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NeuroImmune Pharm Ther . Blood-brain barrier breakdown in COVID-19 ICU survivors: an MRI pilot study

tetano

Editor, Senior Moderator
NeuroImmune Pharm Ther


. 2023 Nov 22;2(4):333-338.
doi: 10.1515/nipt-2023-0018. eCollection 2023 Dec. Blood-brain barrier breakdown in COVID-19 ICU survivors: an MRI pilot study

Wen Shi[SUP] 1 2 [/SUP], Dengrong Jiang[SUP] 2 [/SUP], Hannah Rando[SUP] 3 [/SUP], Shivalika Khanduja[SUP] 3 [/SUP], Zixuan Lin[SUP] 2 [/SUP], Kaisha Hazel[SUP] 2 [/SUP], George Pottanat[SUP] 2 [/SUP], Ebony Jones[SUP] 2 [/SUP], Cuimei Xu[SUP] 2 [/SUP], Doris Lin[SUP] 2 [/SUP], Sevil Yasar[SUP] 4 [/SUP], Sung-Min Cho[SUP] 5 [/SUP], Hanzhang Lu[SUP] 1 2 6 [/SUP]



Affiliations
Abstract

Objectives: Coronavirus disease 2019 (COVID-19) results in severe inflammation at the acute stage. Chronic neuroinflammation and abnormal immunological response have been suggested to be the contributors to neuro-long-COVID, but direct evidence has been scarce. This study aims to determine the integrity of the blood-brain barrier (BBB) in COVID-19 intensive care unit (ICU) survivors using a novel MRI technique.
Methods: COVID-19 ICU survivors (n=7) and age and sex-matched control participants (n=17) were recruited from June 2021 to March 2023. None of the control participants were hospitalized due to COVID-19 infection. The COVID-19 ICU survivors were studied at 98.6 ± 14.9 days after their discharge from ICU. A non-invasive MRI technique was used to assess the BBB permeability to water molecules, in terms of permeability surface area-product (PS) in the units of mL/100 g/min.
Results: PS was significantly higher in COVID-19 ICU survivors (p=0.038) when compared to the controls, with values of 153.1 ± 20.9 mL/100 g/min and 132.5 ± 20.7 mL/100 g/min, respectively. In contrast, there were no significant differences in whole-brain cerebral blood flow (p=0.649) or brain volume (p=0.471) between the groups.
Conclusions: There is preliminary evidence of a chronic BBB breakdown in COVID-19 survivors who had a severe acute infection, suggesting a plausible contributor to neurological long-COVID symptoms.

Keywords: COVID-19; MRI; WEPCAST; blood-brain barrier; permeability.

 
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