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Resting-State Functional Connectivity Alterations in Pediatric Survivors of Severe COVID-19: An Exploratory
Yunuen Rojas-Lemus1, Silvia Hidalgo-Tobón1,2, Daniel Eduardo Alvarez-Amado2
1Universidad Autonoma Metropolitana-Iztapalapa, Mexico City, Mexico.
Insights
Children hospitalized with severe COVID-19 showed altered brain connectivity and cognitive deficits. These findings suggest potential long-term neurocognitive vulnerability in pediatric survivors of critical illness.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Infectious Diseases
Background:
- Pediatric neurocognitive sequelae following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not well understood.
- Understanding long-term effects of severe COVID-19 in children is crucial for effective management and rehabilitation.
Purpose of the Study:
- To investigate resting-state functional connectivity (rs-fC) in pediatric survivors of severe COVID-19.
- To explore cognitive vulnerability in these survivors compared to healthy controls.
Main Methods:
- An observational case-control study was performed.
- 14 children hospitalized for severe COVID-19 and 31 healthy pre-pandemic controls underwent resting-state functional magnetic resonance imaging (rs-fMRI).
- Region-of-interest (ROI)-to-ROI connectivity was analyzed using a standardized pipeline with cluster-level FDR correction.
Main Results:
- Post-COVID participants exhibited altered connectivity, including increased Default Mode-visual medial coupling.
- Stronger dorsal attention-sensorimotor anticorrelations and enhanced temporo-occipital-vermis connectivity were observed.
- Exploratory testing revealed cognitive deficits in timeliness and impulsivity in a subset of post-COVID children.
Conclusions:
- Preliminary findings indicate subtle post-infectious cognitive vulnerability in pediatric COVID-19 survivors.
- These subtle neurobiological and cognitive changes warrant further investigation.
- Larger, longitudinal studies are needed to confirm these preliminary findings and track long-term outcomes.
Objectives:
To assess resting-state functional connectivity and exploratory cognitive vulnerability in pediatric survivors of severe COVID-19 compared with healthy pre-pandemic controls.
Introduction:
Pediatric neurocognitive sequelae after SARS-CoV-2 infection remain poorly characterized.
Methods:
We conducted an observational case-control study including 14 children hospitalized for severe COVID-19 and 31 healthy pre-pandemic controls scanned on the same 3T MRI system using identical rs-fMRI protocols and a standardized CONN/SPM pipeline. ROI-to-ROI connectivity was analyzed with cluster-level FDR correction (P < .05).
Results:
Post-COVID participants showed 3 altered connectivity clusters: increased Default Mode-visual medial coupling, stronger dorsal attention-sensorimotor anticorrelations, and enhanced temporo-occipital-vermis connectivity. In an exploratory subset (8 post-COVID, 12 controls), 50% of post-COVID children had abnormally low Timeliness and 25% low Impulsivity MOXO-d-CPT z-scores, whereas no controls were abnormal.
Conclusion:
These preliminary findings suggest subtle post-infectious cognitive vulnerability and warrant confirmation in larger longitudinal cohorts.
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