Brain Metabolic Correlates of Persistent Olfactory Dysfunction after SARS-Cov2 Infection

Donegani, Maria Isabella; Miceli, Alberto; Pardini, Matteo; Bauckneht, Matteo; Chiola, Silvia; Pennone, Michele; Marini, Cecilia; Massa, Federico; Raffa, Stefano; Arnaldi, Dario; Sambuceti, Gianmario; Nobili, Flavio; Morbelli, Silvia

doi:10.3390/biomedicines9030287

Cited by 47 publications

(50 citation statements)

References 34 publications

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“…Sollini et al [39] also demonstrated brain hypometabolism thalamus as well as the right parahippocampal gyrus in 13 post-COVID-19 patients that were associated with persistent symptoms (e.g., anosmia/ageusia and fatigue). Similarly, Donegani et al [40] demonstrated relative hypometabolism in bilateral parahippocampal and fusiform gyri and in the left insula in post-COVID-19 patients with hyposmia compared to controls. This finding largely confirms the topography of brain hypometabolism in patients with post-COVID-19 with persistent hyposmia or with other functional complaints [41].…”

Section: F-fdg-pet/ct and Brain Metabolism Changes In Post-covid-19 Patientsmentioning

confidence: 79%

“…Some studies (summarized in Table 1) have shown that Post-COVID-19 patients with persistent functional symptoms and complaints demonstrate continuous 18 F-FDG-PET hypometabolism in various brain regions [37][38][39][40][41][42][43]. Reduced metabolic activity in the orbitofrontal cortex in COVID-19 anosmia was found by Karimi-Galougahi et al [37], which might suggest that impaired neural function of this region might be a causative mechanism for anosmia, likely due to direct neurotropism of SARS-CoV-2 [39].…”

Section: F-fdg-pet/ct and Brain Metabolism Changes In Post-covid-19 Patientsmentioning

confidence: 99%

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18F-FDG-PET Imaging for Post-COVID-19 Brain and Skeletal Muscle Alterations

Rudroff

Workman

Ponto

2021

Viruses

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Scientific evidence concerning the subacute and long-term effects of coronavirus disease 2019 (COVID-19) is on the rise. It has been established that infection by serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a systemic process that involves multiple organs. The complications and long-term consequences of COVID-19 are diverse and patients need a multidisciplinary treatment approach in the acute and post-acute stages of the disease. A significant proportion of COVID-19 patients experience neurological manifestations, some enduring for several months post-recovery. However, brain and skeletal muscle changes resultant from SARS CoV-2 infection remain largely unknown. Here, we provide a brief overview of the current knowledge, and usefulness, of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) to investigate brain and skeletal muscles changes in Post-COVID-19 patients with persistent symptoms. Furthermore, a brief discussion of future 18F-FDG-PET/CT applications that might advance the current knowledge of the pathogenesis of post-COVID-19 is also provided.

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Section: F-fdg-pet/ct and Brain Metabolism Changes In Post-covid-19 Patientsmentioning

confidence: 79%

Section: F-fdg-pet/ct and Brain Metabolism Changes In Post-covid-19 Patientsmentioning

confidence: 99%

18F-FDG-PET Imaging for Post-COVID-19 Brain and Skeletal Muscle Alterations

Rudroff

Workman

Ponto

2021

Viruses

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“…A SARS‐CoV‐2 axonal transport via the cribriform plate was also suggested ( 78 ). Moreover, a clinical study on patients with persistent hyposmia after SARS‐CoV‐2 infection proved brain hypometabolism bilaterally in the limbic cortex, suggesting the involvement of the distal olfactory pathway ( 79 ). In this review, we detected 57 (28.9%) cases in which olfactory bulb inflammation or viral RNA presence was demonstrated, supporting the olfactory neuroepithelium and bulb as one possible entrance to the CNS.…”

