Diez-Cirarda Maria, Yus-Fuertes Miguel, Delgado-Alonso Cristina, Gil-Martínez Lidia, Jiménez-García Carlos, Gil-Moreno Maria José, Gómez-Ruiz Natividad, Oliver-Mas Silvia, Polidura Carmen, Jorquera Manuela, Gómez-Pinedo Ulises, Arrazola Juan, Sánchez-Ramón Silvia, Matias-Guiu Jorge, Gonzalez-Escamilla Gabriel, Matias-Guiu Jordi A
Department of Neurology, Hospital Universitario Clínico San Carlos. Health Research Institute "San Carlos" (IdISCC). Universidad Complutense de Madrid, Madrid, Spain.
Department of Radiology, Hospital Universitario Clinico San Carlos. Health Research Institute "San Carlos" (IdISCC). Universidad Complutense de Madrid, Madrid, Spain.
Mol Psychiatry. 2025 Jan 15. doi: 10.1038/s41380-024-02886-x.
Patients with post-COVID condition (PCC) present with diverse symptoms which persist at long-term after SARS-CoV-2 infection. Among these symptoms, cognitive impairment is one of the most prevalent and has been related to brain structural and functional changes. The underlying mechanisms of these cognitive and brain alterations remain elusive but neuroinflammation and immune mechanisms have been majorly considered. In this sense, the choroid plexus (ChP) volume has been proposed as a marker of neuroinflammation in immune-mediated conditions and the ChP epithelium has been found particularly susceptible to the effects of SARS-CoV-2. The objective was to investigate the ChP in PCC and evaluate its relationships with cognition, brain, and immunological alterations. One-hundred and twenty-nine patients with PCC after a mean of 14.79 ± 7.17 months of evolution since the infection and 36 healthy controls were recruited. Participants underwent a neuropsychological, and neuroimaging assessment and immunological markers evaluation. Results revealed ChP volume enlargement in PCC compared to healthy controls. The ChP enlargement was associated with cognitive dysfunction, grey matter volume reduction in frontal and subcortical areas, white matter integrity and diffusivity changes and functional connectivity changes. These ChP changes were also related to intermediate monocytes levels. Findings suggest that the ChP integrity may play a relevant role in the pathophysiology of cognitive deficits and the observed brain changes in PCC. The previously documented function of the ChP in maintaining brain homeostasis and regulating the entry of immune cells into the brain supports the presence of neuroinflammatory mechanisms in this disorder.
新冠后综合征（PCC）患者会出现多种症状，这些症状在感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）后长期持续存在。在这些症状中，认知障碍是最常见的症状之一，并且与脑结构和功能变化有关。这些认知和脑改变的潜在机制仍然不清楚，但神经炎症和免疫机制已被主要考虑。从这个意义上说，脉络丛（ChP）体积已被提议作为免疫介导疾病中神经炎症的标志物，并且已发现ChP上皮细胞对SARS-CoV-2的影响特别敏感。目的是研究PCC中的ChP，并评估其与认知、脑和免疫改变的关系。招募了129例感染后平均病程为14.79±7.17个月的PCC患者和36名健康对照者。参与者接受了神经心理学、神经影像学评估和免疫标志物评估。结果显示，与健康对照相比，PCC患者的ChP体积增大。ChP增大与认知功能障碍、额叶和皮质下区域灰质体积减少、白质完整性和扩散率变化以及功能连接变化有关。这些ChP变化也与中间单核细胞水平有关。研究结果表明，ChP完整性可能在PCC认知缺陷的病理生理学以及观察到的脑变化中起相关作用。ChP在维持脑稳态和调节免疫细胞进入脑方面的先前记录的功能支持了该疾病中神经炎症机制的存在。
