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. 2022 Jun:217:107263.
doi: 10.1016/j.clineuro.2022.107263. Epub 2022 Apr 26.

Headache and cognitive disturbance correlate with ganglion cell layer thickness in patients who recovered from COVID-19

Aslihan Taskiran-Sag  1 , Erdal Eroglu  2 , Kemal Ozulken  3 , Sule Canlar  4 , Baris Mustafa Poyraz  5 , Manolya Berguzar Sekerlisoy  6 , Tarkan Mumcuoglu  7
Affiliations

Headache and cognitive disturbance correlate with ganglion cell layer thickness in patients who recovered from COVID-19

Aslihan Taskiran-Sag et al. Clin Neurol Neurosurg. 2022 Jun.

Abstract

Background: Retinal abnormalities are being increasingly reported in COVID-19, in addition to the well-known symptoms of this disease accounting for the neurological involvement. In this study, we aimed to investigate whether ganglion cell layer thickness (GCLT) was different in recovered COVID-19 patients compared to controls in the subacute stage and to determine whether it correlated with COVID-19-related neurological symptoms or pneumonia.

Methods: This study involved 40 patients who had recovered from COVID-19 and 40 age- and sex-matched healthy controls. All the participants underwent ophthalmological examination, spectral domain optical coherence tomography and neurological examination. The clinical and biochemical properties of the patients were noted and their correlations with GCLT were sought.

Results: The duration after COVID-19 infection was 113 ± 62 (mean ± SD) days. At this subacute stage, there was no significant difference between the GCLT measurements of the COVID-19 patients and the controls (14 ± 4.0 µm [median ± IQR] vs 16 ± 4.8 µm, respectively). When we analyzed the relationships with neurological symptoms in the patient group, we found that patients with cognitive symptoms had lower GCLT values compared to those without (13 ± 3 µm vs. 16 ± 4 µm, respectively; p = 0.002). Patients who suffered headache during the acute infection also had lower GCLT values compared to those without (14 ± 4 µm vs. 18 ± 5 µm, respectively; p = 0.015). The GCLT values did not differ significantly with respect to anosmia, ageusia, sleep disturbances, having had COVID-19 pneumonia, or smoking status. Age, duration after COVID-19, and blood levels of thyroid stimulating hormone, glucose, vitamin D and vitamin B12 were not in correlation with GCLT in our study.

Conclusion: Our findings highlight an association between GCLT values and neurological symptoms such as cognitive disturbance (brain fog) and headache in patients who had recovered after non-severe COVID-19 infection. Neuroretinal involvement by SARS-CoV2 might be linked to central neurological symptoms. The patients with lower GCLT values may benefit from close monitoring for neurological problems.

Keywords: Brain fog; COVID-19; Ganglion cell layer; Headache; Optical coherence tomography.

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Figures

Fig. 1
Fig. 1
Ganglion cell layer thickness measurements at macula via OCT did not show a significant difference between cases of COVID-19 and controls.
See this image and copyright information in PMC

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