Pihlajamaa Janne, Ollila Henriikka, Martola Juha, Kuusela Linda, Pihlaja Riikka, Tuulio-Henriksson Annamari, Koskinen Sanna, Salmela Viljami, Hokkanen Laura, Tiainen Marjaana, Hästbacka Johanna
HUS Medical Imaging Centre, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Department of Perioperative and Intensive Care, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Neuroimage Rep. 2025 Mar 22;5(2):100254. doi: 10.1016/j.ynirp.2025.100254. eCollection 2025 Jun.
COVID-19 has been linked to many neurological complications, including cognitive impairment and findings in brain imaging. However, limited data exist regarding the link between magnetic resonance imaging (MRI) findings and cognitive functioning in COVID-19 patients.In this observational prospective study, we investigated the association between brain MRI findings, particularly cerebral microbleeds (CMBs) and white matter hyperintensities (WMHs), and cognitive functioning in COVID-19 survivors.
Six months after acute COVID-19 diagnosed in 2020, 67 ICU-treated, 44 ward-treated, and 44 home-isolated patients, as well as 48 non-COVID-19 controls, underwent MRI and comprehensive neuropsychological evaluation. We applied multivariable linear regression models to investigate the independent associations of total cognitive score and domain scores separately with CMBs, WMHs and other factors.
Age (p < 0.001, β = -0.36) and educational level (p < 0.001, β = 0.42) predominantly explained the differences in cognitive functioning. A lower total cognitive score was associated with the number of CMBs (p = 0.0016), but not with COVID-19 (p = 0.714). Among COVID-19 patients, treatment in a regular ward (p = 0.007, β = -0.46), a high burden of WMHs (p = 0.004, β = -1.35), and having one to three CMBs (p = 0.01, β = -0.43) were associated with lower total cognitive scores.
We observed a significant association between the presence of CMBs and lower cognitive scores, regardless of COVID-19 history. However, our results do not support CMBs to be independently associated with cognitive functioning. Additionally, WMH burden was associated with lower cognitive scores.
新型冠状病毒肺炎（COVID-19）已与许多神经系统并发症相关联，包括认知障碍和脑成像检查结果。然而，关于COVID-19患者磁共振成像（MRI）检查结果与认知功能之间的联系，现有数据有限。在这项观察性前瞻性研究中，我们调查了脑MRI检查结果，尤其是脑微出血（CMB）和白质高信号（WMH）与COVID-19幸存者认知功能之间的关联。
2020年确诊急性COVID-19六个月后，67例在重症监护病房（ICU）接受治疗的患者、44例在普通病房接受治疗的患者、44例居家隔离患者以及48例非COVID-19对照者接受了MRI检查和全面的神经心理学评估。我们应用多变量线性回归模型分别研究总认知评分和各领域评分与CMB、WMH及其他因素之间的独立关联。
年龄（p < 0.001，β = -0.36）和教育水平（p < 0.001，β = 0.42）是认知功能差异的主要影响因素。总认知评分较低与CMB数量相关（p = 0.0016），但与COVID-19无关（p = 0.714）。在COVID-19患者中，在普通病房接受治疗（p = 0.007，β = -0.46）、WMH负担较重（p = 0.004，β = -1.35）以及有1至3个CMB（p = 0.01，β = -0.43）与较低的总认知评分相关。
无论有无COVID-19病史，我们均观察到CMB的存在与较低的认知评分之间存在显著关联。然而，我们的结果并不支持CMB与认知功能独立相关。此外，WMH负担与较低的认知评分相关。
