Post-hospitalisation COVID-19 cognitive deficits at one year are global and associated with elevated brain injury markers and grey matter volume reduction

IF 58.7 1区医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY

Nature Medicine Pub Date : 2024-09-23 DOI:10.1038/s41591-024-03309-8

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, Benedict D. Michael, Stella-Maria Paddick, E. Charles Leek

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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 one-year cognitive, serum biomarker, and neuroimaging findings from a prospective, national 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 COVID-19. 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. 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.

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COVID-19 住院一年后出现的认知障碍是全面性的，与脑损伤标志物升高和灰质体积缩小有关

COVID-19 后持续性认知缺陷的范围、病理生理学和恢复轨迹尚不清楚，这限制了我们制定预防和治疗策略的能力。我们报告了一项前瞻性全国认知研究的一年认知、血清生物标志物和神经影像学结果，该研究将 351 名需要住院治疗的 COVID-19 患者与 2,927 名常模匹配对照组进行了比较。认知障碍是整体性的，与脑损伤标志物升高以及COVID-19一年后前扣带回皮质体积缩小有关。最初感染性损伤的严重程度、急性期后的精神症状以及脑病史与最大的认知缺陷有关。主观和客观认知缺陷之间有很强的一致性。对106名患者进行的纵向随访表明，他们的病情有恢复的趋势。这些发现共同支持了中重度 COVID-19 脑损伤可能由免疫介导的假设，并为治疗策略的开发提供了指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nature Medicine 医学-生化与分子生物学

CiteScore

100.90

自引率

0.70%

发文量

525

审稿时长

1 months

期刊介绍： Nature Medicine is a monthly journal publishing original peer-reviewed research in all areas of medicine. The publication focuses on originality, timeliness, interdisciplinary interest, and the impact on improving human health. In addition to research articles, Nature Medicine also publishes commissioned content such as News, Reviews, and Perspectives. This content aims to provide context for the latest advances in translational and clinical research, reaching a wide audience of M.D. and Ph.D. readers. All editorial decisions for the journal are made by a team of full-time professional editors. Nature Medicine consider all types of clinical research, including: -Case-reports and small case series -Clinical trials, whether phase 1, 2, 3 or 4 -Observational studies -Meta-analyses -Biomarker studies -Public and global health studies Nature Medicine is also committed to facilitating communication between translational and clinical researchers. As such, we consider “hybrid” studies with preclinical and translational findings reported alongside data from clinical studies.

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