People who had recovered from COVID-19, including those no longer reporting symptoms, exhibited significant cognitive deficits versus controls when controlling for age, gender, education level, income, racial-ethnic group, pre-existing medical disorders, tiredness, depression and anxiety. The deficits were of substantial effect size for people who had been hospitalised (N = 192), but also for non-hospitalised cases who had biological confirmation of COVID-19 infection (N = 326).
Research presented at the Alzheimer’s Association International Conference suggests even mild cases of COVID-19 may be associated with cognitive deficits months after recovery.
Up to one-third of patients with COVID-19 analyzed in this review experienced at least 1 neurologic manifestation. One in 50 patients experienced stroke. In those >60 years of age, more than one-third had acute confusion/delirium; the presence of neurologic manifestations in this group was associated with nearly a doubling of mortality.
This is to our knowledge the first longitudinal imaging study of SARS-CoV-2 in which the participants were initially scanned before any of them had been infected. Our longitudinal analyses revealed a significant, deleterious impact associated with SARS-CoV-2. This effect could be seen mainly in the limbic and olfactory cortical system, for example, with a change in diffusion measures—proxies for tissue damage—in regions that are functionally connected to the piriform cortex, olfactory tubercle and anterior olfactory nucleus, as well as a more pronounced reduction of grey matter thickness and contrast in the participants infected with SARS-CoV-2 in the left parahippocampal gyrus and lateral orbitofrontal cortex. Although the greater atrophy for the participants who tested positive for SARS-CoV-2 was localised to a few, mainly limbic, regions, the increase in CSF volume and decrease in whole-brain volume suggests an additional diffuse loss of grey matter superimposed onto the more regional effects observed in the olfactory-related areas.
Coronavirus disease 2019 (COVID-19) can damage cerebral small vessels and cause neurological symptoms. Here we describe structural changes in cerebral small vessels of patients with COVID-19 and elucidate potential mechanisms underlying the vascular pathology.