Slow but Evident Recovery from Neocortical Dysfunction and Cognitive Impairment in a Series of Chronic COVID-19 Patients.
Slow but Evident Recovery from Neocortical Dysfunction and Cognitive Impairment in a Series of Chronic COVID-19 Patients.
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DOI：
10.2967/jnumed.121.262128
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发表时间：
2021-07-01
期刊：
影响因子：
--
通讯作者：
Hosp JA
中科院分区：
文献类型：
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作者：
Blazhenets G;Schroeter N;Bormann T;Thurow J;Wagner D;Frings L;Weiller C;Meyer PT;Dressing A;Hosp JA
认知障碍是2019冠状病毒病（COVID-19）的常见症状，可能与亚急性期18F-FDG PET显示的皮质代谢低下有关。但目前尚不清楚这些变化是否可逆。研究方法：我们前瞻性地评估了8名COVID-19患者在亚急性期（一旦不再具有传染性）和慢性期（症状发作后1.6个月）的蒙特利尔认知评估评分和18F-FDG PET扫描。在两个阶段分析先前建立的COVID-19相关协方差模式的表达，以检查COVID-19后认知障碍的时间进程。为了进一步验证，我们还进行了常规的组分析。结果如下：随访18F-FDG PET显示，最初的额顶叶显著减少，颞叶代谢减退程度较小，这种减少伴随着认知的显著改善。先前建立的COVID-19相关模式的表达在随访时显著降低，并与蒙特利尔认知评估表现呈负相关。然而，18F-FDG PET和认知评估均提示存在残留损害。结论：尽管可以清楚地说明局部神经元功能和认知的显著恢复，但在COVID-19表现后6个月，一些患者的残留物仍然是可测量的。鉴于目前的疫情形势以及COVID-19长期影响的巨大不确定性，本研究提供了最高医学和社会经济相关性的新见解。
Cognitive impairment is a frequent complaint in coronavirus disease 2019 (COVID-19) and can be related to cortical hypometabolism on 18F-FDG PET at the subacute stage. However, it is unclear if these changes are reversible. Methods: We prospectively assessed the Montreal Cognitive Assessment scores and 18F-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. Results: Follow-up 18F-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 18F-FDG PET and cognitive assessment suggest a residual impairment. Conclusion: 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.