{"doi":"10.1093/brain/awab009","title":"Cognitive impairment and altered cerebral glucose metabolism in the subacute stage of COVID-19","abstract":"During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, neurological symptoms increasingly moved into the focus of interest. In this prospective cohort study, we assessed neurological and cognitive symptoms in hospitalized coronavirus disease-19 (COVID-19) patients and aimed to determine their neuronal correlates. Patients with reverse transcription-PCR-confirmed COVID-19 infection who required inpatient treatment primarily because of non-neurological complications were screened between 20 April 2020 and 12 May 2020. Patients (age > 18 years) were included in our cohort when presenting with at least one new neurological symptom (defined as impaired gustation and/or olfaction, performance < 26 points on a Montreal Cognitive Assessment and/or pathological findings on clinical neurological examination). Patients with ≥2 new symptoms were eligible for further diagnostics using comprehensive neuropsychological tests, cerebral MRI and 18fluorodeoxyglucose (FDG) PET as soon as infectivity was no longer present. Exclusion criteria were: premorbid diagnosis of cognitive impairment, neurodegenerative diseases or intensive care unit treatment. Of 41 COVID-19 inpatients screened, 29 patients (65.2 ± 14.4 years; 38% female) in the subacute stage of disease were included in the register. Most frequently, gustation and olfaction were disturbed in 29/29 and 25/29 patients, respectively. Montreal Cognitive Assessment performance was impaired in 18/26 patients (mean score 21.8/30) with emphasis on frontoparietal cognitive functions. This was confirmed by detailed neuropsychological testing in 15 patients. 18FDG PET revealed pathological results in 10/15 patients with predominant frontoparietal hypometabolism. This pattern was confirmed by comparison with a control sample using voxel-wise principal components analysis, which showed a high correlation (R2 = 0.62) with the Montreal Cognitive Assessment performance. Post-mortem examination of one patient revealed white matter microglia activation but no signs of neuroinflammation. Neocortical dysfunction accompanied by cognitive decline was detected in a relevant fraction of patients with subacute COVID-19 initially requiring inpatient treatment. This is of major rehabilitative and socioeconomic relevance.","journal":"Brain","year":2021,"id":145474,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":405,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9652,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":617634,"name":"Andrea Dreßing","orcid":"0000-0003-1415-1929","position":1,"is_corresponding":false},{"id":617635,"name":"Ganna Blazhenets","orcid":"0000-0003-2419-7373","position":2,"is_corresponding":false},{"id":617636,"name":"Tobias Bormann","orcid":"0000-0001-5502-6505","position":3,"is_corresponding":false},{"id":617637,"name":"Alexander Rau","orcid":"0000-0001-5881-6043","position":4,"is_corresponding":false},{"id":617638,"name":"Marius Schwabenland","orcid":"0000-0003-2205-5427","position":5,"is_corresponding":false},{"id":617639,"name":"Johannes Thurow","orcid":"0000-0001-6703-6030","position":6,"is_corresponding":false},{"id":108191,"name":"Dirk Wagner","orcid":"0000-0002-3271-5815","position":7,"is_corresponding":false},{"id":617640,"name":"Cornelius F. Waller","orcid":"0000-0002-5777-0212","position":8,"is_corresponding":false},{"id":619382,"name":"Wolf D Niesen","orcid":null,"position":9,"is_corresponding":false},{"id":617641,"name":"Lars Frings","orcid":"0000-0001-9377-8935","position":10,"is_corresponding":false},{"id":617642,"name":"Horst Urbach","orcid":"0000-0001-7264-4807","position":11,"is_corresponding":false},{"id":87170,"name":"Marco Prinz","orcid":"0000-0002-0349-1955","position":12,"is_corresponding":false},{"id":609040,"name":"Cornelius Weiller","orcid":"0000-0002-2448-5714","position":13,"is_corresponding":false},{"id":619383,"name":"Nils Schroeter","orcid":null,"position":14,"is_corresponding":false},{"id":617643,"name":"Philipp T. Meyer","orcid":"0000-0001-8336-750X","position":15,"is_corresponding":false},{"id":617633,"name":"Jonas A. Hosp","orcid":"0000-0001-7696-9334","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":null,"created_at":"2026-07-18T23:42:12.871665Z","pmid":"33822001","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}