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Neuropsychiatric symptoms and brain hypoxia in Post-COVID-19 condition: Evidence from population and laboratory studies
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Neuropsychiatric symptoms and brain hypoxia in Post-COVID-19 condition: Evidence from population and laboratory studies

Peter Hall, Hasan Ayaz, Gang Meng, Anna Hudson, Mohammad Nazmus Sakib, Anne Quah, Thomas Agar, Christian Boudreau and Geoffrey Fong
Brain, behavior, and immunity, v 114, pp 71-72
Nov 2023
DOI: https://doi.org/10.1016/j.bbi.2024.01.205

Abstract

Background: Prior studies have documented impaired cognitive performance, structural brain differences, and self-reported neuropsychiatric symptoms among those with a prior SARS-CoV-2 infection. Although hypoxia is one hypothesized mechanism, few studies have used brain imaging techniques that are suited for assessing brain oxygenation changes. Likewise, no studies using population-level data have employed latent variable modelling of neuropsychiatric symptoms. The current investigation comprised a laboratory study (Study 1) and population survey (Study 2) to make use of these improved methods. It was anticipated that prior SARS-CoV-2 infection would be associated with worse performance on cognitive tasks, less task-related oxygen uptake within the prefrontal cortex (Study 1), and emergence of neuropsychiatric symptoms (Study 2). Methods: Participants in Study 1 (N = 120) performed a Flanker task and a delay discounting task; task-related cerebral oxygenation changes were assessed using functional near-infrared spectroscopy (fNIRS). In Study 2 (N =2,002), COVID-19 infection status was assessed at baseline and neuropsychiatric symptoms at 6-month follow-up; SEM was used to model latent variables representing neuropsychiatric symptoms. Results: In Study 1, a positive infection history was associated with worse Flanker performance (coefficient: −22.862, SE = 10.096, t =2.265, p =.026). This main effect was modified by a joint moderating effect of age and sex (ΔR2 =0.057, F(1,108) = 3.416, p = .036), such that effects were strongest among older adult women (effect: 9.603, SE = 4.452, t = 2.157, p = .033). Functional imaging findings indicated reduced task-related oxygenation changes in the superior frontal gyrus, especially for females (F1,143.1 = 6.352, p = .013). In Study 2, a positive infection history at baseline predicted more latent cognitive and psychiatric symptoms at follow-up. Emergent infection between waves predicted marginally greater psychiatric symptoms for unvaccinated individuals (est = 0.589, SE = 0.321, p = .066). Conclusions: Prior symptomatic SARS-CoV-2 infection is associated with task-related hypoxia within the prefrontal cortex and predicts neuropsychiatric symptom emergence when the latter are modelling using latent variables.

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