Cognitive functioning and brain MRI findings six months after acute COVID-19. A prospective observational study

Q4 Neuroscience

Neuroimage. Reports Pub Date : 2025-03-22 DOI:10.1016/j.ynirp.2025.100254

Janne Pihlajamaa , Henriikka Ollila , Juha Martola , Linda Kuusela , Riikka Pihlaja , Annamari Tuulio-Henriksson , Sanna Koskinen , Viljami Salmela , Laura Hokkanen , Marjaana Tiainen , Johanna Hästbacka

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Abstract

Introduction

COVID-19 has been linked to many neurological complications, including cognitive impairment and findings in brain imaging. However, limited data exist regarding the link between magnetic resonance imaging (MRI) findings and cognitive functioning in COVID-19 patients.

In this observational prospective study, we investigated the association between brain MRI findings, particularly cerebral microbleeds (CMBs) and white matter hyperintensities (WMHs), and cognitive functioning in COVID-19 survivors.

Methods

Six months after acute COVID-19 diagnosed in 2020, 67 ICU-treated, 44 ward-treated, and 44 home-isolated patients, as well as 48 non-COVID-19 controls, underwent MRI and comprehensive neuropsychological evaluation. We applied multivariable linear regression models to investigate the independent associations of total cognitive score and domain scores separately with CMBs, WMHs and other factors.

Results

Age (p < 0.001, β = −0.36) and educational level (p < 0.001, β = 0.42) predominantly explained the differences in cognitive functioning. A lower total cognitive score was associated with the number of CMBs (p = 0.0016), but not with COVID-19 (p = 0.714). Among COVID-19 patients, treatment in a regular ward (p = 0.007, β = −0.46), a high burden of WMHs (p = 0.004, β = −1.35), and having one to three CMBs (p = 0.01, β = −0.43) were associated with lower total cognitive scores.

Conclusion

We observed a significant association between the presence of CMBs and lower cognitive scores, regardless of COVID-19 history. However, our results do not support CMBs to be independently associated with cognitive functioning. Additionally, WMH burden was associated with lower cognitive scores.

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急性COVID-19后6个月的认知功能和脑MRI结果。一项前瞻性观察研究

covid -19与许多神经系统并发症有关，包括认知障碍和脑成像结果。然而，关于COVID-19患者的磁共振成像（MRI）结果与认知功能之间的联系的数据有限。在这项观察性前瞻性研究中，我们调查了脑MRI结果，特别是脑微出血（CMBs）和白质高强度（WMHs）与COVID-19幸存者认知功能之间的关系。方法对2020年确诊急性COVID-19的67例重症监护室患者、44例病房患者、44例家庭隔离患者及48例非COVID-19对照组进行MRI和综合神经心理评估。我们应用多变量线性回归模型分别考察了认知总分和领域得分与CMBs、wmh等因素的独立相关性。结果：年龄(p <；0.001, β = - 0.36)和教育水平(p <；0.001, β = 0.42)主要解释了认知功能的差异。认知总分较低与CMBs数量相关（p = 0.0016），但与COVID-19无关（p = 0.714）。在COVID-19患者中，在常规病房接受治疗（p = 0.007, β = - 0.46）、高wmh负担（p = 0.004, β = - 1.35）和有1至3个CMBs （p = 0.01, β = - 0.43）与总认知评分较低相关。结论我们观察到CMBs的存在与较低的认知评分之间存在显著关联，无论是否有COVID-19病史。然而，我们的研究结果并不支持CMBs与认知功能独立相关。此外，WMH负担与较低的认知得分有关。

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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