Objective: To investigate the incidence and spectrum of neuroimaging ndings and their prognostic role
in hospitalized COVID-19 patients in Government Medical College Nagpur along with their correlation
with D-Dimer Values and GCS .
Methods: This is a retrospective cohort study of 774 COVID-19 conrmed patients admitted to Government Medical College
st st Nagpur between 1 April 2020 and 31 October 2020. Clinical data were extracted from electronic medical records, and
particularly data of all neurological symptoms were extracted from the imaging reports. Four neuro-radiologists evaluated all
neuroimaging studies for acute neuroimaging ndings related to COVID-19. Plasma D-dimer levels were measured using a
particle-enhanced, immunoturbidimetric assay on admission in the 116 patients who came for evaluation of neurological
symptoms.
Moreover ,the patients were classied into different groups as mild, moderate and severe based on their GCS scores and was
assessed with respect to their neuro-imaging ndings.
Results: 15 % of the admitted patients suffered from neurological symptoms. Acute stroke was the most common nding in the
patients with positive neuroimaging ndings resulting in 34.4% of the patients with positive neuroimaging ndings. Other
ndings were subacute infarcts (13.8%), Chronic lacunar infarcts (20.6%) , Intraparenchymal hemorrhage in 10.4 %,
hypertensive encephalopathy in 7 % and subarachanoid hemorrhage in 3.4 %.
Plasma median D-dimer levels were signicantly (P = 0.000) higher in Acute stroke patients as compared to COVID 19
positive patients who had negative CT scan imaging features(0.88; interquartile range [IQR], 0.28–2.11 mg/L and 0.31; IQR,
0.17–0.74 mg/L).
Patients who have positive neuroimaging ndings presented with a lower GCS whereas patients who had negative
neuroimaging ndings presented with a higher GCS.
Conclusions: Our study demonstrates acute stroke is the most common neuroloimaging nding in hospitalized COVID 19
Patients. Moreover D-Dimer values are highly predictive of acute ischemic stroke. Patients with positive neuro-imaging ndings
have poor GCS scores.
Prognostic Value of the Preoperative Plasma D-Dimer Levels in Patients with Upper Tract Urothelial Carcinoma in a Retrospective Cohort Study