European journal of radiology · 2025
Changes in the cerebral glymphatic system after rehabilitation of COVID-19 patients: A five-year follow-up study.
СтатьяНазвание и аннотация: Перевод в очереди
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Yao Jiaqi, Zhang Lijie, Huang Sihong, Cao Shirui, Xu Xinjia, Yang Junjie, Zeng Yule, Liu Jun
Аннотация
BACKGROUND: COVID-19 patients often experience cognitive deficits and sleep disorders, potentially linked to cerebral glymphatic system (GS) dysfunction. Long-term progression remains unclear.
METHODS: A prospective follow-up study was conducted on 17 COVID-19 patients at 1(V1), 2 (V2), and 5 years (V5) post-discharge. Multimodal MRI was used to assess the Analysis Along the Perivascular Space (ALPS) index, White Matter Free Water (WM-FW), Choroid Plexus Volume (CPV), and Global Blood-Oxygen-Level-Dependent-Cerebrospinal Fluid (gBOLD-CSF) Coupling, alongside comprehensive neuropsychological tests. Data were analyzed using Linear Mixed-Effects Models (LME), correlation, and regression analyses (P < 0.05), with Minimal Clinically Important Difference (MCID) and Receiver Operating Characteristic (ROC) analyses applied to evaluate clinical significance and discriminative performance.
RESULTS: COVID-19 patients exhibited persistent declines in cognitive and sleep functions, as measured by the Logical Memory Test-B (V5: P < 0.001) and the Pittsburgh Sleep Quality (V1: P < 0.001, V5: P = 0.004). The ALPS index remained reduced (V1L:P = 0.026; V2L:P = 0.011; V5R: P = 0.025), while WM-FW fluctuated nonlinearly (V1:P = 0.028; V5:P = 0.045) and CPV was stable (L: χ2 = 0.36, P = 0.83; R: χ2 = 0.27, P = 0.87). gBOLD-CSF showed significant recovery (χ2 = 24.95, P < 0.001), exceeding the MCID and correlating with word fluency (β = -0.754, P < 0.001) and sleep quality; ROC analysis confirmed high discriminative power (AUC = 0.853).
CONCLUSION: Structural GS impairment may persist up to 5 years, while gBOLD-CSF shows reversible, clinically meaningful recovery. Integrating four imaging markers, this study outlines a "persistent damage-partial recovery-nonlinear fluctuation" trajectory, offering mechanistic insights into SARS-CoV-2 infection and a potential biomarker for long-term monitoring.
METHODS: A prospective follow-up study was conducted on 17 COVID-19 patients at 1(V1), 2 (V2), and 5 years (V5) post-discharge. Multimodal MRI was used to assess the Analysis Along the Perivascular Space (ALPS) index, White Matter Free Water (WM-FW), Choroid Plexus Volume (CPV), and Global Blood-Oxygen-Level-Dependent-Cerebrospinal Fluid (gBOLD-CSF) Coupling, alongside comprehensive neuropsychological tests. Data were analyzed using Linear Mixed-Effects Models (LME), correlation, and regression analyses (P < 0.05), with Minimal Clinically Important Difference (MCID) and Receiver Operating Characteristic (ROC) analyses applied to evaluate clinical significance and discriminative performance.
RESULTS: COVID-19 patients exhibited persistent declines in cognitive and sleep functions, as measured by the Logical Memory Test-B (V5: P < 0.001) and the Pittsburgh Sleep Quality (V1: P < 0.001, V5: P = 0.004). The ALPS index remained reduced (V1L:P = 0.026; V2L:P = 0.011; V5R: P = 0.025), while WM-FW fluctuated nonlinearly (V1:P = 0.028; V5:P = 0.045) and CPV was stable (L: χ2 = 0.36, P = 0.83; R: χ2 = 0.27, P = 0.87). gBOLD-CSF showed significant recovery (χ2 = 24.95, P < 0.001), exceeding the MCID and correlating with word fluency (β = -0.754, P < 0.001) and sleep quality; ROC analysis confirmed high discriminative power (AUC = 0.853).
CONCLUSION: Structural GS impairment may persist up to 5 years, while gBOLD-CSF shows reversible, clinically meaningful recovery. Integrating four imaging markers, this study outlines a "persistent damage-partial recovery-nonlinear fluctuation" trajectory, offering mechanistic insights into SARS-CoV-2 infection and a potential biomarker for long-term monitoring.