White matter integrity in hospitalized COVID-19 patients is not associated with short- and long-term clinical outcomes.
| Autor: | van Lith TJ; Department of Neurology, Donders Center for Medical Neurosciences, Radboud University Medical Center, Nijmegen, Netherlands., Li H; Department of Neurology, Donders Center for Medical Neurosciences, Radboud University Medical Center, Nijmegen, Netherlands., van der Wijk MW; Department of Neurology, Donders Center for Medical Neurosciences, Radboud University Medical Center, Nijmegen, Netherlands., Wijers NT; Department of Neurology, Leiden University Medical CenterLeiden, Netherlands., Sluis WM; Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, Netherlands., Wermer MJH; Department of Neurology, University Medical Center Groningen, Groningen, Netherlands., de Leeuw FE; Department of Neurology, Donders Center for Medical Neurosciences, Radboud University Medical Center, Nijmegen, Netherlands., Meijer FJA; Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands., Tuladhar AM; Department of Neurology, Donders Center for Medical Neurosciences, Radboud University Medical Center, Nijmegen, Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | Frontiers in neurology [Front Neurol] 2024 Aug 08; Vol. 15, pp. 1440294. Date of Electronic Publication: 2024 Aug 08 (Print Publication: 2024). |
| DOI: | 10.3389/fneur.2024.1440294 |
| Abstrakt: | Objectives: SARS-CoV-2 infection is associated with a decline in functional outcomes; many patients experience persistent symptoms, while the underlying pathophysiology remains unclear. This study investigated white matter (WM) integrity on brain MRI in hospitalized COVID-19 patients and its associations with clinical outcomes, including long COVID. Materials and Methods: We included hospitalized COVID-19 patients and controls from CORONavirus and Ischemic Stroke (CORONIS), an observational cohort study, who underwent MRI-DWI imaging at baseline shortly after discharge (<3 months after positive PCR) and 3 months after baseline scanning. We assessed WM integrity using diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) and performed comparisons between groups and within patients. Clinical assessment was conducted at 3 and 12 months with functional outcomes such as modified Rankin Scale (mRS), Post-COVID-19 Functional Status scale (PCFS), Visual Analogue Scale (VAS), and long COVID, cognitive assessment was conducted by the Modified Telephone Interview for Cognitive Status (TICS-M), and the Hospital Anxiety and Depression Scale (HADS) was used to assess mood disorder. Associations between WM integrity and clinical outcomes were evaluated using logistic regression and linear regression. Results: A total of 49 patients (mean age 59.5 years) showed higher overall peak width of skeletonized mean diffusivity (PSMD) ( p = 0.030) and lower neurite density index (NDI) in several WM regions compared with 25 controls at the baseline ( p < 0.05; FWE-corrected) but did not remain statistically significant after adjusting for WM hyperintensities. Orientation dispersion index (ODI) increased after 3-month follow-up in several WM regions within patients ( p < 0.05), which remained significant after correction for changes in WMH volume. Patients exhibited worse clinical outcomes compared with controls. Low NDI at baseline was associated with worse performance on the Post-COVID-19 Functional Status scale after 12 months ( p = 0.018). Conclusion: After adjusting for WMH, hospitalized COVID-19 patients no longer exhibited lower WM integrity compared with controls. WM integrity was generally not associated with clinical assessments as measured shortly after discharge, suggesting that factors other than underlying WM integrity play a role in worse clinical outcomes or long COVID. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. (Copyright © 2024 van Lith, Li, van der Wijk, Wijers, Sluis, Wermer, de Leeuw, Meijer and Tuladhar.) |
| Databáze: | MEDLINE |
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