Abstract Details

Title The MRI Analysis of 300 Subjects Revealed Grey Matter Atrophy of the Frontal Lobe and Limbic System in Four SARS-CoV-2 Strains

Topic Infectious Disease

Presentation(s) S21 - Acute and Post-Acute Sequelae of COVID-19 (4:06 PM-4:18 PM)

Poster/Presentation
Number 004

Background The neuropsychiatric symptoms of the post-COVID syndrome are frequent and debilitating and represents a major public health concern. Unfortunately, neither the physiopathology nor the underlying cerebral alterations are understood.

Objective To compare patterns of grey matter atrophy (GMA) in post-COVID syndrome according to four different strains of SARS-CoV-2

Design/Methods We analyzed 3T T1 MRI of 300 post-COVID subjects (non-hospitalized, median age 40 years, 209 women, an average of 150 days from diagnosis): 188 infected with the Alpha strain, 29 infected with the P.2-Gamma strain, 61 infected with the P.1+P.1.*-Gamma strain, 22 infected with the Delta strain and 90 healthy controls scanned during the pandemic. We used the Fiocruz database (http://www.genomahcov.fiocruz.br/dashboard/) to separate groups according to the predominant strains by intervals. The CAT12-toolbox/SPM12/MATLAB2019 was used to perform Voxel-Based Morphometry (VBM) analysis and investigate GMA among groups (adjusted for intracranial volume, age, and sex). We reported significant p-values<0.001 corrected for multiple comparisons.

Results Overall, all four groups of strains presented GMA atrophy of the bilateral anterior cingula and ventromedial frontal lobes. Besides, Strain P.2-Gamma showed GMA of the right cuneus and left superior occipital gyrus. The P.1+P.1.*-Gamma Strain presented more widespread atrophy (right angular gyrus, fusiform gyrus, frontal operculum and precuneus, and left frontal operculum and precuneus). Interestingly, the Alpha and Delta Strains revealed exclusive frontal lobe GMA.

Conclusions Despite the mild acute infection, all four groups presented GMA of the anterior cingula and ventromedial frontal area, suggesting similarities in neurotropism, cerebral injury, and physiopathology. Additionally, different strains showed individual variations of GMA. These findings. The atrophy of the limbic system and frontal lobes may be somehow associated with the highly prevalent neuropsychiatric symptoms (dysexecutive syndrome, depression, and anxiety) in the post-COVID syndrome. Further analyses are necessary to correlate brain atrophy with neuropsychiatric dysfunction and eventually provide therapeutic targets.

Authors/Disclosures
Lucas S. Silva, MD (University of Campinas) PRESENTER	Dr. Silva has nothing to disclose.
Beatriz Costa (University of Campinas)	Miss Costa has nothing to disclose.
	No disclosure on file
Rafael Joao	Mr. Joao has nothing to disclose.
	No disclosure on file
Italo Karmann Aventurato, MD	Dr. Karmann Aventurato has received research support from Coordenadoria de Aperfeiçoamento de Pessoal de Ensino Superior (CAPES). Dr. Karmann Aventurato has received research support from Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP).
Marina K. Alvim (Hospital Das Clinicas Unicamp)	Dr. Alvim has nothing to disclose.
Mariana R. Brito, MD (Hospital De Clinicas Da Unicamp)	No disclosure on file
Fernando Cendes, MD, PhD, FAAN (Departamento de Neurologia; FCM; UNICAMP)	Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB Pharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Biopharma. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for United Medical – Brazil. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Zodiac Pharma . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Eurofarma – Brazil . Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Epilepsia. Dr. Cendes has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology - Epilepsy. The institution of Dr. Cendes has received research support from São Paulo Research Foundation - FAPESP. The institution of Dr. Cendes has received research support from Conselho Nacional de Desenvolvimento Científico e Tecnológico - Brazil . The institution of Dr. Cendes has received research support from NIH.
Clarissa L. Yasuda, MD, PhD (University of Campinas)	Prof. Yasuda has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for LIBBS. Prof. Yasuda has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ABBOTT. Prof. Yasuda has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for LIBBS.