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Brain structure and function in people recovering from COVID-19 after hospital discharge or self-isolation: a
Bradley J MacIntosh1, Xiang Ji2, J Jean Chen2
1Hurvitz Brain Sciences Program (MacIntosh, Gao, Masellis, Goubran, Lam, Heyn, Black, Graham), Physical Sciences Platform (MacIntosh, Jegatheesan, Goubran, Graham), Evaluative Clinical Sciences, Integrated Community Program (Cheng), Harquail Centre for Neuromodulation (Rabin) and Evaluative Clinical Sciences, Trauma, Emergency & Critical Care Research Program (Fowler), Sunnybrook Research Institute; Department of Medical Biophysics (MacIntosh, Chen, Chad, Jegatheesan, Goubran, Graham), University of Toronto; LC Campbell Cognitive Neurology Research Group (Ji, Gao, Masellis, Lam, Black), Sunnybrook Hospital; Rotman Research Institute (Chen, Gilboa, Roudaia, Sekuler, Chad), Baycrest Health Sciences; Division of Neurology (Masellis, Rabin, Lam, Black), Department of Medicine, University of Toronto; Rehabilitation Sciences Institute (Rabin), Department of Medical Imaging (Heyn) and Department of Psychology (Gilboa, Sekuler), University of Toronto; Department of Medicine (Cheng, Fowler), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Psychology, Neuroscience & Behaviour (Sekuler), McMaster University, Hamilton, Ont. brad.macintosh@utoronto.ca.
Background:
The detailed extent of neuroinvasion or deleterious brain changes resulting from COVID-19 and their time courses remain to be determined in relation to "long-haul" COVID-19 symptoms. Our objective is to determine whether there are alterations in functional brain imaging measures among people with COVID-19 after hospital discharge or self-isolation.
Methods:
This paper describes a protocol for NeuroCOVID-19, a longitudinal observational study of adults aged 20-75 years at Sunnybrook Health Sciences Centre in Toronto, Ontario, that began in April 2020. We aim to recruit 240 adults, 60 per group: people who contracted COVID-19 and were admitted to hospital (group 1), people who contracted COVID-19 and self-isolated (group 2), people who experienced influenza-like symptoms at acute presentation but tested negative for COVID-19 and self-isolated (group 3, control) and healthy people (group 4, control). Participants are excluded based on premorbid neurologic or severe psychiatric illness, unstable cardiovascular disease, and magnetic resonance imaging (MRI) contraindications. Initial and 3-month follow-up assessments include multiparametric brain MRI and electroencephalography. Sensation and cognition are assessed alongside neuropsychiatric assessments and symptom self-reports. We will test the data from the initial and follow-up assessments for group differences based on 3 outcome measures: MRI cerebral blood flow, MRI resting state fractional amplitude of low-frequency fluctuation and electroencephalography spectral power.
Interpretation:
If neurophysiologic alterations are detected in the COVID-19 groups in our NeuroCOVID-19 study, this information could inform future research regarding interventions for long-haul COVID-19. The study results will be disseminated to scientists, clinicians and COVID-19 survivors, as well as the public and private sectors to provide context on how brain measures relate to lingering symptoms.
