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Abstract Details

White Matter Hyperintensities in Brains of Patients with Long-covid
General Neurology
P5 - Poster Session 5 (11:45 AM-12:45 PM)
7-009
To investigate brain white matter hyperintensities (WMH) as a potential indicator of microvascular disease associated with long-COVID.

Approximately 10% of patients with acute SARS-CoV-2 infection present with persistent symptoms recognized as long-COVID. Neurological and cognitive symptoms are prevalent in patients with long-COVID (PwLC), requiring a deeper understanding of the biological basis for potential therapeutic interventions. Cerebrovascular complications are observed during acute infection, underscoring the importance of understanding cerebrovascular outcomes. 
Hospitalized PwLC (n= 24), non-hospitalized PwLC (n = 76 during the acute infection) and controls (n = 75) who did not have a reported symptomatic Covid infection were recruited from the community at five US sites. PwLC were included if they developed neurological or cognitive sequelae within 6 months of confirmed infection and had at least one ongoing neurological symptom. Clinical evaluation and MRI were performed an average of 20±10 months after the acute infection. WMH volumes were measured from 3D T2-weighted FLAIR MRIs using a semi-automated approach for WMH segmentation. A linear regression model predicting log transformed WMH volume was used to investigate the association of age, groups, and the interaction of these two predictors along with an adjustment for total intracranial volume and site.
Compared to controls, hospitalized PwLC, had a higher WMH volume relative to total intracranial volume associated with older age (intercept estimate = -1.906, p = 0.006). There were no group level difference between non-hospitalized PwLC and controls.  

Our observation suggests that hospitalization during acute COVID in older adults is associated with an increased risk in microvascular injury in the white matter and are more susceptible to cerebrovascular adverse outcomes than controls or those who do not require hospitalization. Impact of such microvascular changes on cognitive outcomes and persistence of long-COVID symptoms is yet to be studied.

