Dados do Trabalho

Título

Grey matter atrophy according to four COVID-19 strains: frontal lobe and limbic atrophy are common to different strains.

Resumo

Introduction: The presence of neuropsychiatric symptoms in the post-COVID syndrome seems frequent and debilitating and represents a major public health concern. Unfortunately, neither the physiopathology nor the underlying cerebral alterations are understood.
Objectives: To investigate structural brain alterations (gray matter atrophy) associated with post-COVID syndrome in patients with different strains of SARS-CoV-2.
Materials and Methods: We analyzed 3T T1 MRI images of 300 post-COVID patients followed at the University of Campinas (median age: 40 y.o.; 209 women): 188 infected with the Alpha strain, 29 infected with the P.2-Gamma strain, 61 infected with the P.1+P.1.*-Gamma strain, 22 infected with the Delta strain and 90 healthy controls scanned during the pandemic. The determination of strain was according to the Fiocruz database (http://www.genomahcov.fiocruz.br/dashboard/), which exhibits the Brazilian SARS-CoV-2 predominant strains by intervals. We used the CAT12 toolbox/ SPM12/MATLAB 2019 to perform Voxel-Based Morphometry (VBM) analysis (to detect grey matter atrophy (GMA)) and statistical analyses. We reported p-values<0.001, we used sex, age and total intracranial volume as covariates and corrected the results for multiple comparisons.

Results: Overall, all four strains presented GMA atrophy of bilateral anterior cingula and ventromedial frontal lobes. In addition, Strain P.2-Gamma showed GMA of the right cuneus and left superior occipital gyrus. The P.1+P.1.*-Gamma Strain presented more widespread atrophy, mainly in the right angular gyrus, fusiform gyrus, frontal operculum and precuneus and left frontal operculum and precuneus. Interestingly, the Alpha and Delta Strains revealed exclusive frontal lobe GMA.
Conclusion: Despite the vaccination and some differences, in acute presentation, all four groups presented GMA of THE anterior cingula and ventromedial frontal area. Although different strains may show individual variations, post-COVID syndrome seems to exhibit some commonalities of GMA. These findings suggest similarities in terms of cerebral injury and physiopathology across different SARS-CoV-2 strains. Given the location of GMA, these areas may be somehow associated with the highly prevalent neuropsychiatric symptoms (dysexecutive syndrome, depression and anxiety) in post-COVID syndrome. Further research in this area is necessary to correlate with neuropsychiatric dysfunction and to detect therapeutic targets.

Palavras Chave

SARS-CoV-2, Neurocovid, COVID, post-COVID syndrome, long COVID, long haul COVID, neuropsychiatric, VBM, MRI