Posthospitalization COVID-19 cognitive deficits at 1 year are global and associated with elevated brain injury markers and gray matter volume reduction
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期刊论文
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发表日期:
2024年9月23日
- Greta K. Wood,
- Brendan F. Sargent,
- Zain-Ul-Abideen Ahmad,
- Kukatharmini Tharmaratnam,
- Cordelia Dunai,
- Franklyn N. Egbe,
- Naomi H. Martin,
- Bethany Facer,
- Sophie L. Pendered,
- Henry C. Rogers,
- Christopher Hübel,
- Daniel J. van Wamelen,
- Richard A. I. Bethlehem,
- Valentina Giunchiglia,
- Peter J. Hellyer,
- William Trender,
- Gursharan Kalsi,
- Edward Needham,
- Ava Easton,
- Thomas A. Jackson,
- Colm Cunningham,
- Rachel Upthegrove,
- Thomas A. Pollak,
- Matthew Hotopf,
- Tom Solomon,
- Sarah L. Pett,
- Pamela J. Shaw,
- Nicholas Wood,
- Neil A. Harrison,
- Karla L. Miller,
- Peter Jezzard,
- Guy Williams,
- Eugene P. Duff,
- Steven Williams,
- Fernando Zelaya,
- Stephen M. Smith,
- Simon Keller,
- Matthew Broome,
- Nathalie Kingston,
- Masud Husain,
- Angela Vincent,
- John Bradley,
- Patrick Chinnery,
- David K. Menon,
- John P. Aggleton,
- Timothy R. Nicholson,
- John-Paul Taylor,
- Anthony S. David,
- Alan Carson,
- Ed Bullmore,
- Gerome Breen,
- Adam Hampshire,
- Ali M. Alam,
- Ammar Al-Chalabi,
- Christopher M. Allen,
- Jay Amin,
- Cherie Armour,
- Mark R. Baker,
- Suzanne Barrett,
- Neil Basu,
- Rahul Batra,
- Laura Benjamin,
- Alex Berry,
- Richard A. I. Bethlehem,
- Bethan Blackledge,
- Sarah A. Boardman,
- John Bradley,
- David P. Breen,
- Judith Breuer,
- Matthew Broome,
- Ed Bullmore,
- Matthew Butler,
- Hannah Castell,
- Jonathan Cavanagh,
- David Christmas,
- David M. Christmas,
- Jonathan R. I. Coleman,
- Alaistair Coles,
- Ceryce Collie,
- Nadine Cossette,
- David Cousins,
- Alastair Darby,
- Nicholas Davies,
- Sylviane Defres,
- Katherine C. Dodd,
- Alex Dregan,
- Eugene Duff,
- Mark A. Ellul,
- Nikos Evangelou,
- Peter M. Fernandes,
- Richard Francis,
- Ian Galea,
- Afagh Garjani,
- Lily George,
- Valentina Giunchiglia,
- Kiran Glen,
- Rebecca Gregory,
- Michael Griffiths,
- Victoria Grimbly,
- Alexander Grundmann,
- Savini Gunatilake,
- Shahd H. M. Hamid,
- Marc Hardwick,
- Jade D. Harris,
- Ewan Harrison,
- Paul J. Harrison,
- Monika Hartmann,
- Claire Hetherington,
- Orla Hilton,
- Julian Hiscox,
- Eva Maria Hodel,
- Angela E. Holland,
- Yun Huang,
- Stella Hughes,
- Sarosh Irani,
- Thomas M. Jenkins,
- Johan Kallberg Zvrskovec,
- Sandar Kyaw,
- Gabriella Lewis,
- James B. Lilleker,
- Michael P. Lunn,
- Claire L. MacIver,
- Daniel Madarshahian,
- Parisa Mansoori,
- Naomi Martin,
- Gavin McDonnell,
- Emily McGlinchey,
- Stephen McKeever,
- Ryan McIlwaine,
- Andrew M. McIntosh,
- Karla L. Miller,
- Dina Monssen,
- Christopher M. Morris,
- Ciaran Mulholland,
- Akshay Nair,
- Virginia Newcombe,
- Nathalie Nicholas,
- Timothy R. Nicholson,
- Ronan O’Malley,
- Obioma Orazulume,
- Marlies Ostermann,
- Alish Palmos,
- Arvind Patel,
- Sharon Peacock,
- Sophie L. Pendered,
- Thomas A. Pollak,
- Angela Roberts,
- Silvia Rota,
- Rustam Al-Shahi Salman,
- Merna Samuel,
- Brendan F. Sargent,
- Stephen J. Sawcer,
- Adam W. Seed,
- Scott Semple,
- Rajish S. K. Shil,
- Adam Sieradzki,
- Bhagteshwar Singh,
- Craig J. Smith,
- Jacqueline Smith,
- Stephen M. Smith,
- Leonie Taams,
- Arina Tamborska,
- Rhys H. Thomas,
- Emma Thomson,
- William Trender,
- Zain-Ul-Abideen Ahmad,
- Jonathan Underwood,
- Tonny Veenith,
- Annalena Venneri,
- Daniel J. van Wamelen,
- Guy Williams,
- Sui Hsien Wong,
- Michael S. Zandi,
- Benedict D. Michael,
- Stella-Maria Paddick,
- E. Charles Leek
摘要
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.