Quantitative susceptibility mapping at 7 T in COVID-19: brainstem effects and outcome associations
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Le résumé fourni par la source
Post-mortem studies have shown that patients dying from severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection frequently have pathological changes in their CNS, particularly in the brainstem. Many of these changes are proposed to result from para-infectious and/or post-infection immune responses. Clinical symptoms such as fatigue, breathlessness, and chest pain are frequently reported in post-hospitalized coronavirus disease 2019 (COVID-19) patients. We propose that these symptoms are in part due to damage to key neuromodulatory brainstem nuclei. While brainstem involvement has been demonstrated in the acute phase of the illness, the evidence of long-term brainstem change on MRI is inconclusive. We therefore used ultra-high field (7 T) quantitative susceptibility mapping (QSM) to test the hypothesis that brainstem abnormalities persist in post-COVID patients and that these are associated with persistence of key symptoms. We used 7 T QSM data from 30 patients, scanned 93-548 days after hospital admission for COVID-19 and compared them to 51 age-matched controls without prior history of COVID-19 infection. We correlated the patients' QSM signals with disease severity (duration of hospital admission and COVID-19 severity scale), inflammatory response during the acute illness (C-reactive protein, D-dimer and platelet levels), functional recovery (modified Rankin scale), depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7). In COVID-19 survivors, the MR susceptibility increased in the medulla, pons and midbrain regions of the brainstem. Specifically, there was increased susceptibility in the inferior medullary reticular formation and the raphe pallidus and obscurus. In these regions, patients with higher tissue susceptibility had worse acute disease severity, higher acute inflammatory markers, and significantly worse functional recovery. This study contributes to understanding the long-term effects of COVID-19 and recovery. Using non-invasive ultra-high field 7 T MRI, we show evidence of brainstem pathophysiological changes associated with inflammatory processes in post-hospitalized COVID-19 survivors.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Quantitative susceptibility mapping at 7 T in COVID-19: brainstem effects and outcome associations
- Date Crossref
- 07/10/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Cambridge Department of Clinical Neurosciences pays non établi dans la noticeUniversité ou école supérieure
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Invicro (United Kingdom) pays non établi dans la noticeEntreprise
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Imperial College London Burlington Danes Building pays non établi dans la noticeUniversité ou école supérieure
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University of Oxford Nuffield Department of Clinical Neurosciences pays non établi dans la noticeUniversité ou école supérieure
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Oxford University Hospitals NHS Trust pays non établi dans la noticeÉtablissement de santé
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Wellcome Centre for Integrative Neuroimaging pays non établi dans la noticeStructure de recherche
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Heidelberg University pays non établi dans la noticeUniversité ou école supérieure
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Central Institute of Mental Health pays non établi dans la noticeÉtablissement de santé
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MRC Cognition and Brain Sciences Unit pays non établi dans la noticeStructure de recherche
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Medical Research Council pays non établi dans la noticeOrganisme public
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Radcliffe Department of Medicine and Oxford University Hospitals NHS Foundation Trust Division of Cardiovascular Medicine pays non établi dans la noticeUniversité ou école supérieure
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University of Heidelberg Department of Addictive Behaviour and Addiction Medicine pays non établi dans la noticeUniversité ou école supérieure
Department of Clinical Neurosciences — University of Cambridge, Invicro (United Kingdom) et Burlington Danes Building — Imperial College London, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.