Lipton Michael L, Fleysher Roman, Song Joan Y, Ye Kenny, Zimmerman Molly E, Lipton Richard B, Daily Johanna P
Department of Radiology, Columbia University Irving Medical Center, New York, NY, USA.
Department of Biomedical Engineering, Columbia University, New York, NY, USA.
Heliyon. 2024 Jul 18;10(15):e34764. doi: 10.1016/j.heliyon.2024.e34764. eCollection 2024 Aug 15.
This study examined the brain effects of mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection which are incompletely understood. Our objective was to ascertain within-person changes associated with mild coronavirus disease 2019 (COVID-19) in otherwise healthy adults.
We leveraged existing pre-pandemic baseline neuroimaging and neurocognitive data, and collected follow-up data from uninfected controls and individuals with prior mild COVID-19, during December 2020 and January 2021, when vaccines were not yet available. We compared change during follow-up in patients (n = 5) versus controls (n = 15).
We identified a decrease of intracellular volume fraction (ICVF), decrease of isotropic volume fraction (ISO) and decrease of orientation dispersion index (ODI) in multiple inferior frontal regions of interest in COVID-19 patients; this longitudinal change was significantly different from the control group which demonstrated increases in equivalent measures. This pattern suggests injury with neuronal loss and/or inflammation as underlying mechanisms. Neurocognitive studies identified a pattern of cognitive decline (processing speed, executive function, verbal learning, working memory) in patients, that did not reach significance.
Our pilot data suggests that mild COVID-19 may result in brain pathology and impact neurocognitive function in younger adults in a manner parallel to prior findings in older individuals. Though findings may not generalize to other SARS-CoV-2 variants, larger longitudinal studies of mild COVID-19 should be undertaken to understand the potential clinical implications of these findings over the longer term.
本研究探讨了轻度严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染对大脑的影响，目前对此尚未完全了解。我们的目的是确定在其他方面健康的成年人中与轻度2019冠状病毒病（COVID-19）相关的个体内部变化。
我们利用了大流行前现有的基线神经影像学和神经认知数据，并在2020年12月至2021年1月期间，在尚无疫苗可用时，收集了未感染对照组和既往有轻度COVID-19个体的随访数据。我们比较了患者（n = 5）与对照组（n = 15）随访期间的变化。
我们发现COVID-19患者多个感兴趣的额下区域的细胞内体积分数（ICVF）降低、各向同性体积分数（ISO）降低和方向离散指数（ODI）降低；这种纵向变化与显示等效测量值增加的对照组有显著差异。这种模式表明以神经元丢失和/或炎症为潜在机制的损伤。神经认知研究发现患者存在认知下降模式（处理速度、执行功能、言语学习、工作记忆），但未达到显著水平。
我们的初步数据表明，轻度COVID-19可能导致大脑病变，并以与先前在老年人中的发现相似的方式影响年轻人的神经认知功能。尽管这些发现可能不适用于其他SARS-CoV-2变体，但应开展更大规模的轻度COVID-19纵向研究，以了解这些发现的长期潜在临床意义。
