Posthospitalization COVID-19 cognitive deficits at 1 year are global and associated with elevated brain injury markers and gray matter volume reduction
Year: 2024
Type: article
Study design: Observational Study
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 1-year cognitive, serum biomarker and neuroimaging findings from a prospective, national study of cognition in 351 COVID-19 patients who required hospitalization, compared with 2,927 normative matched controls. Cognitive deficits were global, associated with elevated brain injury markers and reduced anterior cingulate cortex volume 1 year after COVID-19. Severity of the initial infective insult, postacute psychiatric symptoms and a history of encephalopathy were associated with the greatest deficits. There was strong concordance between subjective and objective cognitive deficits. Longitudinal follow-up in 106 patients demonstrated a trend toward recovery. Together, these findings support the hypothesis that brain injury in moderate to severe COVID-19 may be immune-mediated, and should guide the development of therapeutic strategies.
Source: Nature Medicine
Authors: Greta K. Wood, Brendan F. Sargent, Zain-Ul-Abideen Ahmad, Kukatharmini Tharmaratnam, Cordelia Dunai, Franklyn N. Egbe, Naomi H. Martin, Bethany Facer, Sophie L. Pendered, Henry C. Rogers, Christopher Hübel, Daniel J. van Wamelen, Richard A. I. Bethlehem, Valentina Giunchiglia, Peter J. Hellyer, William Trender, Gursharan Kalsi, Edward Needham, Ava Easton, Thomas A. Jackson, Colm Cunningham, Rachel Upthegrove, Thomas A. Pollak, Matthew Hotopf, Tom Solomon, Sarah L. Pett, Pamela J. Shaw, Nicholas Wood, Neil A. Harrison, Karla L. Miller, Peter Jezzard, Guy Williams, Eugene P. Duff, Steven Williams, Fernando Zelaya, Stephen M. Smith, Simon Keller, Matthew Broome, Nathalie Kingston, Masud Husain, Angela Vincent, John Bradley, Patrick Chinnery, David K. Menon, John P. Aggleton, Timothy R. Nicholson, John-Paul Taylor, Anthony S. David, Alan Carson, Ed Bullmore, Gerome Breen, Adam Hampshire, Ali M. Alam, Ammar Al-Chalabi, Christopher M. Allen, Jay Amin, Cherie Armour, Mark R. Baker, Suzanne Barrett, Neil Basu, Rahul Batra, Laura Benjamin, Alex Berry, Richard A. I. Bethlehem, Bethan Blackledge, Sarah A. Boardman, John Bradley, David P. Breen, Judith Breuer, Matthew Broome, Ed Bullmore, Matthew Butler, Hannah Castell, Jonathan Cavanagh, David Christmas, David M. Christmas, Jonathan R. I. Coleman, Alaistair Coles, Ceryce Collie, Nadine Cossette, David Cousins, Alastair Darby, Nicholas Davies, Sylviane Defres, Katherine C. Dodd, Alex Dregan, Eugene Duff, Mark A. Ellul, Nikos Evangelou, Peter M. Fernandes, Richard Francis, Ian Galea, Afagh Garjani, Lily George, Valentina Giunchiglia, Kiran Glen, Rebecca Gregory, Michael Griffiths, Victoria Grimbly, Alexander Grundmann, Savini Gunatilake, Shahd H. M. Hamid, Marc Hardwick, Jade D. Harris, Ewan Harrison, Paul J. Harrison, Monika Hartmann, Claire Hetherington, Orla Hilton, Julian Hiscox, Eva Maria Hodel, Angela E. Holland, Yun Huang, Stella Hughes, Sarosh Irani, Thomas M. Jenkins, Johan Kallberg Zvrskovec, Sandar Kyaw, Gabriella Lewis, James B. Lilleker, Michael P. Lunn, Claire L. MacIver, Daniel Madarshahian, Parisa Mansoori, Naomi Martin, Gavin McDonnell, Emily McGlinchey, Stephen McKeever, Ryan McIlwaine, Andrew M. McIntosh, Karla L. Miller, Dina Monssen, Christopher M. Morris, Ciaran Mulholland, Akshay Nair, Virginia Newcombe, Nathalie Nicholas, Timothy R. Nicholson, Ronan O’Malley, Obioma Orazulume, Marlies Ostermann, Alish Palmos, Arvind Patel, Sharon Peacock, Sophie L. Pendered, Thomas A. Pollak, Angela Roberts, Silvia Rota, Rustam Al-Shahi Salman, Merna Samuel, Brendan F. Sargent, Stephen J. Sawcer, Adam W. Seed, Scott Semple, Rajish S. K. Shil, Adam Sieradzki, Bhagteshwar Singh, Craig J. Smith, Jacqueline Smith, Stephen M. Smith, Leonie Taams, Arina Tamborska, Rhys H. Thomas, Emma Thomson, William Trender, Zain-Ul-Abideen Ahmad, Jonathan Underwood, Tonny Veenith, Annalena Venneri, Daniel J. van Wamelen, Guy Williams, Sui Hsien Wong, Michael S. Zandi, Benedict D. Michael, Stella-Maria Paddick, E. Charles Leek
