Risk factors and abnormal cerebrospinal fluid associate with cognitive symptoms after mild COVID-19

Alexandra C Apple; Alexis Oddi; Michael J Peluso; Breton M Asken; Timothy J Henrich; J Daniel Kelly; Samuel J Pleasure; Steven G Deeks; Isabel Elaine Allen; Jeffrey N Martin; Lishomwa C Ndhlovu; Bruce L Miller; Melanie L Stephens; Joanna Hellmuth

doi:10.1002/acn3.51498

Risk factors and abnormal cerebrospinal fluid associate with cognitive symptoms after mild COVID-19

Ann Clin Transl Neurol. 2022 Feb;9(2):221-226. doi: 10.1002/acn3.51498. Epub 2022 Jan 19.

Authors

Alexandra C Apple^{1

2}, Alexis Oddi^{1

2}, Michael J Peluso³, Breton M Asken^{1

2}, Timothy J Henrich⁴, J Daniel Kelly^{5

6}, Samuel J Pleasure^{2

7}, Steven G Deeks³, Isabel Elaine Allen⁵, Jeffrey N Martin⁵, Lishomwa C Ndhlovu⁸, Bruce L Miller^{1

2}, Melanie L Stephens^{1

2}, Joanna Hellmuth^{1

2}

Affiliations

¹ Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, California, USA.
² Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, USA.
³ Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
⁴ Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California, USA.
⁵ Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, California, USA.
⁶ Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, USA.
⁷ Department of Neurology, University of California, San Francisco, San Francisco, California, USA.
⁸ Division of Infectious Disease, Department of Medicine, Weill Cornell Medicine, New York, New York, USA.

Abstract

Cognitive post-acute sequelae of SARS-CoV-2 (PASC) can occur after mild COVID-19. Detailed clinical characterizations may inform pathogenesis. We evaluated 22 adults reporting cognitive PASC and 10 not reporting cognitive symptoms after mild SARS-CoV-2 infection through structured interviews, neuropsychological testing, and optional cerebrospinal fluid (CSF) evaluations (53%). Delayed onset of cognitive PASC occurred in 43% and associated with younger age. Cognitive PASC participants had a higher number of pre-existing cognitive risk factors (2.5 vs. 0; p = 0.03) and higher proportion with abnormal CSF findings (77% vs. 0%; p = 0.01) versus controls. Cognitive risk factors and immunologic mechanisms may contribute to cognitive PASC pathogenesis.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Aged
COVID-19 / cerebrospinal fluid
COVID-19 / physiopathology*
Cerebrospinal Fluid / virology*
Cognition / physiology*
Disease Progression
Female
Humans
Male
Middle Aged
Research Personnel
Risk Factors
SARS-CoV-2 / pathogenicity*
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding