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Cognitive impairment and altered cerebral glucose metabolism in the subacute stage of COVID-19.
Hosp, Jonas A; Dressing, Andrea; Blazhenets, Ganna; Bormann, Tobias; Rau, Alexander; Schwabenland, Marius; Thurow, Johannes; Wagner, Dirk; Waller, Cornelius; Niesen, Wolf D; Frings, Lars; Urbach, Horst; Prinz, Marco; Weiller, Cornelius; Schroeter, Nils; Meyer, Philipp T.
  • Hosp JA; Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Dressing A; Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Blazhenets G; Freiburg Brain Imaging Center, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Bormann T; Department of Nuclear Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Rau A; Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Schwabenland M; Department of Neuroradiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Thurow J; Institute of Neuropathology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Wagner D; Department of Nuclear Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Waller C; Division of Infectious Diseases, Department of Internal Medicine II, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Niesen WD; Department of Internal Medicine I, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Frings L; Department of Neurology and Clinical Neuroscience, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Urbach H; Department of Nuclear Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Prinz M; Department of Neuroradiology, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Weiller C; Institute of Neuropathology, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Schroeter N; Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Meyer PT; Signalling Research Centres BIOSS and CIBSS, University of Freiburg, Freiburg, Germany.
Brain ; 144(4): 1263-1276, 2021 05 07.
Article in English | MEDLINE | ID: covidwho-1313840
Semantic information from SemMedBD (by NLM)
1. Neurobehavioral Manifestations PROCESS_OF hospitalized patients
Subject
Neurobehavioral Manifestations
Predicate
PROCESS_OF
Object
hospitalized patients
2. Neurologic Symptoms PROCESS_OF Cohort
Subject
Neurologic Symptoms
Predicate
PROCESS_OF
Object
Cohort
3. Performance PROCESS_OF Patients
Subject
Performance
Predicate
PROCESS_OF
Object
Patients
4. Tomograph USES C0046056
Subject
Tomograph
Predicate
USES
Object
C0046056
5. Hypometabolism PROCESS_OF Patients
Subject
Hypometabolism
Predicate
PROCESS_OF
Object
Patients
6. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
7. Neurobehavioral Manifestations PROCESS_OF hospitalized patients
Subject
Neurobehavioral Manifestations
Predicate
PROCESS_OF
Object
hospitalized patients
8. Neurologic Symptoms PROCESS_OF Cohort
Subject
Neurologic Symptoms
Predicate
PROCESS_OF
Object
Cohort
9. Performance PROCESS_OF Patients
Subject
Performance
Predicate
PROCESS_OF
Object
Patients
10. Tomography, Emission-Computed USES fluorodeoxyglucose F18
Subject
Tomography, Emission-Computed
Predicate
USES
Object
fluorodeoxyglucose F18
11. Hypometabolism PROCESS_OF Patients
Subject
Hypometabolism
Predicate
PROCESS_OF
Object
Patients
12. COVID-19 PROCESS_OF Patients
Subject
COVID-19
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PROCESS_OF
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Patients
ABSTRACT
During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, neurological symptoms increasingly moved into the focus of interest. In this prospective cohort study, we assessed neurological and cognitive symptoms in hospitalized coronavirus disease-19 (COVID-19) patients and aimed to determine their neuronal correlates. Patients with reverse transcription-PCR-confirmed COVID-19 infection who required inpatient treatment primarily because of non-neurological complications were screened between 20 April 2020 and 12 May 2020. Patients (age > 18 years) were included in our cohort when presenting with at least one new neurological symptom (defined as impaired gustation and/or olfaction, performance < 26 points on a Montreal Cognitive Assessment and/or pathological findings on clinical neurological examination). Patients with ≥2 new symptoms were eligible for further diagnostics using comprehensive neuropsychological tests, cerebral MRI and 18fluorodeoxyglucose (FDG) PET as soon as infectivity was no longer present. Exclusion criteria were premorbid diagnosis of cognitive impairment, neurodegenerative diseases or intensive care unit treatment. Of 41 COVID-19 inpatients screened, 29 patients (65.2 ± 14.4 years; 38% female) in the subacute stage of disease were included in the register. Most frequently, gustation and olfaction were disturbed in 29/29 and 25/29 patients, respectively. Montreal Cognitive Assessment performance was impaired in 18/26 patients (mean score 21.8/30) with emphasis on frontoparietal cognitive functions. This was confirmed by detailed neuropsychological testing in 15 patients. 18FDG PET revealed pathological results in 10/15 patients with predominant frontoparietal hypometabolism. This pattern was confirmed by comparison with a control sample using voxel-wise principal components analysis, which showed a high correlation (R2 = 0.62) with the Montreal Cognitive Assessment performance. Post-mortem examination of one patient revealed white matter microglia activation but no signs of neuroinflammation. Neocortical dysfunction accompanied by cognitive decline was detected in a relevant fraction of patients with subacute COVID-19 initially requiring inpatient treatment. This is of major rehabilitative and socioeconomic relevance.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Cerebral Cortex / Cognitive Dysfunction / Mental Status and Dementia Tests / COVID-19 / Glucose Type of study: Etiology study / Incidence study / Observational study / Qualitative research / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Brain Year: 2021 Document Type: Article Affiliation country: Brain

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cerebral Cortex / Cognitive Dysfunction / Mental Status and Dementia Tests / COVID-19 / Glucose Type of study: Etiology study / Incidence study / Observational study / Qualitative research / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Brain Year: 2021 Document Type: Article Affiliation country: Brain