Plasma Markers of Neurologic Injury and Inflammation in People With Self-Reported Neurologic Postacute Sequelae of SARS-CoV-2 Infection

Neurology Neuroimmunology & Neuroinflammation, Journal Year: 2022, Volume and Issue: 9(5)

Published: June 14, 2022

The biologic mechanisms underlying neurologic postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) are incompletely understood.We measured markers injury (glial fibrillary acidic protein [GFAP], neurofilament light chain [NfL]) and soluble inflammation among a cohort people with prior confirmed SARS-CoV-2 at early late recovery after the initial illness (defined as less than greater 90 days, respectively). primary clinical outcome was presence self-reported CNS PASC symptoms during time point. We compared fold changes in marker values between those without using linear mixed-effects models examined relationships immunologic rank correlations.Of 121 individuals, 52 reported symptoms. During recovery, who went on to report had elevations GFAP (1.3-fold higher mean ratio, 95% CI 1.04-1.63, p = 0.02), but not NfL (1.06-fold 0.89-1.26, 0.54). neither nor levels were elevated Although absolute did differ, demonstrated stronger downward trend over comparison (p 0.041). Those also exhibited interleukin 6 (48% 38% recovery), monocyte chemoattractant 1 (19% tumor necrosis factor α 13% recovery). correlated several immune activation recovery; these correlations attenuated recovery.Self-reported present approximately 4 months associated earlier points. Some inflammatory pathways seem be involved infection. Additional work will needed better characterize processes identify interventions prevent or treat this condition.

Language: Английский

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Causal effect of COVID‐19 on Alzheimer's disease: A Mendelian randomization study

Journal of Medical Virology, Journal Year: 2022, Volume and Issue: 95(1)

Published: Aug. 30, 2022

It was reported that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may cause brain size reduction and cognitive decline. Whether COVID-19 contribute to the development of Alzheimer's disease (AD) is not known. We conducted genetic correlation Mendelian randomization (MR) analyses assess relationships potential causal associations between AD three outcomes (SARS-CoV-2 infection, hospitalization, critical COVID-19) by utilizing genome-wide association study datasets on these traits. A map COVID-19-driven molecular pathways constructed investigate mechanisms underlying connection. Genetic indicated had a significant positive with hospitalized (rg = 0.271). The MR analysis from inverse-variance-weighted model showed liabilities (odds ratio: 1.02, 95% confidence interval: 1.01-1.03) (1.01, 1.00-1.02) were associated an increased risk for AD. However, no effect liability SARS-CoV-2 detected (1.03, 0.97-1.09). total 60 functionally interconnected genes mediate COVID-19-AD connection, which functional enrichment in immunity-related tissue lung brain. Our suggests AD, while suffering mild case increase influence be mediated acting predominantly

Language: Английский

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Post-COVID-19 Syndrome is Rarely Associated with Damage of the Nervous System: Findings from a Prospective Observational Cohort Study in 171 Patients

Neurology and Therapy, Journal Year: 2022, Volume and Issue: 11(4), P. 1637 - 1657

Published: Aug. 26, 2022

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect multiple organs. Reports of persistent or newly emergent symptoms, including those related to the nervous system, have increased over course pandemic, leading introduction post-COVID-19 syndrome. However, this novel is still ill-defined and structured objectification complaints scarce. Therefore, we performed a prospective observational cohort study better define validate subjective neurological disturbances in patients with syndrome.A total 171 fulfilling WHO Delphi consensus criteria underwent comprehensive diagnostic work-up neurovascular, electrophysiological, blood analysis. In addition, magnetic resonance imaging (MRI) lumbar puncture were conducted subgroups patients. Furthermore, neuropsychological, psychosomatic, fatigue assessment.Patients predominantly female, middle-aged, had incurred mostly mild-to-moderate COVID-19. most frequent included fatigue, difficulties concentration, memory deficits. (85.8%), in-depth assessment yielded no pathological findings. 97.7% cases, either diagnosis other than post COVID-19 syndrome, likely preceding could be established. Sensory motor more often associated Previous psychiatric conditions identified as risk factor for developing We found high somatization scores our patient group that correlated cognitive deficits extent fatigue.Albeit frequently reported by patients, objectifiable affection system rare Instead, elevated levels point towards pathogenesis potentially involving psychosomatic factors. thorough important order not miss diseases post-COVID-19.

