The kynurenine pathway relates to post‐acuteCOVID‐19 objective cognitive impairment andPASC

Annals of Clinical and Translational Neurology, Год журнала: 2023, Номер 10(8), С. 1338 - 1352

Опубликована: Июнь 15, 2023

To determine the prevalence and natural history of post-acute COVID-19 objective cognitive impairment function, their relationship to demographic, clinical factors, sequelae (PASC), biomarkers.A total 128 patients (age = 46 ± 15; 42% women, acute disease severity: not hospitalized: 38.6% mild: 0-1 symptoms, 52% 2+ symptoms; 9.4% hospitalized) completed standard cognition, olfaction, mental health examinations 2-, 4-, 12-month post diagnosis. Over same time frame, WHO-defined PASC was determined. Blood cytokines, peripheral neurobiomarkers, kynurenine pathway (KP) metabolites were measured. Objective function demographically/practice corrected, determined using evidence-based Global Deficit Score method detect at least mild (GDS > 0.5). Linear mixed effect regression models with (month diagnosis) evaluated relationships cognition.Across study period, moderate ranged from 16% 26%, 46.5% impaired once. Impairment associated poorer work capacity (p < 0.05), 2-month objectively tested anosmia 0.05). 0.01) without disability 0.03) severity. KP measures showed prolonged activation (2 8 months) 0.0001) linked IFN-beta in those PASC. Of blood analytes, only (elevated quinolinic acid, 3-hydroxyanthranilic kynurenine, kynurenine/tryptophan ratio) 0.001) performance greater likelihood impairment. PASC, independent abnormal 0.03).The relates thereby enabling biomarker therapeutic possibilities.

Язык: Английский

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Neurovascular coupling impairment as a mechanism for cognitive deficits in COVID-19

Brain Communications, Год журнала: 2024, Номер 6(2)

Опубликована: Янв. 1, 2024

Abstract Components that comprise our brain parenchymal and cerebrovascular structures provide a homeostatic environment for proper neuronal function to ensure normal cognition. Cerebral insults (e.g. ischaemia, microbleeds infection) alter cellular physiologic processes within the neurovascular unit contribute cognitive dysfunction. COVID-19 has posed significant complications during acute convalescent stages in multiple organ systems, including brain. Cognitive impairment is prevalent complication patients, irrespective of severity SARS-CoV-2 infection. Moreover, overwhelming evidence from vitro, preclinical clinical studies reported SARS-CoV-2-induced pathologies components are associated with impairment. Neurovascular disruption alters coupling response, critical mechanism regulates cerebromicrovascular blood flow meet energetic demands locally active neurons. Normal processing achieved through response involves coordinated action cells (i.e. neurons glia) cell types endothelia, smooth muscle pericytes). However, current work on COVID-19-induced yet investigate as causal factor. Hence, this review, we aim describe SARS-CoV-2's effects how they can impact decline disease. Additionally, explore potential therapeutic interventions mitigate Given great both individuals public health, necessity effort fundamental scientific research application becomes imperative. This integrated endeavour crucial mitigating deficits induced by its subsequent burden especially vulnerable population.

Язык: Английский

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Post-COVID cognitive deficits at one year are global and associated with elevated brain injury markers and grey matter volume reduction: national prospective study

Research Square (Research Square), Год журнала: 2024, Номер unknown

Опубликована: Янв. 5, 2024

The spectrum, pathophysiology, and recovery trajectory of persistent post-COVID-19 cognitive deficits are unknown, limiting our ability to develop prevention treatment strategies. We report the one-year cognitive, serum biomarker, neuroimaging findings from a prospective, national longitudinal study cognition in 351 COVID-19 patients who had required hospitalisation, compared 2,927 normative matched controls. Cognitive were global associated with elevated brain injury markers reduced anterior cingulate cortex volume one year after admission. severity initial infective insult, post-acute psychiatric symptoms, history encephalopathy greatest deficits. There was strong concordance between subjective objective Treatment corticosteroids during acute phase appeared protective against Together, these support hypothesis that moderate severe is immune-mediated, should guide development therapeutic

