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Neuropsychologic Profiles and Cerebral Glucose Metabolism in Neurocognitive Long COVID Syndrome.
Dressing, Andrea; Bormann, Tobias; Blazhenets, Ganna; Schroeter, Nils; Walter, Lea I; Thurow, Johannes; August, Dietrich; Hilger, Hanna; Stete, Katarina; Gerstacker, Kathrin; Arndt, Susan; Rau, Alexander; Urbach, Horst; Rieg, Siegbert; Wagner, Dirk; Weiller, Cornelius; Meyer, Philipp T; Hosp, Jonas A.
  • Dressing A; Department of Neurology and Clinical Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Bormann T; Freiburg Brain Imaging Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Blazhenets G; Department of Neurology and Clinical Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Schroeter N; Freiburg Brain Imaging Center, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Walter LI; Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Thurow J; Department of Neurology and Clinical Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • August D; Department of Neurology and Clinical Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Hilger H; Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Stete K; Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Gerstacker K; Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Arndt S; Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Rau A; Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg; and.
  • Urbach H; Department of Otorhinolaryngology - Head and Neck Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg; and.
  • Rieg S; Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Wagner D; Department of Neuroradiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Weiller C; Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Meyer PT; Division of Infectious Diseases, Department of Medicine II, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Hosp JA; Department of Neurology and Clinical Neuroscience, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
J Nucl Med ; 63(7): 1058-1063, 2022 07.
Article in English | MEDLINE | ID: covidwho-1470742
ABSTRACT
During the coronavirus disease 2019 (COVID-19) pandemic, Long COVID syndrome, which impairs patients through cognitive deficits, fatigue, and exhaustion, has become increasingly relevant. Its underlying pathophysiology, however, is unknown. In this study, we assessed cognitive profiles and regional cerebral glucose metabolism as a biomarker of neuronal function in outpatients with long-term neurocognitive symptoms after COVID-19.

Methods:

Outpatients seeking neurologic counseling with neurocognitive symptoms persisting for more than 3 mo after polymerase chain reaction (PCR)-confirmed COVID-19 were included prospectively between June 16, 2020, and January 29, 2021. Patients (n = 31; age, 53.6 ± 2.0 y) in the long-term phase after COVID-19 (202 ± 58 d after positive PCR) were assessed with a neuropsychologic test battery. Cerebral 18F-FDG PET imaging was performed in 14 of 31 patients.

Results:

Patients self-reported impaired attention, memory, and multitasking abilities (31/31), word-finding difficulties (27/31), and fatigue (24/31). Twelve of 31 patients could not return to the previous level of independence/employment. For all cognitive domains, average group results of the neuropsychologic test battery showed no impairment, but deficits (z score < -1.5) were present on a single-patient level mainly in the domain of visual memory (in 7/31; other domains ≤ 2/31). Mean Montreal Cognitive Assessment performance (27/30 points) was above the cutoff value for detection of cognitive impairment (<26 points), although 9 of 31 patients performed slightly below this level (23-25 points). In the subgroup of patients who underwent 18F-FDG PET, we found no significant changes of regional cerebral glucose metabolism.

Conclusion:

Long COVID patients self-report uniform symptoms hampering their ability to work in a relevant fraction. However, cognitive testing showed minor impairments only on a single-patient level approximately 6 mo after the infection, whereas functional imaging revealed no distinct pathologic changes. This clearly deviates from previous findings in subacute COVID-19 patients, suggesting that underlying neuronal causes are different and possibly related to the high prevalence of fatigue.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cerebrum / COVID-19 / Glucose Type of study: Qualitative research / Risk factors Topics: Long Covid / Variants Limits: Humans / Middle aged Language: English Journal: J Nucl Med Year: 2022 Document Type: Article Affiliation country: Jnumed.121.262677

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Cerebrum / COVID-19 / Glucose Type of study: Qualitative research / Risk factors Topics: Long Covid / Variants Limits: Humans / Middle aged Language: English Journal: J Nucl Med Year: 2022 Document Type: Article Affiliation country: Jnumed.121.262677