Post-COVID cognitive deficits at one year are global and associated with elevated brain injury markers and grey matter volume reduction: national prospective study-Reference-Cited by-同舟云学术

Post-COVID cognitive deficits at one year are global and associated with elevated brain injury markers and grey matter volume reduction: national prospective study

Published:2024-01-05 Issue: Volume: Page:
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Author:

Michael Benedict¹,Wood Greta²^ORCID,Sargent Brendan²,Ahmad Zain-Ul-Abideen³,Tharmaratnam Kukatharamini¹^ORCID,Dunai Cordelia²,Egbe Franklyn¹^ORCID,Martin Naomi⁴,Facer Bethany⁵,Pendered Sophie²,Rogers Henry³,Hübel Christopher³,Wamelen Daniel van³^ORCID,Bethlehem Richard⁶,Giunchiglia Valentina⁷,Hellyer Peter⁸,Trender William⁹^ORCID,Kalsi Gursharan³,Needham Edward¹⁰^ORCID,Easton Ava²,Jackson Thomas¹¹,Cunningham Colm¹²^ORCID,Upthegrove Rachel¹³^ORCID,Pollak Thomas³,Hotopf Matthew³,Solomon Tom¹⁴^ORCID,Pett Sarah¹⁵,Shaw Pamela¹⁶^ORCID,Wood Nicholas¹⁷^ORCID,Harrison Neil¹⁸^ORCID,Miller Karla¹⁹,Jezzard Peter²⁰^ORCID,Williams Guy²¹,Duff Eugene²²,Williams Steven²³^ORCID,Zelaya Fernando⁸,Smith Stephen²⁴^ORCID,Keller Simon⁵,Broome Matthew¹³,Kingston Nathalie,Husain Masud²⁰^ORCID,Vincent Angela²⁰^ORCID,Bradley John¹⁰^ORCID,Chinnery Patrick²⁵,Menon David¹⁰^ORCID,Aggleton John²⁶,Nicholson Timothy²⁷,Taylor John-Paul²⁸,David Anthony²⁹,Carson Alan³⁰,Bullmore Edward³¹,Breen Gerome⁸^ORCID,Hampshire Adam⁹,Paddick Stella-Maria³²,corsortium COVID-CNS³³,Leek Charles³⁴

Affiliation:

1. University of Liverpool

2. Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool

3. Institute of Psychiatry, Psychology & Neuroscience, King's College London

4. Institute of Psychiatry, Psychology & Neuroscience

5. Institute of Systems, Molecular and Integrative Biology, University of Liverpool

6. Department of Psychology, University of Cambridge

7. Department of Brain Sciences, Faculty of Medicine, Imperial College London

8. King's College London

9. Imperial College London

10. University of Cambridge

11. Institute of Inflammation and Ageing, University of Birmingham

12. Trinity College Dublin

13. University of Birmingham

14. U Liverpool

15. Medical Research Council Clinical Trials Unit at University College London

16. University of Sheffield

17. University College London Queen Square Institute of Neurology

18. Cardiff University

19. Wellcome Centre for Integrative Neuroimaging, FMRIB, Oxford University

20. University of Oxford

21. Wolfson Brain Imaging Centre, University of Cambridge

22. UK Dementia Research Institute, Department of Brain Sciences, Imperial College London

23. Institute of Pyschiatry, Psychology and Neuroscience, King's College London

24. Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford

25. MRC Mitochondrial Biology Unit, University of Cambridge

26. School of Psychology, Cardiff University

27. KCL, UK

28. Translational and Clinical Research Institute, Newcastle University

29. Institute of Mental Health, UCL

30. Centre for Clinical Brain Sciences, University of Edinburgh; 49 Little France Crescent, Edinburgh, United Kingdom EH16 4SB

31. ImmunoPsychiatry, GlaxoSmithKline Research and Development

32. Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University

33. University of Liverpool and King's College London

34. Department of Psychology, Institute of Population Health, University of Liverpool

Abstract

Abstract The spectrum, pathophysiology, and recovery trajectory of persistent post-COVID-19 cognitive deficits are unknown, limiting our ability to develop prevention and treatment strategies. We report the one-year cognitive, serum biomarker, and neuroimaging findings from a prospective, national longitudinal study of cognition in 351 COVID-19 patients who had required hospitalisation, compared to 2,927 normative matched controls. Cognitive deficits were global and associated with elevated brain injury markers and reduced anterior cingulate cortex volume one year after admission. The severity of the initial infective insult, post-acute psychiatric symptoms, and a history of encephalopathy were associated with greatest deficits. There was strong concordance between subjective and objective cognitive deficits. Treatment with corticosteroids during the acute phase appeared protective against cognitive deficits. Together, these findings support the hypothesis that brain injury in moderate to severe COVID-19 is immune-mediated, and should guide the development of therapeutic strategies.

Publisher

Research Square Platform LLC

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