Nature medicine
Published

Post-hospitalisation COVID-19 cognitive deficits at one year are global and associated with elevated brain injury markers and grey matter volume reduction

Authors

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, COVID-CNS Consortium, Benedict D Michael, Stella-Maria Paddick, E Charles Leek
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Abstract

Nat Med. 2024 Sep 23. doi: 10.1038/s41591-024-03309-8. Online ahead of print.

ABSTRACT

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 one-year cognitive, serum biomarker, and neuroimaging findings from a prospective, national study of cognition in 351 COVID-19 patients who had required hospitalisation, compared to 2,927 normative matched controls. Cognitive deficits were global and associated with elevated brain injury markers, and reduced anterior cingulate cortex volume one year after COVID-19. The severity of the initial infective insult, post-acute psychiatric symptoms, and a history of encephalopathy were associated with 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.

PMID:39312956 | DOI:10.1038/s41591-024-03309-8