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The Karolinska NeuroCOVID study protocol: Neurocognitive impairment, biomarkers and advanced imaging in critical care survivors
Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden.; Karolinska Univ Hosp, Funct Perioperat Med & Intens Care PMI, Stockholm, Sweden..
Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.;Karolinska Univ Hosp, Dept Neuroradiol, Stockholm, Sweden..
Karolinska Inst, Dept Neurobiol Care Sci & Soc, Clin Geriatr, Stockholm, Sweden.;Karolinska Univ Hosp, Theme Inflammat & Aging, Stockholm, Sweden..
Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden.;Karolinska Univ Hosp, Funct Perioperat Med & Intens Care PMI, Stockholm, Sweden..
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2022 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 66, no 6, p. 759-766Article in journal (Refereed) Published
Abstract [en]

Background: This is the study plan of the Karolinska NeuroCOVID study, a study of neurocognitive impairment after severe COVID-19, relating post-intensive care unit (ICU) cognitive and neurological deficits to biofluid markers and MRI. The COVID-19 pandemic has posed enormous health challenges to individuals and health- systems worldwide. An emerging feature of severe COVID-19 is that of temporary and extended neurocognitive impairment, exhibiting a myriad of symptoms and signs. The causes of this symptomatology have not yet been fully elucidated. Methods: In this study, we aim to investigate patients treated for severe COVID-19 in the ICU, as to describe and relate serum-, plasma- and cerebrospinal fluid-borne molecular and cellular biomarkers of immune activity, coagulopathy, cerebral damage, neuronal inflammation, and degeneration, to the temporal development of structural and functional changes within the brain as evident by serial MRI and extensive cognitive assessments at 3-12 months after ICU discharge. Results: To date, we have performed 51 3-month follow-up MRIs in the ICU survivors. Of these, two patients (similar to 4%) have had incidental findings on brain MRI findings requiring activation of the Incidental Findings Management Plan. Furthermore, the neuropsychological and neurological examinations have so far revealed varying and mixed patterns. Several patients expressed cognitive and/or mental concerns and fatigue, complaints closely related to brain fog. Conclusion: The study goal is to gain a better understanding of the pathological mechanisms and neurological consequences of this new disease, with a special emphasis on neurodegenerative and neuroinflammatory processes, in order to identify targets of intervention and rehabilitation.

Place, publisher, year, edition, pages
WILEY , 2022. Vol. 66, no 6, p. 759-766
Keywords [en]
biomarkers, brain injury, COVID-19, critical care, magnetic resonance imaging, neurocognitive disorders, patient outcome assessment
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:mdh:diva-58050DOI: 10.1111/aas.14062ISI: 000777175900001PubMedID: 35332517Scopus ID: 2-s2.0-85127407309OAI: oai:DiVA.org:mdh-58050DiVA, id: diva2:1652830
Available from: 2022-04-20 Created: 2022-04-20 Last updated: 2022-08-29Bibliographically approved

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Thunborg, Charlotta

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