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. 2022 Feb;9(2):221-226.
doi: 10.1002/acn3.51498. Epub 2022 Jan 19.

Risk factors and abnormal cerebrospinal fluid associate with cognitive symptoms after mild COVID-19

Alexandra C Apple  1   2 , Alexis Oddi  1   2 , Michael J Peluso  3 , Breton M Asken  1   2 , Timothy J Henrich  4 , J Daniel Kelly  5   6 , Samuel J Pleasure  2   7 , Steven G Deeks  3 , Isabel Elaine Allen  5 , Jeffrey N Martin  5 , Lishomwa C Ndhlovu  8 , Bruce L Miller  1   2 , Melanie L Stephens  1   2 , Joanna Hellmuth  1   2
Affiliations

Risk factors and abnormal cerebrospinal fluid associate with cognitive symptoms after mild COVID-19

Alexandra C Apple et al. Ann Clin Transl Neurol. 2022 Feb.

Abstract

Cognitive post-acute sequelae of SARS-CoV-2 (PASC) can occur after mild COVID-19. Detailed clinical characterizations may inform pathogenesis. We evaluated 22 adults reporting cognitive PASC and 10 not reporting cognitive symptoms after mild SARS-CoV-2 infection through structured interviews, neuropsychological testing, and optional cerebrospinal fluid (CSF) evaluations (53%). Delayed onset of cognitive PASC occurred in 43% and associated with younger age. Cognitive PASC participants had a higher number of pre-existing cognitive risk factors (2.5 vs. 0; p = 0.03) and higher proportion with abnormal CSF findings (77% vs. 0%; p = 0.01) versus controls. Cognitive risk factors and immunologic mechanisms may contribute to cognitive PASC pathogenesis.

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Conflict of interest statement

Dr. Apple, Ms. Oddi, and Dr. Peluso have no disclosures. Dr. Asken received speaker honorarium from the American College of Sports Medicine outside of the submitted work. Dr. Henrich is the received research funds from the National Institutes of Health and holds grants/contracts with Merck and Co. and Gilead Biosciences outside of the submitted work. Dr. Kelly hs no disclosures. Dr. Pleasure received the National Institutes of Health/NINDS grant R01NS118995‐14S supporting this work. Dr. Deeks, Dr. Allen, and Dr. Martin have no disclosures. Dr. Ndhlovu received consulting fees from work as a scientific advisor for Abbvie, ViiV, and Cytodyn outside of the submitted work. Dr. Miller is the recipient of grants/contracts P30AG062422, P01AG019724, R01AG057234 from the National Institute of Health/NIA outside of the submitted work; has received royalties/licenses from Cambridge University Press, Guilford Publications, Inc., Johns Hopkins Press, Oxford University Press, Taylor & Francis Group, Elsevier, Inc. and Up‐to‐Date outside of the submitted work; has participated on advisory boards for The John Douglas French Foundation (Medical Advisor), The Larry L. Hillblom Foundation (scientific advisor), Association for Frontotemporal Degeneration (scientific advisor), National Institute for Health Research Cambridge Biomedical Research Centre and its subunit, the Biomedical Research Unit in Dementia (scientific advisor), University of Washington ADRC (external advisor), Stanford University ADRC (external advisor), Arizona Alzheimer's Disease Center (external advisor), Massachusetts Alzheimer Disease Research Center (external advisor), The Buck Institute for Research on Aging (scientific advisor), University of Southern California P01 Urban Air Pollution and Alzheimer's Disease: Risk, Heterogeneity and Mechanisms (external advisory committee) outside of the submitted work. Dr. Hellmuth received grant support from the National Institutes of Health/NIMH K23MH114724 supporting this work and personal fees for medical‐legal consultation outside of the submitted work.

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