The spectrum, pathophysiology and recovery trajectory of persistent post-COVID-19 cognitive deficits are unknown, limiting our ability to develop prevention and treatment strategies. We report the 1-year cognitive, serum biomarker and neuroimaging findings from a prospective, national study of cognition in 351 COVID-19 patients who required hospitalization, compared with 2,927 normative matched controls. Cognitive deficits were global, associated with elevated brain injury markers and reduced anterior cingulate cortex volume 1 year after COVID-19. Severity of the initial infective insult, postacute psychiatric symptoms and a history of encephalopathy were associated with the greatest deficits. There was strong concordance between subjective and objective cognitive deficits. Longitudinal follow-up in 106 patients demonstrated a trend toward recovery. Together, these findings support the hypothesis that brain injury in moderate to severe COVID-19 may be immune-mediated, and should guide the development of therapeutic strategies.

Posthospitalization COVID-19 cognitive deficits at 1 year are global and associated with elevated brain injury markers and gray matter volume reduction / Wood, G. K.; Sargent, B. F.; Ahmad, Z. -U. -A.; Tharmaratnam, K.; Dunai, C.; Egbe, F. N.; Martin, N. H.; Facer, B.; Pendered, S. L.; Rogers, H. C.; Hubel, C.; Van Wamelen, D. J.; Bethlehem, R. A. I.; Giunchiglia, V.; Hellyer, P. J.; Trender, W.; Kalsi, G.; Needham, E.; Easton, A.; Jackson, T. A.; Cunningham, C.; Upthegrove, R.; Pollak, T. A.; Hotopf, M.; Solomon, T.; Pett, S. L.; Shaw, P. J.; Wood, N.; Harrison, N. A.; Miller, K. L.; Jezzard, P.; Williams, G.; Duff, E. P.; Williams, S.; Zelaya, F.; Smith, S. M.; Keller, S.; Broome, M.; Kingston, N.; Husain, M.; Vincent, A.; Bradley, J.; Chinnery, P.; Menon, D. K.; Aggleton, J. P.; Nicholson, T. R.; Taylor, J. -P.; David, A. S.; Carson, A.; Bullmore, E.; Breen, G.; Hampshire, A.; Zandi, M. S.; Wong, S. H.; Williams, G.; Van Wamelen, D. J.; Venneri, A.; Veenith, T.; Underwood, J.; Ahmad, Z. -U. -A.; Trender, W.; Thomson, E.; Thomas, R. H.; Tamborska, A.; Taams, L.; Smith, S. M.; Smith, J.; Smith, C. J.; Singh, B.; Sieradzki, A.; Shil, R. S. K.; Semple, S.; Seed, A. W.; Sawcer, S. J.; Sargent, B. F.; Samuel, M.; Salman, R. A. -S.; Rota, S.; Roberts, A.; Pollak, T. A.; Peacock, S.; Patel, A.; Palmos, A.; Ostermann, M.; Orazulume, O.; O'Malley, R.; Nicholas, N.; Newcombe, V.; Nair, A.; Mulholland, C.; Morris, C. M.; Monssen, D.; Mcintosh, A. M.; Mcilwaine, R.; Mckeever, S.; Mcglinchey, E.; Mcdonnell, G.; Martin, N.; Mansoori, P.; Madarshahian, D.; Maciver, C. L.; Lunn, M. P.; Lilleker, J. B.; Lewis, G.; Kyaw, S.; Zvrskovec, J. K.; Jenkins, T. M.; Irani, S.; Hughes, S.; Huang, Y.; Holland, A. E.; Hodel, E. M.; Hiscox, J.; Hilton, O.; Hetherington, C.; Hartmann, M.; Harrison, P. J.; Harrison, E.; Harris, J. D.; Hardwick, M.; Hamid, S. H. M.; Gunatilake, S.; Grundmann, A.; Grimbly, V.; Griffiths, M.; Gregory, R.; Glen, K.; George, L.; Garjani, A.; Galea, I.; Francis, R.; Fernandes, P. M.; Evangelou, N.; Ellul, M. A.; Duff, E.; Dregan, A.; Dodd, K. C.; Defres, S.; Davies, N.; Darby, A.; Cousins, D.; Cossette, N.; Collie, C.; Coles, A.; Coleman, J. R. I.; Christmas, D. M.; Christmas, D.; Cavanagh, J.; Castell, H.; Butler, M.; Broome, M.; Breuer, J.; Breen, D. P.; Bradley, J.; Boardman, S. A.; Blackledge, B.; Berry, A.; Benjamin, L.; Batra, R.; Basu, N.; Barrett, S.; Baker, M. R.; Armour, C.; Amin, J.; Allen, C. M.; Al-Chalabi, A.; Alam, A. M.; Michael, B. D.; Paddick, S. -M.; Leek, E. C.. - In: NATURE MEDICINE. - ISSN 1078-8956. - 31:1(2025), pp. 101417.245-101417.257. [10.1038/s41591-024-03309-8]

Posthospitalization COVID-19 cognitive deficits at 1 year are global and associated with elevated brain injury markers and gray matter volume reduction

