Brain magnetic resonance imaging findings six months after critical COVID-19: A prospective cohort study

Henriikka Ollila; Janne Pihlajamaa; Juha Martola; Linda Kuusela; Kaj Blennow; Henrik Zetterberg; Viljami Salmela; Laura Hokkanen; Marjaana Tiainen; Johanna Hästbacka

doi:10.1016/j.jcrc.2023.154502

Brain magnetic resonance imaging findings six months after critical COVID-19: A prospective cohort study

J Crit Care. 2024 Apr:80:154502. doi: 10.1016/j.jcrc.2023.154502. Epub 2023 Dec 19.

Authors

Affiliations

¹ Department of Perioperative, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. Electronic address: henriikka.ollila@helsinki.fi.
² HUS Medical Imaging Centre, Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
³ Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
⁴ Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK; UK Dementia Research Institute at UCL, London, UK; Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China; UW Department of Medicine, School of Medicine and Public Health, Madison, WI, USA.
⁵ Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
⁶ Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
⁷ Department of Perioperative, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

PMID: 38113746
DOI: 10.1016/j.jcrc.2023.154502

Abstract

Background: COVID-19 patients suffered from neurological symptoms in the acute phase. Whether this led to long-term consequences was unknown. We studied long-term brain MRI findings in ICU-treated COVID-19 patients and compared them with findings in groups with less severe acute disease.

Materials and methods: In this prospective cohort study, 69 ICU-treated, 46 ward-treated, and 46 home-isolated patients, as well as 53 non-COVID-19 controls, underwent brain MRI six months after acute COVID-19. Plasma neurofilament light chain (NfL), a biomarker of neuroaxonal injury, was measured simultaneously.

Results: Ischaemic infarctions existed in 5.8% of ICU-treated patients. Cerebral microbleeds (CMBs) existed in 27 (39.1%) ICU-treated, 13 (28.3%) ward-treated, 8 (17.4%) home-isolated COVID-19 patients, and 12 (22.6%) non-COVID controls. Patients with CMBs were older (p < 0.001), had a higher level of plasma NfL (p = 0.003), and higher supplementary oxygen days (p < 0.001). In multivariable analysis, age (OR 1.06, 95% CI 1.02-1.09) and supplementary oxygen days (OR 1.07, 95% CI 1.02-1.13) were associated with CMBs. The ICU group showed prevalent distribution of CMBs in deep regions.

Conclusion: Age and supplementary oxygen days were independently associated with CMBs; COVID-19 status showed no association. Accumulation of risk factors in the ICU group may explain the higher prevalence of CMBs.

Trial registration: ClinicalTrials.govNCT04864938, registered February 9, 2021.

Keywords: Brain MRI; COVID-19; Intensive care; Long-term.

Publication types

Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural

MeSH terms

Brain
COVID-19* / complications
Cerebral Hemorrhage* / complications
Humans
Infant, Newborn
Magnetic Resonance Imaging / adverse effects
Oxygen
Prospective Studies
Risk Factors

Substances

Oxygen

Associated data

ClinicalTrials.gov/NCT04864938

Grants and funding

R01 AG068398/AG/NIA NIH HHS/United States