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Details of Brain Damage in COVID-19 Patients

Article

Originally published in Mass General

In This Article

  • While it is primarily a respiratory disease, COVID-19 infection affects other organs in the body, including the brain
  • To better understand the neurological effects of COVID-19, researchers at Massachusetts General Hospital used a specialized magnetic resonance technique to identify metabolic disturbances in the brain

Researchers at Massachusetts General Hospital have conducted one of the first spectroscopic imaging-based studies of neurological injury in COVID-19 patients. Among six infected patients who had neurological symptoms, they observed some of the same metabolic disturbances in the brain as other patients who suffered oxygen deprivation (hypoxia) from other causes. The results are reported in the American Journal of Neuroradiology.

Senior author Eva-Maria Ratai, PhD, an investigator in the Martinos Center for Biomedical Imaging at Mass General, said that their objective was to identify the biological underpinnings of symptoms related to COVID-19 infection, including temporary loss of smell, dizziness, confusion, seizures and stroke.

The study used 3 Tesla Magnetic Resonance Spectroscopy (MRS), a specialized type of scanning that can identify neurochemical abnormalities even when structural imaging findings are normal. Study participants' brains showed N-acetyl-aspartate (NAA) reduction, choline elevation and myo-inositol elevation, similar to what is seen with these metabolites in other patients with white matter abnormalities (leukoencephalopathy) after hypoxia without COVID-19.

One of the patients with COVID-19 who showed the most severe white matter damage (necrosis and cavitation) had particularly pronounced lactate elevation on MRS, which is another sign of brain damage from oxygen deprivation.

Akila Weerasekera, PhD, a postdoctoral research fellow and co-first author of the study with Mass General neuroradiologist Otto Rapalino, MD, said that MRS could be used as a disease and therapy monitoring tool, as it can better characterize pathological processes when compared to conventional structural MR imaging.

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