Infectious Disease

Persistent cognitive impairment after mild COVID infection linked to CSF ​​inflammation

April 03, 2022

1 min read

Source/Disclosures

sources:

Hellmuth J, et al. Cognitive symptoms after mild SARS-CoV-2 infection associate with higher levels of CSF immune activation and immunovascular markers. Presented at: American Academy of Neurology annual meeting; April 2-7, 2022; Seattle.

Disclosures:
Hellmuth reports receiving funds to serve as an expert witness for McAngus Goudelock & Courie law firm.

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SEATTLE — People with persistent cognitive symptoms after mild COVID-19 infection had elevated cerebrospinal fluid inflammatory markers, according to a presentation at the 2022 American Academy of Neurology annual meeting.

“Many millions of people experienced persistent symptoms following a SARS-CoV-2 infection, which can affect even young, healthy adults with a mild case,” Joanna Hellmuth, MD, MHS, assistant professor of neurology at the University of California, San Francisco, said during the presentation. “However, there are not yet effective laboratory tests or treatments … in part because we do not understand the underlying biology.”

Source: Adobe Stock.

Seeking to measure immune activation and immunovascular markers in the CSF of patients with persistent cognitive issues after SARS-CoV-2 infection, Hellmuth and colleagues enrolled 33 participants (median age, 40 years) who recovered from mild COVID-19 infection. Of those, 23 had new, persistent cognitive symptoms and 10 exhibited no cognitive impairment.

All participants were offered CSF analysis from a lumbar puncture and 54% (13 in the cognitively affected group, 5 controls) accepted. CSF was collected a median of 10.2 months following onset of COVID symptoms.

Researchers found that those with acute-onset cognitive symptoms had higher levels of CSF immunovascular marker VEGF-C compared with those with delayed-onset cognitive symptoms, as well as cognitively asymptomatic controls.

In addition, those with acute-onset symptoms also had higher CSF levels of IP-10, IL-8, placental growth factor and intercellular adhesion molecule-1.

Hellmuth and colleagues also reported that participants with COVID-associated cognitive impairment had higher levels of inflammatory markers in their CSF, compared with those who did not experience cognitive changes.

“If true, these findings imply that inflammation in the brain may contribute to these cognitive changes after COVID, and also that a SARS-CoV-2 infection could trigger an immunovascular dysregulation via endothelial dysfunction and activation,” Hellmuth said. “In those with early-onset cognitive issues after COVID, this homeostasis is not regained later.”

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American Academy of Neurology Annual Meeting

American Academy of Neurology Annual Meeting

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