Section: Discussionmentioning

confidence: 99%

SARS‐CoV‐2 and the brain: A review of the current knowledge on neuropathology in COVID‐19

et al. 2021

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SARS‐CoV‐2 (severe acute respiratory syndrome coronavirus 2), the new coronavirus responsible for the pandemic disease in the last year, is able to affect the central nervous system (CNS). Compared with its well‐known pulmonary tropism and respiratory complications, little has been studied about SARS‐CoV‐2 neurotropism and pathogenesis of its neurological manifestations, but also about postmortem histopathological findings in the CNS of patients who died from COVID‐19 (coronavirus disease 2019). We present a systematic review, carried out according to the Preferred Reporting Items for Systematic Review standards, of the neuropathological features of COVID‐19. We found 21 scientific papers, the majority of which refer to postmortem examinations; the total amount of cases is 197. Hypoxic changes are the most frequently reported alteration of brain tissue, followed by ischemic and hemorrhagic lesions and reactive astrogliosis and microgliosis. These findings do not seem to be specific to SARS‐CoV‐2 infection, they are more likely because of systemic inflammation and coagulopathy caused by COVID‐19. More studies are needed to confirm this hypothesis and to detect other possible alterations of neural tissue. Brain examination of patients dead from COVID‐19 should be included in a protocol of standardized criteria to perform autopsies on these subjects.

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“…Evidence of injury at the level of the CNS is very limited at this time, however, a functional imaging study of patients with persistent anosmia following recovery of SARS-CoV-2 infection displayed reduced metabolism in bilateral limbic cortices and the insular cortex of the left hemisphere, as compared to controls ( Donegani et al, 2021 ). This suggests brain involvement in SARS-CoV-2-associated anosmia that may also impact cognitive function, as these brain regions are involved in multiple cognitive processes, including learning and memory, word, face, and body recognition, and consciousness.…”

Section: Discussionmentioning

confidence: 99%

Age-Associated Neurological Complications of COVID-19: A Systematic Review and Meta-Analysis

Sullivan

Fischer

2021

Front. Aging Neurosci.

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The outbreak of the novel and highly infectious severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has resulted in hundreds of millions of infections and millions of deaths globally. Infected individuals that progress to coronavirus disease-19 (COVID-19) experience upper and lower respiratory complications that range in severity and may lead to wide-spread inflammation and generalized hypoxia or hypoxemia that impacts multiple organ systems, including the central and peripheral nervous systems. Since the SARS-CoV-2 outbreak, multiple reports continue to emerge that detail neurological symptoms, ranging from relatively mild (e.g., impaired taste and/or smell) to severe (e.g., stroke), suggesting SARS-CoV-2 may be neurotropic and/or contribute to nervous system injury through direct and/or indirect mechanisms. To gain insight into the types of neurological complications associated with SARS-CoV-2 infection and their possible relationship with age, sex, COVID-19 severity, and comorbidities, we performed a systematic review of case reports and series published in 2020 – April 4, 2021 of infected patients with neurological manifestations. Meta-analyses were conducted using individual patient data from reports where these data could be extracted. Here, we report neurological injury occurs across the lifespan in the context of infection, with and without known comorbidities, and with all disease severities, including asymptomatic patients. Older individuals, however, are more susceptible to developing life-threatening COVID-19 and cerebrovascular disease (CVD), such as stroke. A mild but inverse correlation with age was seen with CNS inflammatory diseases, such as encephalitis, as well as taste and/or smell disorders. When reported, increased age was also associated with comorbid cardiovascular risk factors, including hypertension, diabetes mellitus, and lipid disorders, but not with obesity. Obesity did correlate with development of critical COVID-19. Discussion into potential pathophysiological mechanisms by which neurological symptoms arise and long-term consequences of infection to the nervous system is also provided.

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Brain Metabolic Correlates of Persistent Olfactory Dysfunction after SARS-Cov2 Infection

Cited by 47 publications

References 34 publications

18F-FDG-PET Imaging for Post-COVID-19 Brain and Skeletal Muscle Alterations

18F-FDG-PET Imaging for Post-COVID-19 Brain and Skeletal Muscle Alterations

SARS‐CoV‐2 and the brain: A review of the current knowledge on neuropathology in COVID‐19

Age-Associated Neurological Complications of COVID-19: A Systematic Review and Meta-Analysis

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