Dynamic white matter changes in recovered COVID-19 patients: a two-year follow-up study

白质 磁共振弥散成像 认知 纵向研究 医学 韦氏成人智力量表 方差分析 2019年冠状病毒病(COVID-19) 部分各向异性 内科学 磁共振成像 儿科 病理 精神科 放射科 疾病 传染病(医学专业)
作者
Sihong Huang,Xin Zhou,Wei Zhao,Jun Liu,Danhui Yang,Yijie Huang,Yanjing Chen,Huiting Zhang,Guang Yang,Jun Liu,Hong Luo
出处
期刊:Theranostics [Ivyspring International Publisher]
卷期号:13 (2): 724-735 被引量:30
标识
DOI:10.7150/thno.79902
摘要

Background and purpose: Long COVID with regard to the neurological system deserves more attention, as a surge of treated patients are being discharged from the hospital. As the dynamic changes in white matter after two years remain unknown, this characteristic was the focus of this study. Methods: We investigated 17 recovered COVID-19 patients at two years after discharge. Diffusion tensor imaging, neurite orientation dispersion and density imaging were performed to identify white matter integrity and changes from one to two years after discharge. Data for 13 revisited healthy controls were collected as a reference. Subscales of the Wechsler Intelligence scale were used to assess cognitive function. Repeated-measures ANOVA was used to detect longitudinal changes in 17 recovered COVID-19 patients and 13 healthy controls after one-year follow-up. Correlations between diffusion metrics, cognitive function, and other clinical characteristics (i.e., inflammatory factors) were also analyzed. Results: Longitudinal analysis showed the recovery trends of large-scale brain regions, with small-scale brain region deterioration from one year to two years after SARS-CoV-2 infection. However, persistent white matter abnormalities were noted at two years after discharge. Longitudinal changes of cognitive function showed no group difference. But cross-sectional cognitive difference between recovered COVID-19 patients and revisited HCs was detected. Inflammation levels in the acute stage correlated positively with white matter abnormalities and negatively with cognitive function. Moreover, the more abnormal the white matter was at two years, the greater was the cognitive deficit present. Conclusion: Recovered COVID-19 patients showed longitudinal recovery trends of white matter. But also had persistent white matter abnormalities at two years after discharge. Inflammation levels in the acute stage may be considered predictors of cognition and white matter integrity, and the white matter microstructure acts as a biomarker of cognitive function in recovered COVID-19 patients. These findings provide an objective basis for early clinical intervention.

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