Metabolic Analysis of Ongoing Neuropsychiatric Symptoms Post SARS-COV-2 Through Magnetic Resonance Spectroscopy

Background

Previous research has established that SARS-COV-2 infection not only leads to acute systemic damage but also results in persistent symptoms, collectively known as "long-term COVID." Our research aims to verify whether the sustained presence of neuro-psychiatric symptoms after SARS-COV-2 infection is linked to changes in the metabolite GABA and/or an imbalance in excitatory-inhibitory (E/I) function.

Methods

Using Magnetic Resonance Spectroscopy (MRS) techniques, we investigated the levels of metabolites (GABA and Glx) and the excitatory-inhibitory balance (E/I) in the rACC and dACC brain regions, examining differences between two groups. Anxiety and depression states were assessed in all participants (37 in the infection group, 44 in the control group).

Results

In the rACC brain region, the study revealed higher GABA levels (p=0.004) and depression scores (p=0.001) in the COVID-19 infection group compared to the control group. The previously established excitatory-inhibitory balance (E/I) was disrupted (p=0.056, r=0.317). Additionally, depression scores and GABA concentration in the COVID-19 infection group showed a positive correlation (p=0.026, r=0.366), and Glx/GABA exhibited a negative correlation (p=0.019, r=-0.384).

Conclusion

The precise pathological mechanisms of "long-term COVID" remain incompletely understood. Our study suggests that in patients post COVID-19 infection, elevated GABA levels beyond normal may trigger a range of neuro-psychiatric symptoms and emotional changes by disrupting the excitatory-inhibitory balance. The implicated physiological processes include the activation of the transporter protein TSPO and the initiation of long neural circuits within the brain.