Language: Английский

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Trajectories of Neurologic Recovery 12 Months After Hospitalization for COVID-19

Neurology, Journal Year: 2022, Volume and Issue: 99(1)

Published: March 21, 2022

Little is known about trajectories of recovery 12 months after hospitalization for severe COVID-19. We conducted a prospective, longitudinal cohort study patients with and without neurologic complications during index COVID-19 from March 10, 2020, to May 20, 2020. Phone follow-up batteries were performed at 6 onset. The primary 12-month outcome was the modified Rankin Scale (mRS) score comparing or using multivariable ordinal analysis. Secondary outcomes included activities daily living (Barthel Index), telephone Montreal Cognitive Assessment (t-MoCA), Quality Life in Neurologic Disorders (Neuro-QoL) anxiety, depression, fatigue, sleep. Changes scores compared nonparametric paired-samples sign test. Twelve-month completed 242 (median age 65 years, 64% male, 34% intubated hospitalization) 174 both 6- follow-up. At months, 197/227 (87%) had ≥1 abnormal metric: mRS >0 (75%), Barthel Index <100 (64%), t-MoCA ≤18 (50%), high anxiety (7%), depression (4%), fatigue (9%), poor sleep (10%). did not differ significantly among those (n = 113) 129) adjusting age, sex, race, pre-COVID-19 mRS, intubation status (adjusted OR 1.4, 95% CI 0.8-2.5), although higher (T 47 vs 44; p 0.037). Significant improvements observed (56% improved, median difference 1 point; 0.002) Neuro-QoL (45% improved; 0.003). Nonsignificant occurred sleep, 48%, 38% patients, respectively. remained unchanged between >50% patients. COVID-19, 87% ongoing abnormalities functional, cognitive, metrics cognition persisted 50% history dementia/cognitive abnormality. Only severity differed hospitalization. However, significant cognitive (t-MoCA) 56% 45% respectively, months. These results may be generalizable mild moderate

Language: Английский

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Effects of COVID-19 on cognition and brain health

Trends in Cognitive Sciences, Journal Year: 2023, Volume and Issue: 27(11), P. 1053 - 1067

Published: Aug. 30, 2023

COVID-19 is associated with a range of neurological, cognitive, and mental health symptoms both acutely chronically that can persist for many months after infection in people long-COVID syndrome. Investigations cognitive function neuroimaging have begun to elucidate the nature some these symptoms. They reveal that, although deficits may be related brain imaging abnormalities people, also occur absence objective or changes. Furthermore, impairment detected even asymptomatic individuals. We consider evidence regarding symptoms, deficits, neuroimaging, as well their possible underlying mechanisms.

Language: Английский

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Links between COVID-19 and Parkinson’s disease/Alzheimer’s disease: reciprocal impacts, medical care strategies and underlying mechanisms

Translational Neurodegeneration, Journal Year: 2023, Volume and Issue: 12(1)

Published: Jan. 30, 2023

Abstract The impact of coronavirus disease 2019 (COVID-19) pandemic on patients with neurodegenerative diseases and the specific neurological manifestations COVID-19 have aroused great interest. However, there are still many issues concern to be clarified. Therefore, we review current literature complex relationship between an emphasis Parkinson’s (PD) Alzheimer’s (AD). We summarize infection symptom severity, progression, mortality rate PD AD, discuss whether could trigger AD. In addition, susceptibility prognosis in AD also included. order achieve better management patients, modifications care strategies, drug therapies, vaccines during listed. At last, mechanisms underlying link reviewed.

