ABSTRACT
Background: COVID-19 has been associated with cerebral microbleeds (CMB). Previously, an association of ApoE4 with COVID-19 severity and CMBs in autopsy was found. In this study, we investigated if carrying the Apoe4 allele relates to the number of CMBs in magnetic resonance imaging (MRI) in patients recovered from COVID-19. Material(s) and Method(s): Adult patients recovered from COVID-19 and a control group without a history of COVID-19 was recruited. Exclusion criteria were major neurologic disease, developmental disability or pregnancy. The participants underwent brain MRI 6 months after infection, and a blinded neuroradiologist analyzed the findings. ApoE was genotyped using a microarray. Statistical analysis was performed using the statistical software R. A negative binomial model was chosen based on the distribution of CMBs. Result(s): Of the 216 subjects that underwent MRI, 168 consented to genetic testing, additionally 2 patients were excluded due to extensive CMBs and 1 due to diffuse axonal injury. We included 113 COVID-19 patients (49 ICU-treated, 29 ward-treated and 35 home-isolated) and 52 controls. The most prevalent comorbidities were hypertension, asthma and diabetes. CMBs was found in 47 subjects, with the number of CMBs ranging from 0 to 26. The ApoeE4 allele was carried by 37%, equally distributed among the groups. After adjustment, age (aRR = 1.06, p = 0.007) and COVID-19 (aRR = 2.59, p = 0.038) were independently associated with CMBs. The ApoE4 allele (aRR = 2.16, p = 0.07, CI = 0.94-5.10) was not significant. Conclusion(s): Age and previous COVID-19, but not possession of the ApoeE4 allele, were independently associated with the number of CMBs.
ABSTRACT
Background: We aimed to report long-term brain magnetic resonance imaging (MRI) findings in survivors of ICU-treated COVID-19 compared to other groups. Material(s) and Method(s): In this prospective cohort study 70 ICU-treated, 46 ward-treated and 46 home-isolated patients, diagnosed with COVID-19 in 2020, underwent brain MRI 6 months after the acute phase to determine the presence of cerebral microbleeds (CMB) and Fazekas scale. Result(s): CMBs existed in 27 (38.6%) ICU-treated, 13 (28.3%) ward-treated, 8 (17.4%) home-isolated COVID-19 patients, and in 12 (22.6%) non-COVID controls (Figure 1). The number of CMBs in COVID-19 patients and controls was median 2 (IQR 1-4) and 1 (IQR 1-2), respectively. Patients with CMBs differed from those without, regarding age (median 62 vs. 52 years, p < 0.001), history of arterial hypertension (50% vs. 31%, p = 0.03), need of ICU (56% vs. 38%, p = 0.03) and ventilator treatment (42% vs. 22%, p = 0.01), length of hospital stay (median 21 vs. 12 days, p < 0.001), and supplementary oxygen therapy (median 18 vs. 10 days, p = 0.008), respectively. Within the ICU group, patients with and without CMBs differed regarding the duration of ICU stay (median 17 vs. 9 days, p = 0.006), and mechanical ventilation (median 14 vs. 6 days, p = 0.002). In multivariable analysis, only age was associated with CMBs (OR 1.06, 95% CI 1.02-1.09). The majority of subjects in all groups had Fazekas scale one for white matter hyperintensities (Figure 1). Conclusion(s): Although the severity of respiratory failure and history of arterial hypertension were associated with the presence of CMBs, only age was an independent predictor of CMBs.
ABSTRACT
Background/Objectives: One of the most remarkable features of SARS-CoV-2 infection is that a large proportion of individuals are asymptomatic while others experience progressive, even lifethreatening acute respiratory distress syndrome, and some suffer from prolonged symptoms (long COVID). The contribution of host genetics to susceptibility and severity of infectious disease is well-documented, and include rare monogenic inborn errors of immunity as well as common genetic variation. Studies on genetic risk factors for long COVID have not yet been published. Method(s): We compared long COVID (1534) to COVID-19 patients (96,692) and population controls (800,353) using both questionnaire and EHR- based studies. First meta-analysis of 11 GWAS studies from 8 countries did not show genome-wide significant associations. Result(s): Testing 24 variants earlier associated to COVID-19 susceptibility or severity by COVID-19 Host Genetics Initiative showed genetic variation in rs505922, an intronic variant in ABO blood group gene, to be associated with long COVID compared to population controls (OR = 1.16, 95% CI: 1.07-1.27, p = 0.033). (Within-COVID analysis gave similar OR, but was not significant after conservative Bonferroni correction (OR = 1.17, 95% CI: 1.06-1.30, p = 092)). Conclusion(s): The first data freeze of the Long COVID Host Genetics Initiative suggests that the O blood group is associated with a 14% reduced risk for long COVID. The following data freezes with growing sample sizes will possibly elucidate long COVID pathophysiology and pave the way for possible treatments for long lasting COVID symptoms.