BACKGROUNDThe coronavirus disease 2019 (COVID-19) rapidly progressed to a global pandemic . Although some patients totally recover from COVID-19 pneumonia, the disease's long-term effects on the brain still need to be explored.
METHODSWe recruited 51 patients with 2 subtypes of COVID-19 (19 mild and 32 severe) with no specific neurological manifestations at the acute stage and no obvious lesions on the conventional MRI 3 months after discharge . Changes in gray matter morphometry, cerebral blood flow (CBF), and white matter (WM) microstructure were investigated using MRI . The relationship between brain imaging measurements and inflammation markers was further analyzed.
RESULTSCompared with healthy controls, the decrease in cortical thickness/CBF and the changes in WM microstructure were more severe in patients with severe disease than in those with mild disease, especially in the frontal and limbic systems . Furthermore, changes in brain microstructure, CBF, and tract parameters were significantly correlated (P <0.05) with the inflammatory markers C-reactive protein, procalcitonin, and interleukin 6.
CONCLUSIONIndirect injury related to inflammatory storm may damage the brain, altering cerebral volume, CBF, and WM tracts . COVID-19-related hypoxemia and dysfunction of vascular endothelium may also contribute to neurological changes . The abnormalities in these brain areas need to be monitored during recovery, which could help clinicians understand the potential neurological sequelae of COVID-19.
FUNDINGNatural Science Foundation of China.