Department of Nuclear Medicine, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany;
Department of Neurology and Clinical Neuroscience, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany.
J Nucl Med. 2021 Jul 1;62(7):910-915. doi: 10.2967/jnumed.121.262128. Epub 2021 Mar 31.
Cognitive impairment is a frequent complaint in coronavirus disease 2019 (COVID-19) and can be related to cortical hypometabolism on F-FDG PET at the subacute stage. However, it is unclear if these changes are reversible. We prospectively assessed the Montreal Cognitive Assessment scores and F-FDG PET scans of 8 COVID-19 patients at the subacute stage (once no longer infectious) and the chronic stage (˜6 mo after symptom onset). The expression of the previously established COVID-19-related covariance pattern was analyzed at both stages to examine the time course of post-COVID-19 cognitive impairment. For further validation, we also conducted a conventional group analysis. Follow-up F-FDG PET revealed that there was a significant reduction in the initial frontoparietal and, to a lesser extent, temporal hypometabolism and that this reduction was accompanied by a significant improvement in cognition. The expression of the previously established COVID-19-related pattern was significantly lower at follow-up and correlated inversely with Montreal Cognitive Assessment performance. However, both F-FDG PET and cognitive assessment suggest a residual impairment. Although a significant recovery of regional neuronal function and cognition can be clearly stated, residuals are still measurable in some patients 6 mo after manifestation of COVID-19. Given the current pandemic situation and tremendous uncertainty concerning the long-term effects of COVID-19, the present study provides novel insights of the highest medical and socioeconomic relevance.
认知障碍是 2019 年冠状病毒病（COVID-19）的常见主诉，并且在亚急性期的 F-FDG PET 上可能与皮质代谢低下有关。然而，这些变化是否可逆尚不清楚。我们前瞻性评估了 8 例 COVID-19 患者在亚急性期（不再具有传染性后）和慢性期（发病后约 6 个月）的蒙特利尔认知评估评分和 F-FDG PET 扫描。在两个阶段分析了先前建立的 COVID-19 相关协变量模式的表达，以检查 COVID-19 后认知障碍的时间进程。为了进一步验证，我们还进行了常规组分析。随访 F-FDG PET 显示，初始额顶叶和颞叶代谢低下显著减少，并且认知功能显著改善。随访时先前建立的 COVID-19 相关模式的表达显著降低，与蒙特利尔认知评估表现呈负相关。然而，无论是 F-FDG PET 还是认知评估都提示存在残留损害。尽管可以明确说明区域神经元功能和认知的显著恢复，但在 COVID-19 表现后 6 个月，一些患者仍可测量到残留损害。鉴于当前的大流行情况以及对 COVID-19 长期影响的巨大不确定性，本研究提供了具有最高医学和社会经济相关性的新见解。