Язык: Английский

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Melatonin: a ferroptosis inhibitor with potential therapeutic efficacy for the post-COVID-19 trajectory of accelerated brain aging and neurodegeneration

Molecular Neurodegeneration, Год журнала: 2024, Номер 19(1)

Опубликована: Апрель 19, 2024

Abstract The unprecedented pandemic of COVID-19 swept millions lives in a short period, yet its menace continues among survivors the form post-COVID syndrome. An exponentially growing number suffer from cognitive impairment, with compelling evidence trajectory accelerated aging and neurodegeneration. novel enigmatic nature this yet-to-unfold pathology demands extensive research seeking answers for both molecular underpinnings potential therapeutic targets. Ferroptosis, an iron-dependent cell death, is strongly proposed underlying mechanism post-COVID-19 neurodegeneration discourse. incites neuroinflammation, iron dysregulation, reactive oxygen species (ROS) accumulation, antioxidant system repression, renin-angiotensin (RAS) disruption, clock gene alteration. These events pave way ferroptosis, which shows signature COVID-19, premature aging, neurodegenerative disorders. In search treatment, melatonin shines as promising ferroptosis inhibitor repeatedly reported safety tolerability. According to various studies, has proven efficacy attenuating severity certain manifestations, validating reputation anti-viral compound. Melatonin well-documented anti-aging properties combating neurodegenerative-related pathologies. can block leading since it efficient anti-inflammatory, chelator, antioxidant, angiotensin II antagonist, regulator. Therefore, we propose culprit behind melatonin, well-fitting inhibitor, treatment.

Язык: Английский

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Definitions and symptoms of the post-COVID syndrome: an updated systematic umbrella review

European Archives of Psychiatry and Clinical Neuroscience, Год журнала: 2024, Номер unknown

Опубликована: Июль 25, 2024

Abstract Post-COVID syndrome (PCS) describes a persistent complex of symptoms following COVID-19 episode, lasting at least 4 to 12 weeks, depending on the specific criteria used for its definition. It is often associated with moderate severe impairments daily life and represents major burden many people worldwide. However, especially during first two years pandemic, therapeutic diagnostic uncertainties were prominent due novelty disease non-specific definitions that overlooked functional deficits lacked objective assessment. The present work comprehensively examines status PCS as depicted in recent reviews meta-analyses, alongside exploring impairments. We searched database Pubmed meta-analysis evaluating period between May 31, 2022, December 2023. Out 95 studies, 33 selected inclusion our analyses. Furthermore, we extended upon prior research by systematically recording linked identified studies. found fatigue, neurological complaints, exercise intolerance most frequently reported symptoms. In conclusion, over past eighteen months, there has been notable increase quantity quality studies PCS. still remains clear need improvement, particularly regard definition necessary diagnosing this syndrome. Enhancing aspect will render future more comparable precise, thereby advancing understanding

Язык: Английский

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Scientific Rationale for the Treatment of Cognitive Deficits from Long COVID

Neurology International, Год журнала: 2023, Номер 15(2), С. 725 - 742

Опубликована: Май 31, 2023

Sustained cognitive deficits are a common and debilitating feature of “long COVID”, but currently there no FDA-approved treatments. The functions the dorsolateral prefrontal cortex (dlPFC) most consistently afflicted by long COVID, including in working memory, motivation, executive functioning. COVID-19 infection greatly increases kynurenic acid (KYNA) glutamate carboxypeptidase II (GCPII) brain, both which can be particularly deleterious to PFC function. KYNA blocks NMDA nicotinic-alpha-7 receptors, two receptors required for dlPFC neurotransmission, GCPII reduces mGluR3 regulation cAMP-calcium-potassium channel signaling, weakens network connectivity neuronal firing. Two agents approved other indications may helpful restoring physiology: antioxidant N-acetyl cysteine inhibits production KYNA, α2A-adrenoceptor agonist guanfacine regulates signaling is also anti-inflammatory. Thus, these treating symptoms COVID.

