Two-year follow-up of brain structural changes in patients who recovered from COVID-19: A prospective study

The long-term effects of COVID-19 on brain structure remain unclear. A prospective study was conducted to explore the changes in brain structure in COVID-19 survivors at one and two years after discharge (COVID-19one, COVID-19two). The difference in gray matter volume (GMV) was analyzed using the voxel-based morphometry method, and correlation analyses were conducted. The dynamic changes in clinical sequelae varied. The GMVs in the cerebellum and vermis were reduced in COVID-19one and COVID-19two, positively correlated with lymphocyte count, and negatively correlated with neutrophil count, neutrophil/lymphocyte ratio (COVID-19one), and systemic immune-inflammation index (COVID-19two). The decreased GMVs in the left middle frontal gyrus, inferior frontal gyrus of the operculum, right middle temporal gyrus, and inferior temporal gyrus returned to normal in COVID-19two. The decreased GMV in the left frontal lobe was negatively correlated with the Athens Insomnia Scale (AIS). The GMV in the left temporal lobe was aggravated in COVID-19two and positively correlated with C-reactive protein. In conclusion, GMV recovery coexisted with injury, which was associated with AIS and inflammatory factors. This may shed some light on the dynamic changes in brain structure and the possible predictors that may be related to GMV changes in COVID-19two.

Automated summary

A prospective study examined changes in brain structure in COVID-19 survivors at one and two years after discharge. Gray matter volume (GMV) differences were analyzed using voxel-based morphometry, and correlations were studied. Dynamic changes in clinical sequelae varied. GMV reductions were found in the cerebellum and vermis, and were positively correlated with lymphocyte count and negatively correlated with neutrophil count, neutrophil/lymphocyte ratio (COVID-19one), and systemic immune-inflammation index (COVID-19two). Some GMV reductions returned to normal in COVID-19two. Decreased GMV in the left frontal lobe was negatively correlated with Athens Insomnia Scale (AIS), while GMV in the left temporal lobe worsened and was positively correlated with C-reactive protein.