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J Nucl Med . Slow but evident recovery from neocortical dysfunction and cognitive impairment in a series of chronic COVID-19 patients

tetano

Editor, Senior Moderator
J Nucl Med


. 2021 Mar 31;jnumed.121.262128.
doi: 10.2967/jnumed.121.262128. Online ahead of print.
Slow but evident recovery from neocortical dysfunction and cognitive impairment in a series of chronic COVID-19 patients


Ganna Blazhenets[SUP] 1 [/SUP], Nils Schr?ter[SUP] 2 [/SUP], Tobias Bormann[SUP] 2 [/SUP], Johannes Thurow[SUP] 1 [/SUP], Dirk Wagner[SUP] 3 [/SUP], Lars Frings[SUP] 1 [/SUP], Cornelius Weiller[SUP] 2 [/SUP], Philipp T Meyer[SUP] 1 [/SUP], Andrea Dressing[SUP] 2 [/SUP], Jonas A Hosp[SUP] 2 [/SUP]



Affiliations

Abstract

Cognitive impairment is a frequent complaint in coronavirus disease-19 (COVID-19) and can be related to cortical hypometabolism on [SUP]18[/SUP]F-FDG PET at the subacute stage. However, it is unclear if these changes are reversible. Methods: We prospectively assessed Montreal Cognitive Assessment (MoCA) and [SUP]18[/SUP]F-FDG PET scans in 8 COVID-19 patients at the subacute (as no longer infectious) and chronic stages (approximately six months after symptom onset). The expression of the previously established COVID-19-related covariance pattern was analyzed at both stages to examine the time course of post-COVID-19 cognitive impairment. For further validation, we also conducted a conventional group analysis. Results: Follow-up [SUP]18[/SUP]F-FDG PET revealed a significant reduction of initial frontoparietal and, to a lesser extent, temporal glucose hypometabolism that was accompanied by a significant improvement in cognition. The expression of the previously established COVID-19-related pattern was significantly lower at follow-up and correlated inversely with MoCA performance. However, both [SUP]18[/SUP]F-FDG PET and cognitive assessment suggest a residual impairment. Conclusions: Although a significant recovery of regional neuronal function and cognition can be clearly stated, residuals are still measurable in some patients six months after the manifestation of COVID-19. Given the current pandemic situation and tremendous uncertainty concerning the long-term effects of COVID-19, the present study provides novel insights of highest medical and socioeconomic relevance.

Keywords: COVID-19; FDG PET; Infectious Disease; Montreal Cognitive Assessment; Neurology; PET/CT; cognition; neurology.
 
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