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

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

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.

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et al.
COVID-CNS Consortium
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Wood, Greta K., Sargent, Brendan F. and Ahmad, Zain-Ul-Abideen , et al. and COVID-CNS Consortium (2024) Posthospitalization COVID-19 cognitive deficits at 1 year are global and associated with elevated brain injury markers and gray matter volume reduction. Nature Medicine. (doi:10.1038/s41591-024-03309-8).

Record type: Article

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.

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s41591-024-03309-8 - Version of Record
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Accepted/In Press date: 18 September 2024
e-pub ahead of print date: 23 September 2024
Published date: 23 September 2024
Learn more about Institute for Life Sciences research Learn more about School of Psychology research Learn more about Institute for Life Sciences research

Identifiers

Local EPrints ID: 496859
URI: http://eprints.soton.ac.uk/id/eprint/496859
DOI: doi:10.1038/s41591-024-03309-8
ISSN: 1078-8956
PURE UUID: 2a40f18c-364c-4314-af64-10aac14ae0f2
ORCID for E. Charles Leek: ORCID iD orcid.org/0000-0001-9258-7504
ORCID for Ian Galea: ORCID iD orcid.org/0000-0002-1268-5102

Catalogue record

Date deposited: 08 Jan 2025 11:15
Last modified: 22 Aug 2025 01:51

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Contributors

Author: Greta K. Wood
Author: Brendan F. Sargent
Author: Zain-Ul-Abideen Ahmad
Author: Kukatharmini Tharmaratnam
Author: Cordelia Dunai
Author: Franklyn N. Egbe
Author: Naomi H. Martin
Author: Bethany Facer
Author: Sophie L. Pendered
Author: Henry C. Rogers
Author: Christopher Hübel
Author: Daniel J. van Wamelen
Author: Richard A.I. Bethlehem
Author: Valentina Giunchiglia
Author: Peter J. Hellyer
Author: William Trender
Author: Gursharan Kalsi
Author: Edward Needham
Author: Ava Easton
Author: Thomas A. Jackson
Author: Colm Cunningham
Author: Rachel Upthegrove
Author: Thomas A. Pollak
Author: Matthew Hotopf
Author: Tom Solomon
Author: Sarah L. Pett
Author: Pamela J Shaw
Author: Nicholas Wood
Author: Neil A. Harrison
Author: Karla L. Miller
Author: Peter Jezzard
Author: Guy Williams
Author: Eugene P Duff
Author: Steven Williams
Author: Fernando Zelaya
Author: Stephen M. Smith
Author: Simon Keller
Author: Matthew Broome
Author: Nathalie Kingston
Author: Masud Husain
Author: Angela Vincent
Author: John Bradley
Author: Patrick Chinnery
Author: David K. Menon
Author: John P. Aggleton
Author: Timothy R. Nicholson
Author: John-Paul Taylor
Author: Anthony S. David
Author: Alan Carson
Author: E. Charles Leek ORCID iD
Author: Ian Galea ORCID iD
Corporate Author: et al.
Corporate Author: COVID-CNS Consortium

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