GRAY MATTER ATROPHY ASSOCIATED WITH ANXIETY AND DEPRESSION AFTER MILD COVID-19 INFECTION

RESUMO

INTRODUÇÃO: Despite emerging reports exploring persistent neuropsychiatric symptoms after acute SARS-CoV-2 infection, there is a lack of evaluation of mildly affected patients and neural correlation for their impairments.

OBJETIVOS: We investigate gray matter changes in mildly infected patients according to the presence of symptoms of anxiety and depression.

MÉTODOS: We analyzed 254 patients (non-hospitalized) with confirmed COVID-19 diagnosis (177 women, median age of 41 years (range 18-78), median interval between diagnosis and visit of 82 days [range 13-367]) and compared to a group of 148 healthy controls (100 woman; median age of 35 years [range 17 – 68]), paired by sex (p=0.7). Individuals answered the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) to quantify symptoms’ severity. Patients were split in asymptomatic-group (152, ASYMPT-group; no symptoms of anxiety or depression) and concurrent-symptomatic (102, CONCUR-group; BAI>10 and BDI>13). All individuals underwent 3T MRI. We used CAT12 TOOLBOX/MATLAB2019/SPM12 to perform voxel-based morphometry and analyze grey matter volume (GMV) changes. We covariated the analyses for sex, age and intracranial volume (ICV) and compared groups with Bonferroni correction to adjust for multiple comparisons.

RESULTADOS: While the CONCUR-group presented higher scores (median BDI=21 and BAI=24 score), the ASYMPTO-group (median BDI=5 and BAI=4) and the controls (median BDI=4, BAI=3) resented lower scores. After adjusting the GMV analyses for sex, age and ICV, only the CONCUR-GROUP presented GM reduction in the left cingulum (86 voxels) and inferior frontal lobe (91 voxels), p<0.005. No GM changes were detected in the ASYMPT-group.

CONCLUSÃO: We observed persistent neuropsychiatric symptoms (consistent with long-COVID), associated with GM atrophy in the CONCUR-group. These findings suggest that structural changes may occur even after mild SARS-CoV-2 infection. Early treatment may prevent persistent suffering and improve quality of life.

PALAVRA-CHAVE: COVID-19, Neuroimaging, Neurology