Authors/Disclosures
Merve Atik, MD (Mayo Clinic)
PRESENTER 		Dr. Atik has nothing to disclose.
Scott Przybelski Scott Przybelski has nothing to disclose.
Burcu Zeydan, MD (Mayo Clinic) The institution of Dr. Zeydan has received research support from National Institutes of Health.
Orhun H. Kantarci, MD Dr. Kantarci has nothing to disclose.
June Kendall-Thomas, Clinical Research Coordinator Mrs. Kendall-Thomas has nothing to disclose.
Matthew Senjem (Mayo Clinic) Matthew Senjem has received stock or an ownership interest from Align Technology, Inc.. Matthew Senjem has received stock or an ownership interest from Inovio Biomedical Corp.. Matthew Senjem has received stock or an ownership interest from Johnson & Johnson. Matthew Senjem has received stock or an ownership interest from Mesa Laboratories, Inc.. Matthew Senjem has received stock or an ownership interest from Nvidia Inc.. Matthew Senjem has received stock or an ownership interest from LHC Group, Inc.. Matthew Senjem has received stock or an ownership interest from Natus Medical Incorporated. Matthew Senjem has received stock or an ownership interest from Varex Imaging Corporation. Matthew Senjem has received personal compensation in the range of $100,000-$499,999 for serving as a IT Technical Specialist II with Mayo Clinic.
Ana I. Silva, PhD Dr. Silva has nothing to disclose.
James M. Joers, PhD An immediate family member of Dr. Joers has received personal compensation in the range of $500,000-$999,999 for serving as an officer or member of the Board of Directors for Gillette Children's Specialty Healthcare.
Katherine M. Gundry Mrs. Gundry has nothing to disclose.
Alfredo Lorente Rev. Lorente has nothing to disclose.
Jeromy Thotland Mr. Thotland has nothing to disclose.
Dinesh K. Deelchand, PhD Dr. Deelchand has nothing to disclose.
Young Woo Park, PhD Dr. Park has received intellectual property interests from a discovery or technology relating to health care.
Yuebing Li, MD, PhD, FAAN (Cleveland Clinic) Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Argenx. Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amgen. Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Vertex. The institution of Dr. Li has received research support from Argenx.
Georgios Manousakis, MD, FAAN (University of Minnesota) Dr. Manousakis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Stealth Biotherapeutics. Dr. Manousakis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Argenx. Dr. Manousakis has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. The institution of Dr. Manousakis has received research support from Marzolf foundation.
Abby I. Metzler, MD (University of Minnesota) Dr. Metzler has nothing to disclose.
Christophe Lenglet, PhD Prof. Lenglet has stock in Roche Holding AG. Prof. Lenglet has stock in GSK plc. The institution of Prof. Lenglet has received research support from NIH. The institution of Prof. Lenglet has received research support from NSF. The institution of Prof. Lenglet has received research support from Friedreich Ataxia Research Alliance. The institution of Prof. Lenglet has received research support from National Ataxia Foundation. The institution of Prof. Lenglet has received research support from Minnesota Office of Higher 好色先生. The institution of Prof. Lenglet has received research support from FDA. The institution of Prof. Lenglet has received research support from USU/DOD/Geneva Foundation. Prof. Lenglet has received intellectual property interests from a discovery or technology relating to health care.
Lynn Eberly, PhD Dr. Eberly has nothing to disclose.
Meher Juttukonda, PhD Dr. Juttukonda has nothing to disclose.
David H. Salat David H. Salat has or had stock in Niji.David H. Salat has or had stock in Smart Ion. The institution of David H. Salat has received research support from Renew.
Janet C. Sherman, PhD An immediate family member of Dr. Sherman has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Pieris Pharmaceuticals. Dr. Sherman has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Keches Law. An immediate family member of Dr. Sherman has stock in Deciphera Pharmaceuticals.
Lauren E. Pollak, PhD Dr. Pollak has nothing to disclose.
George K. Harrold, MD (Brigham and Women's Hospital) Dr. Harrold has nothing to disclose.
Shibani S. Mukerji, MD, PhD (Massachusetts General Hospital) Dr. Mukerji has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Dynamed. Dr. Mukerji has or had stock in Gilead Science.Dr. Mukerji has or had stock in Ranpack.Dr. Mukerji has or had stock in Snowflake. An immediate family member of Dr. Mukerji has or had stock in Amgen. The institution of Dr. Mukerji has received research support from NIH. The institution of Dr. Mukerji has received research support from Massachusetts General Hospital.
Sevil Yasar, MD, PhD (Comprehensive Care Practice) Sevil Yasar, MD, PhD has nothing to disclose.
Mehreen Nabi, MBBS Ms. Nabi has nothing to disclose.
Sana Rehman, MBBS Dr. Rehman has nothing to disclose.
Christof Karmonik, PhD (The Methodist Hospital Neurological Institute) No disclosure on file
Syed Gillani, MD (Houston Methodist Hospital) Dr. Gillani has nothing to disclose.
Valerie V. Flores, MS Ms. Flores has nothing to disclose.
Rachel G Davis (Houston Methodist Hospital) No disclosure on file
Tetsuo Ashizawa, MD, FAAN (Methodist Hospital Research Institute) An immediate family member of Dr. Ashizawa has received personal compensation for serving as an employee of Biopath Holdings. The institution of Dr. Ashizawa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UniQure. The institution of Dr. Ashizawa has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cadence. Dr. Ashizawa has received personal compensation in the range of $0-$499 for serving as a Consultant for Astellas. The institution of Dr. Ashizawa has received research support from NIH. The institution of Dr. Ashizawa has received research support from National Ataxia Foundation. The institution of Dr. Ashizawa has received research support from Myotonic Dystrophy Foundation. The institution of Dr. Ashizawa has received research support from Biogen.
Peter B. Barker, MD (Johns Hopkins University S/M) No disclosure on file
Eva-Maria Ratai, PhD Dr. Ratai has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Aletheia. Dr. Ratai has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for BrainSpec.
Gulin Oz, PhD Dr. Oz has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Servier. The institution of Dr. Oz has received research support from Biogen. Dr. Oz has received intellectual property interests from a discovery or technology relating to health care. Dr. Oz has a non-compensated relationship as a Medical Research Advisory Board with National Ataxia Foundation that is relevant to AAN interests or activities. Dr. Oz has a non-compensated relationship as a Scientific Advisory Board with BrainSpec that is relevant to AAN interests or activities.
Kejal Kantarci, MD (Mayo Clinic) The institution of Dr. Kantarci has received research support from Eli Lilly. The institution of Dr. Kantarci has received research support from NIH. The institution of Dr. Kantarci has received research support from ADDF. The institution of Dr. Kantarci has received research support from Eisai. The institution of Dr. Kantarci has received research support from BioArctic.