisms and manifestations. J Neurol Sci 2020;412:116824
10. Marini JJ, Gattinoni L. Management of COVID-19 respiratory distress. JAMA 2020 April 24.
11. Kaveh H, Roya G, Misagh S. Basal Ganglia Involvement and Altered Mental Status: A Unique Neurological Manifestation of Coronavirus Disease 2019. Cureus. 2020 April; 12(4):e7869.
12. Hamming I, Timens W, Bulthuis M, Lely A, Navis G, van Goor H: Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004, 203:631-637.
13. Lau K-K, Yu W-C, Chu C-M, Lau S-T, Sheng B, Yuen K-Y: Possible central nervous system infection by SARS coronavirus. Emerg Infect Dis. 2004, 10:342-344
14. Wang D, Hu B, Hu C, et al.: Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020, 323:1061.
15. Netland J, Meyerholz DK, Moore S, et al. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol. 2008;82:7264–7275
16. Baig AM, Khaleeq A, Ali U, Syeda H: Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020, 11:995-998.

Additional Files



How to Cite

Sadikin C, Meryana M, Besin V, Saelan Y. Neuroimaging Findings in Patients with Covid-19 in Indonesia. Medica Hospitalia J. Clin. Med. [Internet]. 2021 Mar. 23 [cited 2024 Apr. 17];8(1):69-73. Available from:



Original Article

Citation Check