Quantitative susceptibility mapping at 7 T in COVID-19: brainstem effects and outcome associations Article Swipe
Catarina Rua
,
Betty Raman
,
Christopher T. Rodgers
,
Virginia Newcombe
,
Anne E. Manktelow
,
Doris A. Chatfield
,
Stephen Sawcer
,
Joanne Outtrim
,
Victoria Lupson
,
Emmanuel A. Stamatakis
,
Guy Williams
,
William T. Clarke
,
Lin Qiu
,
Martyn Ezra
,
Rory McDonald
,
Stuart Clare
,
Mark Philip Cassar
,
Stefan Neubauer
,
Karen D. Ersche
,
Edward T. Bullmore
,
David Menon
,
Kyle T.S. Pattinson
,
James B. Rowe
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/brain/awae215
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1093/brain/awae215
Post-mortem studies have shown that patients dying from severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection frequently have pathological changes in their CNS, particularly in the brainstem. Many of these changes are proposed to result from para-infectious and/or post-infection immune responses. Clinical symptoms such as fatigue, breathlessness, and chest pain are frequently reported in post-hospitalized coronavirus disease 2019 (COVID-19) patients. We propose that these symptoms are in part due to damage to key neuromodulatory brainstem nuclei. While brainstem involvement has been demonstrated in the acute phase of the illness, the evidence of long-term brainstem change on MRI is inconclusive. We therefore used ultra-high field (7 T) quantitative susceptibility mapping (QSM) to test the hypothesis that brainstem abnormalities persist in post-COVID patients and that these are associated with persistence of key symptoms. We used 7 T QSM data from 30 patients, scanned 93–548 days after hospital admission for COVID-19 and compared them to 51 age-matched controls without prior history of COVID-19 infection. We correlated the patients’ QSM signals with disease severity (duration of hospital admission and COVID-19 severity scale), inflammatory response during the acute illness (C-reactive protein, D-dimer and platelet levels), functional recovery (modified Rankin scale), depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7). In COVID-19 survivors, the MR susceptibility increased in the medulla, pons and midbrain regions of the brainstem. Specifically, there was increased susceptibility in the inferior medullary reticular formation and the raphe pallidus and obscurus. In these regions, patients with higher tissue susceptibility had worse acute disease severity, higher acute inflammatory markers, and significantly worse functional recovery. This study contributes to understanding the long-term effects of COVID-19 and recovery. Using non-invasive ultra-high field 7 T MRI, we show evidence of brainstem pathophysiological changes associated with inflammatory processes in post-hospitalized COVID-19 survivors.
Related Topics
Concepts
Brainstem
Coronavirus disease 2019 (COVID-19)
2019-20 coronavirus outbreak
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Medicine
Outcome (game theory)
Neuroscience
Psychology
Internal medicine
Pathology
Disease
Outbreak
Infectious disease (medical specialty)
Mathematical economics
Mathematics
Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/brain/awae215
- https://academic.oup.com/brain/advance-article-pdf/doi/10.1093/brain/awae215/59603078/awae215.pdf
- OA Status
- hybrid
- Cited By
- 25
- References
- 56
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4403239792
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4403239792Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1093/brain/awae215Digital Object Identifier
- Title
-
Quantitative susceptibility mapping at 7 T in COVID-19: brainstem effects and outcome associationsWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-10-07Full publication date if available
- Authors
-
Catarina Rua, Betty Raman, Christopher T. Rodgers, Virginia Newcombe, Anne E. Manktelow, Doris A. Chatfield, Stephen Sawcer, Joanne Outtrim, Victoria Lupson, Emmanuel A. Stamatakis, Guy Williams, William T. Clarke, Lin Qiu, Martyn Ezra, Rory McDonald, Stuart Clare, Mark Philip Cassar, Stefan Neubauer, Karen D. Ersche, Edward T. Bullmore, David Menon, Kyle T.S. Pattinson, James B. RoweList of authors in order
- Landing page
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https://doi.org/10.1093/brain/awae215Publisher landing page
- PDF URL
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https://academic.oup.com/brain/advance-article-pdf/doi/10.1093/brain/awae215/59603078/awae215.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
hybridOpen access status per OpenAlex
- OA URL
-
https://academic.oup.com/brain/advance-article-pdf/doi/10.1093/brain/awae215/59603078/awae215.pdfDirect OA link when available
- Concepts
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Brainstem, Coronavirus disease 2019 (COVID-19), 2019-20 coronavirus outbreak, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Medicine, Outcome (game theory), Neuroscience, Psychology, Internal medicine, Pathology, Disease, Outbreak, Infectious disease (medical specialty), Mathematical economics, MathematicsTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
25Total citation count in OpenAlex
- Citations by year (recent)
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2025: 22, 2024: 3Per-year citation counts (last 5 years)
- References (count)
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56Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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