Decreased Cerebral Blood Flow Due to COVID-19

The effects of SARS-CoV-2 infection on the central nervous system are complex and likely to involve multiple potential pathways. A recent study demonstrating SARS-CoV-2 infection of tissue-cultured pericyte-like cells supported its neurovascular involvement and neuroinflammation. Recently, there was an attempt by the researchers to probe cerebral blood flow (CBF) using arterial spin labeling (ASL) magnetic resonance imaging (MRI) in non-hospitalized adults recovering from COVID-19. The aim of the study was to compare voxel-wise CBF (with and without partial volume correction) between adults who previously self-isolated at home due to COVID-19 and controls who experienced flu-like symptoms but tested negative for COVID-19.

A total of 50 participants (39 COVID-19, 11 controls) participated in the study. They met eligibility criteria and had ASL and T1-weighted images available. It was found that notably, 92.3% of COVID-19 participants and 72.7% of controls had experienced fatigue at some point between the PCR test and the time of the assessment. Significantly more COVID-19 participants had previously experienced or were currently experiencing smell/taste changes compared to controls. Moreover, relative to controls, the COVID-19 group exhibited significantly decreased CBF in a large cluster of voxels encompassing the thalamus, orbitofrontal cortex, and regions of the basal ganglia, including the caudate, nucleus accumbens, putamen, and pallidum. Interestingly, within the COVID-19 group, CBF differences were observed between those with and without on-going fatigue. On-going fatigue was characterized by a cluster of increased CBF in superior occipital and parietal regions (superior lateral occipital cortex, angular gyrus, superior parietal lobule, supramarginal gyrus) and a cluster of decreased CBF in inferior occipital regions (lingual gyrus, occipital fusiform gyrus, intracalcarine cortex, precuneous cortex).

In conclusion, decreased CBF was significantly observed in those recovering from COVID-19 relative to controls. These decreases were present months after acute infection and were localized to regions that have previously been highlighted as related to SARS-CoV-2 infection.

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