Language: Английский

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COVID-19 and Long COVID: Disruption of the Neurovascular Unit, Blood-Brain Barrier, and Tight Junctions

The Neuroscientist, Journal Year: 2023, Volume and Issue: 30(4), P. 421 - 439

Published: Sept. 11, 2023

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of disease 2019 (COVID-19), could affect brain structure and function. SARS-CoV-2 can enter through different routes, including olfactory, trigeminal, vagus nerves, blood immunocytes. may also from peripheral a disrupted blood-brain barrier (BBB). The neurovascular unit in brain, composed neurons, astrocytes, endothelial cells, pericytes, protects parenchyma by regulating entry substances blood. astrocytes highly express angiotensin converting enzyme (ACE2), indicating that BBB be disturbed lead to derangements tight junction adherens proteins. This leads increased permeability, leakage components, movement immune cells into parenchyma. cross microvascular an ACE2 receptor–associated pathway. exact mechanism dysregulation COVID-19/neuro-COVID is not clearly known, nor development long COVID. Various biomarkers indicate severity neurologic complications COVID-19 help objectively diagnose those developing review highlights importance disruption, as well some potentially useful COVID-19, COVID/neuro-COVID.

Language: Английский

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Pathophysiology, diagnosis, and management of neuroinflammation in covid-19

BMJ, Journal Year: 2023, Volume and Issue: unknown, P. e073923 - e073923

Published: Aug. 18, 2023

Abstract Although neurological complications of SARS-CoV-2 infection are relatively rare, their potential long term morbidity and mortality have a significant impact, given the large numbers infected patients. Covid-19 is now in differential diagnosis number common syndromes including encephalopathy, encephalitis, acute demyelinating encephalomyelitis, stroke, Guillain-Barré syndrome. Physicians should be aware pathophysiology underlying these presentations to diagnose treat patients rapidly appropriately. good evidence has been found for neurovirulence, neuroinvasive neurotropic limited. The most immune mediated vascular, or both. A proportion developed covid, which can include neuropsychiatric presentations. mechanisms covid remain unclear. longer consequences with covid-19 on brain, particularly terms neurodegeneration, will only become apparent time follow-up.

Language: Английский

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Changes in memory and cognition during the SARS-CoV-2 human challenge study

EClinicalMedicine, Journal Year: 2024, Volume and Issue: 76, P. 102842 - 102842

Published: Sept. 21, 2024

Language: Английский

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Systemic inflammation relates to neuroaxonal damage associated with long-term cognitive dysfunction in COVID-19 patients

Brain Behavior and Immunity, Journal Year: 2024, Volume and Issue: 117, P. 510 - 520

Published: Feb. 7, 2024

Cognitive deficits are increasingly recognized as a long-term sequela of severe COVID-19. The underlying processes and molecular signatures associated with these neurological sequalae COVID-19 remain largely unclear, but may be related to systemic inflammation-induced effects on the brain. We studied inflammation-brain interplay its relation development cognitive impairment in patients who survived Trajectories inflammation neuroaxonal damage blood biomarkers during ICU admission were analyzed outcomes. Prospective longitudinal cohort study surviving admission. During admission, was sampled consecutively assess levels inflammatory cytokines neurofilament light chain (NfL) using an ultrasensitive multiplex Luminex assay single molecule array technique (Simoa). functioning evaluated comprehensive neuropsychological assessment six months after ICU-discharge. Ninety-six (median [IQR] age 61 [55–69] years) enrolled from March 2020 June 2021 divided into two cohorts: those received no COVID-19-related immunotherapy (n = 28) treated either dexamethasone or tocilizumab 68). Plasma NfL concentrations increased 95 % their stay, median 23 [18–38] pg/mL at 250 [160–271] 28 days, p < 0.001. Besides age, glomerular filtration rate, immunomodulatory treatment, C-reactive protein, more specific markers day 14 (i.e., interleukin (IL)-8, tumour necrosis factor, IL-1 receptor antagonist) significant predictors (R2 44 %, 0.001), illustrating association between sustained damage. Twenty-six (27 %) exhibited discharge ICU. showed pronounced increase that developed (p 0.03). Higher predicted poorer outcome information processing speed (Trail Making Test A, r −0.26, 0.01; Letter Digit Substitution Test, −0.24, 0.02). Prolonged critically ill is subsequent impairment. Moreover, our findings suggest plasma stay possess prognostic value predicting future

Language: Английский

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