A study abstract presented at the American Academy of Neurology (AAN) reported that People with lasting cognitive impairments following mild COVID showed higher levels of immunological activation and immunovascular markers in their CSF 10 months after acute SARS-CoV-2 infection.

The study involved 13 patients with cognitive disorders and five controls with no cognitive symptoms following COVID. The average age of the participants was 40 years old, and the CSF fluid was collected a median of 10 months after the initial COVID symptoms.

Long COVID patients with cognitive symptoms had greater median CSF levels of C-reactive protein (P=0.004) and serum amyloid A (P=0.001) than COVID patients who had no cognitive abnormalities following infection. Interferon-gamma-inducible protein (IP-10, P=0.059), interleukin (IL)-8 (P=0.059), and immunovascular indicators vascular endothelial growth factor-C (VEGF-C, P=0.095) and VEGFR-1 (the soluble receptor for VEGFs, P=0.059) were all elevated in the CSF following infection.

Results suggest that disruption of small blood arteries in the brain causes a large amount of protein to enter the brain, producing inflammation. The inflammation in the brain could be a key player in the cognitive alterations that occur following COVID. SARS-CoV-2 may also cause immunovascular dysregulation by causing endothelial dysfunction and activation. Some CSF indicators were found to have a high level of specificity for COVID individuals with early-onset cognitive changes.

These findings are paving the way for a better understanding of COVID′s post-acute sequelae and assisting health care providers in meeting patients post-Covid needs. (MedPage Today April 4, 2022)