Institutions: University of Liverpool, Liverpool University Hospitals NHS Foundation Trust, Warneford Hospital, University of Oxford, Wellcome Centre for Integrative Neuroimaging, King's College London, Health Protection Research Unit in Emerging and Zoonotic Infections at University of Liverpool, Aarhus University, Charité – Universitätsmedizin Berlin, Radboud University Nijmegen, Radboud University Medical Center, King's College Hospital, Donders Institute for Brain, Cognition and Behaviour, University of Cambridge, Imperial College London, Encephalitis Society, University of Birmingham, Trinity College Dublin, South London and Maudsley NHS Foundation Trust, Walton Centre, MRC Clinical Trials Unit at UCL, University College London, NIHR Sheffield Biomedical Research Centre, University of Sheffield, UCL Queen Square Institute of Neurology, Cardiff University, UK Dementia Research Institute, NIHR Maudsley Biomedical Research Centre, Birmingham Women’s and Children’s NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, NIHR BioResource, John Radcliffe Hospital, MRC Mitochondrial Biology Unit, Cumbria Northumberland Tyne and Wear NHS Foundation Trust, Newcastle University, University of Edinburgh, Gateshead Health NHS Foundation Trust, Millennium Institute for Care Research, University of Nottingham, University of Southampton, Queen's University Belfast, Northern Health and Social Care Trust, University of Glasgow, Northern Care Alliance NHS Foundation Trust, University of Dundee, NHS Lothian, Edinburgh Royal Infirmary, Liverpool School of Tropical Medicine, University of Manchester, Stroke Association, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Stoke University Hospital, Belfast Health and Social Care Trust, Institute of Mental Health, National Institute for Health and Care Research, Aintree University Hospitals NHS Foundation Trust, Aintree University Hospital
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $12,290
Funders: Wellcome Trust, Encephalitis Society, Government of the United Kingdom, UK Research and Innovation, National Institute for Health Research Health Protection Research Unit, International Seafood Sustainability Foundation, National Institute for Health and Care Research, King's College London, Siemens Healthineers, Seqirus, NIHR BioResource, NIHR Maudsley Biomedical Research Centre, Medical Research Council, NIHR Newcastle Biomedical Research Centre
Awards: G1204445118, G1626344731, G1627812290, G2035586602, Understanding cerebral inflammation in viral encephalitis - how does neuron-glial signalling drive blood-brain barrier permeability?, G2658043112, G2766755624, Identification of early cognitive change in diverse African populations. A harmonisation consortium to inform future dementia prevention studies., G3244023616, Clinical Characterisation of COVID-19 admitted to hospitals in the United Kingdom, Dynamic Imaging in Viral Encephalitis Defines Unique Roles for Chemoattractants., Characterisation of autoantigen-specific human B cells in central nervous system autoantibody-mediated diseases, Respiratory infections, G5492396179, G5918494183, G839011573, The COVID-19 Clinical Neuroscience Study (COVID-CNS), G8415457339
OpenAlex ID: W4402748246