Abstract Details

Title Decreased ADAMTS13 Activity During COVID-19 is Associated with Lower Cognitive Scores After Recovery

Topic Aging, Dementia, and Behavioral Neurology

Presentation(s) P8 - Poster Session 8 (5:30 PM-6:30 PM)

Poster/Presentation
Number 9-004

Objective To examine whether ADAMTS13 activity levels measured at the time of acute SARS-CoV-2 infection predict cognitive impairment after recovery.

Background The critical role of ADAMTS13 in thrombosis is exemplified by its importance in the pathogenesis of thrombotic thrombocytopenic purpura (TTP). Lower ADAMTS13 activity has been linked to increased risk for incident stroke in populational studies and TTP cohorts. COVID-19 patients have an increased risk of thrombotic events and microthrombosis, and have increased risk for long-term cognitive symptoms. Lower levels of ADAMTS13 have been reported in COVID-19 patients with severe compared to those with mild infection.

Design/Methods After consent, patients hospitalized with SARS-CoV-2 infection were enrolled. ADAMTS13 activity levels were measured upon admission and then twice weekly during hospitalization. Presence of long-COVID symptoms was evaluated with the CDC questionnaire. Cognitive screening was performed via telephone using the MoCA -BLIND, version 8.1. Regression analysis was used to evaluate the effect of clinical variables, demographics, and ADAMTS13 activity on MoCA score.

Results We recruited 39 patients with COVID-19, mean age 68 years (range 37-88). Among the 32 (of 39) surviving patients screened for long-COVID symptoms at approximately 16 months after infection, 20 (62.5%) reported ≥1 symptoms, with neurological symptoms present in 18 (56%). Among the 30 patients who completed MoCA testing, mean MoCA score was 16.8; 14 (47%) screened positive for cognitive impairment. Initial ADAMTS13 levels were 68% (range 12-94%), with a significant decrease during admission (p=0.032). ADAMTS13 levels measured at enrollment during COVID-19 hospitalization directly correlated with MoCA scores after adjusting for age and disease severity (adjusted R2=0.28, p=0.019). A 10% decrease in ADAMTS13 activity corresponded to a 1-point decrease in MoCA score (p=0.007).

Conclusions Lower ADAMTS13 activity is associated with decreased cognitive performance after recovery from SARS-CoV-2 infection. Future work is needed to investigate the link between ADAMTS13 activity and post-COVID cognitive decline.

Authors/Disclosures
Philion Gatchoff, MD (OU Health) PRESENTER	Dr. Gatchoff has nothing to disclose.
Claire E. Delpirou Nouh, MD (University of Oklahoma Health Science Center, Department of Neurology)	The institution of Dr. Delpirou Nouh has received research support from Oklahomas Nathan Shock Center. Dr. Delpirou Nouh has a non-compensated relationship as a Volunteer/Board member with Oklahoma Alzheimer Association that is relevant to AAN interests or activities.
Chao Xu	Chao Xu has nothing to disclose.
Andrea Vincent	Andrea Vincent has received personal compensation for serving as an employee of Vista LifeSciences. The institution of Andrea Vincent has received research support from Medical Technology Enterprise Consortium (MTEC).
Leslie Guthery	Leslie Guthery has nothing to disclose.
Jason Sharps	Jason Sharps has nothing to disclose.
Jim Scott (Ouhsc)	No disclosure on file
James George (Home)	James George has nothing to disclose.
Angelia Kirkpatrick	Angelia Kirkpatrick has nothing to disclose.
Calin I. Prodan, MD (Univ of Oklahoma - Neurology Dept)	The institution of Dr. Prodan has received research support from US Department of Veterans Affairs (Merit award CX000340).

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