Trial Report Decreased Cerebral Creatine and N-Acetyl Aspartate Concentrations after Severe [COVID]: A Magnetic Resonance Spectroscopy Study, 2024, Ostojic+

Decreased Cerebral Creatine and N-Acetyl Aspartate Concentrations after Severe COVID-19 Infection: A Magnetic Resonance Spectroscopy Study
Ostojic, Jelena; Kozic, Dusko; Ostojic, Sergej; Ilic, Aleksandra DJ; Galic, Vladimir; Matijasevic, Jovan; Dragicevic, Dusan; Barak, Otto; Boban, Jasmina

BACKGROUND AND OBJECTIVES
The aim of this study was to evaluate brain metabolism using MR spectroscopy (MRS) after recovery from Coronavirus disease (COVID-19) and to test the impact of disease severity on brain metabolites.

METHODS
We performed MRS on 81 individuals (45 males, 36 females, aged 40–60), who had normal MRI findings and had recovered from COVID-19, classifying them into mild (17), moderate (36), and severe (28) groups based on disease severity during the acute phase. The study employed two-dimensional spectroscopic imaging above the corpus callosum, focusing on choline (Cho), creatine (Cr), and N-acetylaspartate (NAA). We analyzed Cho/Cr and NAA/Cr ratios as well as absolute concentrations using water as an internal reference.

RESULTS
Results indicated that the Cho/Cr ratio was higher with increasing disease severity, while absolute Cho and NAA/Cr ratios showed no significant differences across the groups. Notably, absolute Cr and NAA levels were significantly lower in patients with severe disease.

CONCLUSIONS
These findings suggest that the severity of COVID-19 during the acute phase is associated with significant changes in brain metabolism, marked by an increase in Cho/Cr ratios and a reduction in Cr and NAA levels, reflecting substantial metabolic alterations post-recovery.

Link | PDF (Journal of Clinical Medicine) [Open Access]