Abstract
Psychiatric sequelae substantially contribute to the post-acute burden of disease associated with COVID-19, persisting months after clearance of the virus. Brain imaging shows white matter (WM) hypodensities/hyperintensities, and the involvement of grey matter (GM) in prefrontal, anterior cingulate (ACC) and insular cortex after COVID, but little is known about brain correlates of persistent psychopathology.
With a multimodal approach, we studied whole brain voxel-based morphometry, diffusion-tensor imaging, and resting-state connectivity, to correlate MRI measures with depression and post-traumatic distress (PTSD) in 42 COVID-19 survivors without brain lesions, at 90.59 ± 54.66 days after COVID. Systemic immune-inflammation index (SII) measured in the emergency department, which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, predicted worse self-rated depression and PTSD, widespread lower diffusivity along the main axis of WM tracts, and abnormal functional connectivity (FC) among resting state networks. Self-rated depression and PTSD inversely correlated with GM volumes in ACC and insula, axial diffusivity, and associated with FC.
We observed overlapping associations between severity of inflammation during acute COVID-19, brain structure and function, and severity of depression and post-traumatic distress in survivors, thus warranting interest for further study of brain correlates of the post-acute COVID-19 syndrome. Beyond COVID-19, these findings support the hypothesis that regional GM, WM microstructure, and FC could mediate the relationship between a medical illness and its psychopathological sequelae, and are in agreement with current perspectives on the brain structural and functional underpinnings of depressive psychopathology.
【저자키워드】 COVID-19, SARS-CoV-2, Anxiety, Depression, PTSD, magnetic resonance imaging, Grey matter, White matter, Diffusion-tensor imaging, Resting state, Functional connectivity, 【초록키워드】 Inflammation, immune response, severity, neutrophil, virus, Brain, MRI, COVID, Survivors, Platelet, systemic inflammation, disease, association, Hypothesis, post-traumatic, distress, systemic, Brain imaging, Support, Volume, overlapping, Perspective, lesions, syndrome, measure, depressive, acute COVID-19, clearance, survivor, peripheral lymphocyte, widespread, approach, SII, predicted, functional, contribute, correlated, medical illness, reflect, insular cortex, with COVID-19, 【제목키워드】 Inflammatory biomarker, post-traumatic, distress,