Posthospitalization COVID-19 cognitive deficits at 1 year are global and associated with elevated brain injury markers and gray matter volume reduction

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. JacksonColm 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, Stephen M. Smith, John Bradley, Stephen M. Smith, Craig J. Smith, Ciaran Mulholland, Andrew M. McIntosh, Stephen McKeever, Emily McGlinchey, Gavin McDonnell, Stella Hughes, Matthew Butler, John Bradley, Suzanne Barrett, Mark R. Baker, Cherie Armour, Christopher M. Allen, COVID-CNS Consortium

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)
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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.

Original languageEnglish
JournalNature Medicine
Early online date23 Sept 2024
DOIs
Publication statusEarly online date - 23 Sept 2024

Keywords

  • COVID-19
  • Posthospitalization COVID-19 cognitive deficits
  • COVID-19 cognitive deficits
  • elevated brain injury markers

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology

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