Nuklearmedizin 2021; 60(02): 131
DOI: 10.1055/s-0041-1726699
Leuchtturm
Junge Talente

Altered regional cerebral glucose metabolism and its correlation with cognitive impairment in the subacute stage of COVID-19

G Blazhenets
1   Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Nuclear Medicine, Freiburg
,
A Dreßing
2   Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Neurology and Clinical Neuroscience, Freiburg
,
N Schroeter
2   Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Neurology and Clinical Neuroscience, Freiburg
,
T Bormann
2   Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Neurology and Clinical Neuroscience, Freiburg
,
J Thurow
1   Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Nuclear Medicine, Freiburg
,
L Frings
1   Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Nuclear Medicine, Freiburg
,
C Weiller
2   Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Neurology and Clinical Neuroscience, Freiburg
,
JA Hosp
2   Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Neurology and Clinical Neuroscience, Freiburg
,
PT Meyer
1   Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Department of Nuclear Medicine, Freiburg
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    Ziel/Aim Given the rapid spread of SARS-CoV-2 and emerging evidence of neurological symptoms particularly in hospitalized COVID-19 patients, we examined the impact of COVID-19 on the CNS in inpatients at the subacute stage by F-18-FDG PET.

    Methodik/Methods We assessed neurological and neuropsychological symptoms (MoCA) and F-18-FDG PET scans in 15 COVID-19 inpatients (once patients were no longer infectious). All scans were visually read using a 3-step rating scale (normal, mildly and severely abnormal). Principal components analysis (PCA; avoiding the need of a currently unknown reference region) was employed to explore whether a spatial covariance pattern exists in COVID-19 (compared to 45 control patients without somatic CNS disease). Exploratorily, we assessed mean normalized F-18-FDG uptake (lean body weight- and plasma glucose-adjusted standardized uptake value, SUV) in 10 % voxels with highest covariance weights (positive and negative).

    Ergebnisse/Results Visual reads indicated pathological results in 10/15 patients (mainly frontotemporal hypometabolism). We detected a highly significant (p<.001) COVID-19-related spatial covariance pattern characterized by positive weights in brain stem, cerebellum, white matter and mesiotemporal structures and negative weights in wide-spread neocortical areas. Visual reads correlated significantly with the individual pattern expression score (PES) of the COVID-19-related pattern (r = 0.80, p<.001) and we found a highly significant linear relationship between cognitive assessment (MoCA) and the PES (R2=0.62, p<.001). Regional analyses suggest neocortical hypometabolism by no clear-cut regional hypermetabolism (i.e., decreased SUV by -9.4 % [p=.09] and unchanged SUV [+3.5 %; p>.39] in 10 % voxels with most negative and positive weights, respectively).

    Schlussfolgerungen/Conclusions Neocortical dysfunction accompanied by cognitive impairment was detected in two-thirds of inpatients with subacute COVID-19. A clear indication of regional hypermetabolism (suggesting inflammation) was not found. Follow-up studies are currently underway.


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    Publication History

    Article published online:
    08 April 2021

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