Venneri A.;
2025-01-01

Abstract

The spectrum, pathophysiology and recovery trajectory of persistent post-COVID-19 cognitive deficits are unknown, limiting our ability to develop prevention and treatment strategies. We report the 1-year cognitive, serum biomarker and neuroimaging findings from a prospective, national study of cognition in 351 COVID-19 patients who required hospitalization, compared with 2,927 normative matched controls. Cognitive deficits were global, associated with elevated brain injury markers and reduced anterior cingulate cortex volume 1 year after COVID-19. Severity of the initial infective insult, postacute psychiatric symptoms and a history of encephalopathy were associated with the greatest deficits. There was strong concordance between subjective and objective cognitive deficits. Longitudinal follow-up in 106 patients demonstrated a trend toward recovery. Together, these findings support the hypothesis that brain injury in moderate to severe COVID-19 may be immune-mediated, and should guide the development of therapeutic strategies.
2025
Posthospitalization COVID-19 cognitive deficits at 1 year are global and associated with elevated brain injury markers and gray matter volume reduction / Wood, G. K.; Sargent, B. F.; Ahmad, Z. -U. -A.; Tharmaratnam, K.; Dunai, C.; Egbe, F. N.; Martin, N. H.; Facer, B.; Pendered, S. L.; Rogers, H. C.; Hubel, C.; Van Wamelen, D. J.; Bethlehem, R. A. I.; Giunchiglia, V.; Hellyer, P. J.; Trender, W.; Kalsi, G.; Needham, E.; Easton, A.; Jackson, T. A.; Cunningham, C.; Upthegrove, R.; Pollak, T. A.; Hotopf, M.; Solomon, T.; Pett, S. L.; Shaw, P. J.; Wood, N.; Harrison, N. A.; Miller, K. L.; Jezzard, P.; Williams, G.; Duff, E. P.; Williams, S.; Zelaya, F.; Smith, S. M.; Keller, S.; Broome, M.; Kingston, N.; Husain, M.; Vincent, A.; Bradley, J.; Chinnery, P.; Menon, D. K.; Aggleton, J. P.; Nicholson, T. R.; Taylor, J. -P.; David, A. S.; Carson, A.; Bullmore, E.; Breen, G.; Hampshire, A.; Zandi, M. S.; Wong, S. H.; Williams, G.; Van Wamelen, D. J.; Venneri, A.; Veenith, T.; Underwood, J.; Ahmad, Z. -U. -A.; Trender, W.; Thomson, E.; Thomas, R. H.; Tamborska, A.; Taams, L.; Smith, S. M.; Smith, J.; Smith, C. J.; Singh, B.; Sieradzki, A.; Shil, R. S. K.; Semple, S.; Seed, A. W.; Sawcer, S. J.; Sargent, B. F.; Samuel, M.; Salman, R. A. -S.; Rota, S.; Roberts, A.; Pollak, T. A.; Peacock, S.; Patel, A.; Palmos, A.; Ostermann, M.; Orazulume, O.; O'Malley, R.; Nicholas, N.; Newcombe, V.; Nair, A.; Mulholland, C.; Morris, C. M.; Monssen, D.; Mcintosh, A. M.; Mcilwaine, R.; Mckeever, S.; Mcglinchey, E.; Mcdonnell, G.; Martin, N.; Mansoori, P.; Madarshahian, D.; Maciver, C. L.; Lunn, M. P.; Lilleker, J. B.; Lewis, G.; Kyaw, S.; Zvrskovec, J. K.; Jenkins, T. M.; Irani, S.; Hughes, S.; Huang, Y.; Holland, A. E.; Hodel, E. M.; Hiscox, J.; Hilton, O.; Hetherington, C.; Hartmann, M.; Harrison, P. J.; Harrison, E.; Harris, J. D.; Hardwick, M.; Hamid, S. H. M.; Gunatilake, S.; Grundmann, A.; Grimbly, V.; Griffiths, M.; Gregory, R.; Glen, K.; George, L.; Garjani, A.; Galea, I.; Francis, R.; Fernandes, P. M.; Evangelou, N.; Ellul, M. A.; Duff, E.; Dregan, A.; Dodd, K. C.; Defres, S.; Davies, N.; Darby, A.; Cousins, D.; Cossette, N.; Collie, C.; Coles, A.; Coleman, J. R. I.; Christmas, D. M.; Christmas, D.; Cavanagh, J.; Castell, H.; Butler, M.; Broome, M.; Breuer, J.; Breen, D. P.; Bradley, J.; Boardman, S. A.; Blackledge, B.; Berry, A.; Benjamin, L.; Batra, R.; Basu, N.; Barrett, S.; Baker, M. R.; Armour, C.; Amin, J.; Allen, C. M.; Al-Chalabi, A.; Alam, A. M.; Michael, B. D.; Paddick, S. -M.; Leek, E. C.. - In: NATURE MEDICINE. - ISSN 1078-8956. - 31:1(2025), pp. 101417.245-101417.257. [10.1038/s41591-024-03309-8]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/3030259
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