Survivors of SARS-CoV-2 Infection Show Neuropsychiatric Sequelae Measured by Surveys, Neurocognitive Testing, and Magnetic Resonance Imaging: Preliminary Results

Hack, Laura M.; Brawer, Jacob; Chesnut, Megan; Zhang, Xue; Wintermark, Max; Grant, Philip; Bonilla, Hector; Stetz, Patrick; Yesavage, Jerome A.; Subramanian, Aruna; Williams, Leanne M.

doi:10.1101/2021.08.23.21256078

Cited by 4 publications

(12 citation statements)

References 49 publications

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“…A prospective cohort study from the US assessed neurologic symptoms among 100 participants with standardized questionnaires, cognitive tests, and brain scans. 31 Early results from the study reported 2 clusters of neurocognitive impairment. 31 One cluster had people with symptoms affecting all neurocognitive domains, whereas the other cluster had a milder impact limited to people's attention.…”

Section: Author (Year) Country Study Population Major Findingsmentioning

confidence: 98%

“…31 Early results from the study reported 2 clusters of neurocognitive impairment. 31 One cluster had people with symptoms affecting all neurocognitive domains, whereas the other cluster had a milder impact limited to people's attention. 31 Brain imaging results also revealed that people who reported experiencing anosmia -the loss of sense of smell -had structural neurologic differences compared to those who did not report anosmia.…”

Section: Author (Year) Country Study Population Major Findingsmentioning

confidence: 98%

“…31 One cluster had people with symptoms affecting all neurocognitive domains, whereas the other cluster had a milder impact limited to people's attention. 31 Brain imaging results also revealed that people who reported experiencing anosmia -the loss of sense of smell -had structural neurologic differences compared to those who did not report anosmia. 31 Similarly, a prospective study from Italy assessed 109 people from a post-COVID-19 neurologic clinic.…”

Section: Author (Year) Country Study Population Major Findingsmentioning

confidence: 99%

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Subtypes of Post–COVID-19 Condition: A Review of the Emerging Evidence

Basharat¹,

Chao²,

McGill³

2022

cjht

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Post–COVID-19 condition is a growing health concern and has been associated with more than 200 possible symptoms. The diverse and varied ways the condition presents clinically creates challenges for developing standard diagnostic criteria, and for health systems aiming to provide effective treatment and management supports for people. To support health care, decision-makers and clinicians understand the different clinical presentations of the condition, we scanned the evidence base to examine early approaches being used to characterize and describe subtypes of post–COVID-19 condition. Subtypes can be developed with many different disease features and patient factors, but for this report we specifically reviewed potential subtypes based on symptoms and clinical presentation. We found that some of the early approaches used to develop subtypes are based on statistical methods that group together patterns of symptoms. These studies are beginning to reveal potential subtypes based on severity of symptoms, type and co-occurrence of symptoms, and symptoms affecting different organ systems. Many reported symptoms of post–COVID-19 condition are similar to previously characterized health conditions. In some cases, subtypes of post–COVID-19 may be manifestations of those other conditions. For example, certain subtypes may present with symptoms similar to myalgic encephalomyelitis/chronic fatigue syndrome or pulmonary fibrosis. It is uncertain whether those subtypes share the same or distinct pathophysiology and whether they may benefit from similar treatments. Early evidence comparing the variant of infection and its association with potential subtypes of post–COVID-19 condition is emerging, but the findings are currently mixed. Some studies suggest that variants such as Delta and Omicron may result in different clinical presentations, while other studies have not found significant differences. Further research assessing the association between variants and subtypes is likely needed. This review provides some implications and considerations for health systems should emerging research further characterize and validate proposed subtypes. These implications may be important for improving the diagnosis, treatment, and management of post–COVID-19 condition. With estimates in Canada suggesting that more than a million people could be affected by the condition, monitoring ongoing research on subtypes may help support the development of effective and tailored treatments, and guide health systems planning across the country.

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Section: Author (Year) Country Study Population Major Findingsmentioning

confidence: 98%

Section: Author (Year) Country Study Population Major Findingsmentioning

confidence: 98%

Section: Author (Year) Country Study Population Major Findingsmentioning

confidence: 99%

See 1 more Smart Citation

Subtypes of Post–COVID-19 Condition: A Review of the Emerging Evidence

Basharat¹,

Chao²,

McGill³

2022

cjht

View full text Add to dashboard Cite

show abstract

“…In five additional subjects, we analyzed data from a typical resting state fMRI study (Hack et al, 2021) where PPG signals were acquired. A whole brain EPI sequence was used with 3mm isotropic voxels, a flip angle of 77 degrees, TR = 2s, TE = 27.5ms, FOV = 216x216 and 45 slices.…”

