Long-term follow-up of dynamic brain changes in patients recovered from COVID-19 without neurological manifestations.
Long-term follow-up of dynamic brain changes in patients recovered from COVID-19 without neurological manifestations.
复制标题
对从 COVID-19 康复且无神经系统表现的患者的动态大脑变化进行长期随访
DOI：
10.1172/jci.insight.155827
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发表时间：
2022-02-22
期刊：
影响因子：
8
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Tian T;Wu J;Chen T;Li J;Yan S;Zhou Y;Peng X;Li Y;Zheng N;Cai A;Ning Q;Xiang H;Xu F;Qin Y;Zhu W;Wang J
在新冠肺炎病例最初激增后，大量患者在没有进行康复评估的情况下出院。现在，越来越多的患者报告了急性后神经后遗症，被称为“长冠状病毒病”--即使是那些在急性期没有特殊神经表现的患者。大脑的动态变化对于更好地理解和早期预防“慢性冠状病毒病”至关重要。在这里，我们探讨了新冠肺炎对34名没有神经系统表现的出院患者大脑的横断面和纵向后果。使用先进的磁共振成像技术对出院后3~10个月的灰质形态、脑血流量(CBF)和白质束体积进行研究，以探索脑动态变化。总体而言，皮质厚度的差异是动态的，最终回到基线水平。对于皮质CBF，3个月时观察到的重度低灌注者在10个月时趋于恢复。大脑皮质下核团和白质在组间和受试者内的差异显示出不同的趋势，包括可恢复的和长期不可恢复的差异。经过10个月的恢复期，重型患者的核体积缩小仍然比轻度患者更广泛和深刻。我们的研究为新冠肺炎对大脑10个月的作用中可恢复和长期不可恢复的变化共存提供了客观的神经影像证据。其余的潜在异常仍然值得公众关注，这对于更好地理解“长期COVID”和早期临床指导走向完全恢复至关重要。中国国家自然科学基金。
After the initial surge in COVID-19 cases, large numbers of patients were discharged from a hospital without assessment of recovery. Now, an increasing number of patients report postacute neurological sequelae, known as “long COVID” — even those without specific neurological manifestations in the acute phase. Dynamic brain changes are crucial for a better understanding and early prevention of “long COVID.” Here, we explored the cross-sectional and longitudinal consequences of COVID-19 on the brain in 34 discharged patients without neurological manifestations. Gray matter morphology, cerebral blood flow (CBF), and volumes of white matter tracts were investigated using advanced magnetic resonance imaging techniques to explore dynamic brain changes from 3 to 10 months after discharge. Overall, the differences of cortical thickness were dynamic and finally returned to the baseline. For cortical CBF, hypoperfusion in severe cases observed at 3 months tended to recover at 10 months. Subcortical nuclei and white matter differences between groups and within subjects showed various trends, including recoverable and long-term unrecovered differences. After a 10-month recovery period, a reduced volume of nuclei in severe cases was still more extensive and profound than that in mild cases. Our study provides objective neuroimaging evidence for the coexistence of recoverable and long-term unrecovered changes in 10-month effects of COVID-19 on the brain. The remaining potential abnormalities still deserve public attention, which is critically important for a better understanding of “long COVID” and early clinical guidance toward complete recovery. National Natural Science Foundation of China.
影响因子：
3.4
作者：
Wei N;Zhang X;An J;Zhuo Y;Zhang Z
通讯作者：
Zhang Z