2019年冠状病毒病(COVID-19)
感染控制
严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)
医学
2019-20冠状病毒爆发
认知
病毒学
内科学
重症监护医学
精神科
爆发
传染病(医学专业)
疾病
作者
Víctor M Serrano del Pueblo,Gemma Serrano‐Heras,Carlos Manuel Romero Sánchez,Pedro Landete,Laura Rojas-Bartolome,Inmaculada Feria,Richard Morris,Bryan A. Strange,Francisco Mansilla,Linda Zhang,Beatriz Castro-Robles,Lourdes Arias-Salazar,Susana López-López,María de los Ángeles Payá,Tomás Segura,Mayra López
出处
期刊:Brain
[Oxford University Press]
日期:2024-04-02
标识
DOI:10.1093/brain/awae101
摘要
Abstract Between 2.5 and 28% of people infected with SARS-CoV-2 suffer Long COVID or persistence of symptoms for months after acute illness. Many symptoms are neurological, but the brain changes underlying the neuropsychological impairments remain unclear. This study aimed to provide a detailed description of the cognitive profile, the pattern of brain alterations in Long COVID and the potential association between them. To address these objectives, 83 patients with persistent neurological symptoms after COVID-19 were recruited, and 22 now healthy controls chosen because they had suffered COVID-19 but did not experience persistent neurological symptoms. Patients and controls were matched for age, sex and educational level. All participants were assessed by clinical interview, comprehensive standardized neuropsychological tests and structural MRI. The mean global cognitive function of patients with Long COVID assessed by ACE III screening test (Overall Cognitive level - OCLz= -0.39± 0.12) was significantly below the infection recovered-controls (OCLz= +0.32± 0.16, p< 0.01). We observed that 48% of patients with Long COVID had episodic memory deficit, with 27% also impaired overall cognitive function, especially attention, working memory, processing speed and verbal fluency. The MRI examination included grey matter morphometry and whole brain structural connectivity analysis. Compared to infection recovered controls, patients had thinner cortex in a specific cluster centred on the left posterior superior temporal gyrus. In addition, lower fractional anisotropy (FA) and higher radial diffusivity (RD) were observed in widespread areas of the patients’ cerebral white matter relative to these controls. Correlations between cognitive status and brain abnormalities revealed a relationship between altered connectivity of white matter regions and impairments of episodic memory, overall cognitive function, attention and verbal fluency. This study shows that patients with neurological Long COVID suffer brain changes, especially in several white matter areas, and these are associated with impairments of specific cognitive functions.
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