Section: Functional Magnetic Resonance Imagingmentioning

confidence: 99%

“…In order to understand whether the characteristic blood and CSF pulsations could also be observed with a typical resting state fMRI scan, we analyze data from 5 subjects who were scanned in a different project (Hack et al, 2021). In these resting state scans, the echo time is slower and the repetition time is slower (SMS: TE = 11.6ms, FA = 48, TR = 250ms, resting state fMRI: TE = 27.5ms, FA = 77, TR = 2000ms), but each slice is still acquired within a short time of 44.4 ms. Each slice can be aligned to the PPG peak, and cardiac pulsations can be extracted.…”

Section: Cardiac-gated Resting Statementioning

confidence: 99%

Measuring brain beats: cardiac-aligned fast fMRI signals

Hermes

Wandell

et al. 2022

Preprint

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Blood and cerebrospinal fluid (CSF) pulse and flow throughout the brain, driven by the cardiac cycle. These fluid dynamics, which are essential to healthy brain function, are characterized by several noninvasive magnetic resonance imaging (MRI) methods. Recent developments in fast MRI, specifically simultaneous multislice (SMS) acquisition methods, provide a new opportunity to rapidly and broadly assess cardiac-driven flow, including CSF spaces, surface vessels and parenchymal vessels. We use these techniques to assess blood and CSF flow dynamics in brief (3.5 minute) scans on a conventional 3T MRI scanner. Cardiac pulses are measured with a photoplethysmograph (PPG) on the index finger, along with fMRI signals in the brain. We retrospectively analyze the fMRI signals gated to the heart beat. Highly reliable cardiac-gated fMRI temporal signals are observed in CSF and blood on the timescale of one heartbeat (test-retest reliability within subjects R2>0.50). Cardiac pulsations with a local minimum following systole are observed in blood vessels, with earlier extrema in the carotid and basilar arteries and in branches of the anterior, posterior and middle cerebral arteries and extrema ~200 ms later in the superior sagittal, transverse and straight sinuses. CSF spaces in the ventricles and subarachnoid space showed cardiac pulsations with a local maximum following systole instead. Similar responses are observed, with less temporal detail, in slower resting state scans with slice timing retrospectively aligned to the cardiac pulse in the same manner. The SMS measurements rapidly, noninvasively and reliably sample brain-wide fMRI signal pulsations aligned to the heartbeat. The measurements estimate the amplitude and phase of cardiac driven fMRI pulsations in the CSF relative to those in the arteries, which is thought to be an estimate of the local intracranial impedance. Cardiac aligned fMRI signals can provide new insights about fluid dynamics or diagnostics for diseases where these dynamics are important.

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Measuring brain beats: Cardiac‐aligned fast functional magnetic resonance imaging signals

Hermes

Kerr

et al. 2022

Human Brain Mapping

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Blood and cerebrospinal fluid (CSF) pulse and flow throughout the brain, driven by the cardiac cycle. These fluid dynamics, which are essential to healthy brain function, are characterized by several noninvasive magnetic resonance imaging (MRI) methods. Recent developments in fast MRI, specifically simultaneous multislice acquisition methods, provide a new opportunity to rapidly and broadly assess cardiac‐driven flow, including CSF spaces, surface vessels and parenchymal vessels. We use these techniques to assess blood and CSF flow dynamics in brief (3.5 min) scans on a conventional 3 T MRI scanner in five subjects. Cardiac pulses are measured with a photoplethysmography (PPG) on the index finger, along with functional MRI (fMRI) signals in the brain. We, retrospectively, align the fMRI signals to the heartbeat. Highly reliable cardiac‐gated fMRI temporal signals are observed in CSF and blood on the timescale of one heartbeat (test–retest reliability within subjects R2 > 50%). In blood vessels, a local minimum is observed following systole. In CSF spaces, the ventricles and subarachnoid spaces have a local maximum following systole instead. Slower resting‐state scans with slice timing, retrospectively, aligned to the cardiac pulse, reveal similar cardiac‐gated responses. The cardiac‐gated measurements estimate the amplitude and phase of fMRI pulsations in the CSF relative to those in the arteries, an estimate of the local intracranial impedance. Cardiac aligned fMRI signals can provide new insights about fluid dynamics or diagnostics for diseases where these dynamics are important.

show abstract

Survivors of SARS-CoV-2 Infection Show Neuropsychiatric Sequelae Measured by Surveys, Neurocognitive Testing, and Magnetic Resonance Imaging: Preliminary Results

Cited by 4 publications

References 49 publications

Subtypes of Post–COVID-19 Condition: A Review of the Emerging Evidence

Subtypes of Post–COVID-19 Condition: A Review of the Emerging Evidence

Measuring brain beats: cardiac-aligned fast fMRI signals

Measuring brain beats: Cardiac‐aligned fast functional magnetic resonance imaging signals

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