Язык: Английский

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A Comprehensive Review of COVID-19-Related Olfactory Deficiency: Unraveling Associations with Neurocognitive Disorders and Magnetic Resonance Imaging Findings

Diagnostics, Год журнала: 2024, Номер 14(4), С. 359 - 359

Опубликована: Фев. 7, 2024

Olfactory dysfunction (OD) is one of the most common symptoms in COVID-19 patients and can impact patients’ lives significantly. The aim this review was to investigate multifaceted on olfactory system provide an overview magnetic resonance (MRI) findings neurocognitive disorders with COVID-19-related OD. Extensive searches were conducted across PubMed, Scopus, Google Scholar until 5 December 2023. included articles 12 observational studies 1 case report that assess structural changes structures, highlighted through MRI, 10 correlating loss smell or mood patients. MRI consistently indicate volumetric abnormalities, altered signal intensity bulbs (OBs), anomalies cortex among persistent correlation between OD deficits reveals associations cognitive impairment, memory deficits, depressive symptoms. Treatment approaches, including training pharmacological interventions, are discussed, emphasizing need for sustained therapeutic interventions. This points out several limitations current literature while exploring intricate effects its connection disorders. lack objective measurements some potential validity issues self-reports emphasize cautious interpretation. Our research highlights critical extensive larger samples, proper controls, deepen our understanding COVID-19’s long-term neurological dysfunctions.

Язык: Английский

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Cognition and Long COVID: A PRISMA Systematic Review of Longitudinal Studies

Revista de Neurología, Год журнала: 2025, Номер 79(12)

Опубликована: Янв. 24, 2025

Introduction: Long COVID is defined by National Institute for Health and Care Excellence (NICE) as the set of signs symptoms that develop during or after a SARS-CoV-2 infection continue more than twelve weeks without any alternative diagnosis. One most frequent persistent reported patients verified in neuroimaging studies cognitive dysfunction, due to generalized hypoconnectivity diffuse axonal lesion white matter. Therefore, objectives present review are determine how long functions remain affected explore which beyond three months follow-up up 65 years age previous neuropsychological psychiatric complications. Methods: A systematic was performed using PRISMA criteria 11 articles were included through comprehensive search five different databases: PubMed, Medline, Scopus, WOS ProQuest. The risk bias assessed Newcastle-Ottawa scale. Results: Cognitive problems persist over time improve slowly, although seem agree areas improved significantly one year. remained impaired longest processing speed attention. Conclusions: These alterations cause reduction quality life work capacity manifest need intervention.

Язык: Английский

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Cognitive reserve moderates the effect of COVID-19 on cognition: A systematic review and meta-analysis of individual participant data

Neuroscience & Biobehavioral Reviews, Год журнала: 2025, Номер unknown, С. 106067 - 106067

Опубликована: Фев. 1, 2025

Язык: Английский

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Cognitive impairment after recovery from COVID-19: Frequency, profile, and relationships with clinical and laboratory indices

European Neuropsychopharmacology, Год журнала: 2023, Номер 79, С. 22 - 31

Опубликована: Дек. 7, 2023

Cognitive impairment (CI) is regarded as a remarkable burden in COVID-19 survivors. Its prevalence and profile, relationships with the disease clinical laboratory indices, remain unclear. The present study investigated, large sample of patients recovered from COVID-19, frequency CI both face-to-face screening tool comprehensive test battery (MCCB). also evaluated profile its indices psychopathological features. Out 1344 subjects assessed for eligibility, 736 completed phase 11 months after infection; 402 participated baseline an depth cognitive, assessment about one month later. More than third screened presented (COG+); it was associated to age, education, male gender, severity, presence anosmia, dyspnea at rest exertional during acute phase. COG+ showed higher severity depression, anxiety post-traumatic distress, worse global functioning, without CI. MCCB that 45% had involving attention, working memory, verbal learning, visual reasoning problem solving. Finally, neurocognitive functioning inversely correlated LDH blood levels, potential biomarker severity. According our findings, cognitive should be routinely periodically patients, especially older subjects, who experienced more severe symptoms. In case persisting dysfunctions training programs considered treatment strategies.

Язык: Английский

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