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SARS-CoV-2’s brain impact: revealing cortical and cerebellar differences via cluster analysis in COVID-19 recovered patients

  • COVID-19
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Abstract

Background

COVID-19 is a disease known for its neurological involvement. SARS-CoV-2 infection triggers neuroinflammation, which could significantly contribute to the development of long-term neurological symptoms and structural alterations in the gray matter. However, the existence of a consistent pattern of cerebral atrophy remains uncertain.

Objective

Our study aimed to identify patterns of brain involvement in recovered COVID-19 patients and explore potential relationships with clinical variables during hospitalization.

Methodology

In this study, we included 39 recovered patients and 39 controls from a pre-pandemic database to ensure their non-exposure to the virus. We obtained clinical data of the patients during hospitalization, and 3 months later; in addition we obtained T1-weighted magnetic resonance images and performed standard screening cognitive tests.

Results

We identified two groups of recovered patients based on a cluster analysis of the significant cortical thickness differences between patients and controls. Group 1 displayed significant cortical thickness differences in specific cerebral regions, while Group 2 exhibited significant differences in the cerebellum, though neither group showed cognitive deterioration at the group level. Notably, Group 1 showed a tendency of higher D-dimer values during hospitalization compared to Group 2, prior to p-value correction.

Conclusion

This data-driven division into two groups based on the brain structural differences, and the possible link to D-dimer values may provide insights into the underlying mechanisms of SARS-COV-2 neurological disruption and its impact on the brain during and after recovery from the disease.

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Data availability

All the data supporting our findings are contained within the manuscript. De-identified data to replicate our results will be available to qualified researchers upon written request to the corresponding author.

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Funding

This work received funding from CONAHCYT–Mexico grant no. A1-S-10669 and PAPIIT-UNAM grant no. IN214122 given to Juan Fernandez-Ruiz and CONAHCYT–Mexico Ph.D. fellowship no. 789431 given to Angel Omar Romero Molina (CVU: 782944).

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Authors and Affiliations

  1. Instituto de Neuroetologia, Universidad Veracruzana, Xalapa, Veracruz, Mexico

    Angel Omar Romero-Molina, Carlos Roberto Hernandez-Castillo & Juan Fernandez-Ruiz

  2. Laboratorio de Neuropsicologia, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico

    Angel Omar Romero-Molina, Gabriel Ramirez-Garcia, Amanda Chirino-Perez, David Alejandro Fuentes-Zavaleta & Juan Fernandez-Ruiz

  3. Instituto Nacional de Neurologia y Neurocirugia-INNN, Mexico City, Mexico

    Oscar Marrufo-Melendez, Yaneth Rodriguez-Agudelo, Francisco Paz-Rodriguez, Mireya Chavez-Oliveros, Susana Lozano-Tovar, Alonso Gutierrez-Romero, Antonio Arauz-Gongora & Raul Anwar Garcia-Santos

  4. Instituto Nacional de Enfermedades Respiratorias-INER, Mexico City, Mexico

    Diana Lopez-Gonzalez, Mónica Rodriguez-Rodriguez & Armando Castorena-Maldonado

Authors
  1. Angel Omar Romero-Molina
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  2. Gabriel Ramirez-Garcia
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  3. Amanda Chirino-Perez
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  8. Mónica Rodriguez-Rodriguez
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  10. Yaneth Rodriguez-Agudelo
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  11. Francisco Paz-Rodriguez
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  12. Mireya Chavez-Oliveros
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  14. Alonso Gutierrez-Romero
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  15. Antonio Arauz-Gongora
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  16. Raul Anwar Garcia-Santos
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  17. Juan Fernandez-Ruiz
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Contributions

All the authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by all the authors. The first draft of the manuscript was written by Angel Omar Romero-Molina, and all the authors commented on the previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding authors

Correspondence to Raul Anwar Garcia-Santos or Juan Fernandez-Ruiz.

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This project was approved by the research and ethical committee of the Instituto Nacional de Enfermedades Respiratorias under approval number C48-20 and the Instituto Nacional de Neurologia y Neurocirugia under approval number 06–21. Signed informed consent was obtained from all participants and the procedures about human research were according to the Helsinki declaration.

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Romero-Molina, A.O., Ramirez-Garcia, G., Chirino-Perez, A. et al. SARS-CoV-2’s brain impact: revealing cortical and cerebellar differences via cluster analysis in COVID-19 recovered patients. Neurol Sci 45, 837–848 (2024). https://doi.org/10.1007/s10072-023-07266-x

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