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European Journal of Nuclear Medicine and Molecular Imaging ; 49(Supplement 1):S298-S299, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2220011


Aim/Introduction: A substantial amount of post-COVID-19 patients suffer from debilitating fatigue and cognitive impairment persisting months after infection, referred to as 'long COVID'. The pathophysiology of long COVID is unknown, but post-mortem studies have demonstrated that after acute SARS-CoV-2 infection profound neuro-inflammation may be present. However, to date no clear in-vivo evidence for this is available in patients who survived COVID-19. The aim of this study was to quantify neuro-inflammation in-vivo with [18F]DPA-714 positron emission tomography (PET) in post COVID patients with and without long term complaints. [18F] DPA-714 binds with high affinity to translocator protein (TSPO) that is brought to expression on, among others, activated microglia, enabling visualization of neuro inflammation in-vivo. Material(s) and Method(s): We will include patients with and without persisting postinfectious fatigue, cognitive complaints and smell loss or distortions and will relate it to cognitive, psychiatric and post infectious fatigue symptoms. We will assess in-vivo peripheral and neuro-inflammation with a 90 minutes [18F]DPA-714 PET scan, alternately capturing brain (dynamic 60 minutes) and body (30 minutes;pelvic to head) with both continuous on-line and manual arterial blood sampling for full quantification. The 30-minutes body scan will be performed to examine whole-body inflammation (secondary parameter). Brain MRI will be performed for functional and anatomical information. Additionally, neuropsychological assessment and questionnaires will be performed. So far, we included five patients with long COVID with persisting post-infectious fatigue and cognitive complaints, who all got infected in 2020. Two patients were female and patients were on average 59 +/- 5 years of age. Indeed, this is an ongoing study and more data (>20 patients) will become available in the near future. Result(s): We will report on the first results of this crosssectional observational case-control study in which we quantify peripheral and neuro-inflammation with fully quantitative [18F] DPA-714 PET scans in post-COVID-19 patients. Preliminary results indicate profound neuro-inflammation in these first patients with long COVID. Conclusion(s): Preliminary results of this study indicate that patients with long COVID have profound neuro-inflammation. Results of this study may provide important insight into the underlying pathophysiology of long COVID symptoms and may potentially provide opportunities for future (treatment-directed) studies.

Rhinology ; 2022 04 10.
Artigo em Inglês | MEDLINE | ID: covidwho-1786176


BACKGROUND: Sudden smell loss is a specific early symptom of COVID-19, which, prior to the emergence of Omicron, had estimated prevalence of ~40% to 75%. Chemosensory impairments affect physical and mental health, and dietary behavior. Thus, it is critical to understand the rate and time course of smell recovery. The aim of this cohort study was to characterize smell function and recovery up to 11 months post COVID-19 infection. METHODS: This longitudinal survey of individuals suffering COVID-19-related smell loss assessed disease symptoms and gustatory and olfactory function. Participants (n=12,313) who completed an initial survey (S1) about respiratory symptoms, chemosensory function and COVID-19 diagnosis between April and September 2020, were invited to complete a follow-up survey (S2). Between September 2020 and February 2021, 27.5% participants responded (n=3,386), with 1,468 being diagnosed with COVID-19 and suffering co-occurring smell and taste loss at the beginning of their illness. RESULTS: At follow-up (median time since COVID-19 onset ~200 days), ~60% of women and ~48% of men reported less than 80% of their pre-illness smell ability. Taste typically recovered faster than smell, and taste loss rarely persisted if smell recovered. Prevalence of parosmia and phantosmia was ~10% of participants in S1 and increased substantially in S2: ~47% for parosmia and ~25% for phantosmia. Persistent smell impairment was associated with more symptoms overall, suggesting it may be a key marker of long-COVID illness. The ability to smell during COVID-19 was rated slightly lower by those who did not eventually recover their pre-illness ability to smell at S2. CONCLUSIONS: While smell ability improves for many individuals who lost it during acute COVID-19, the prevalence of parosmia and phantosmia increases substantially over time. Olfactory dysfunction is associated with broader persistent symptoms of COVID-19, and may last for many months following acute COVID-19. Taste loss in the absence of smell loss is rare. Persistent qualitative smell symptoms are emerging as common long-term sequelae; more research into treatment options is strongly warranted given that even conservative estimates suggest millions of individuals may experience parosmia following COVID-19. Healthcare providers worldwide need to be prepared to treat post COVID-19 secondary effects on physical and mental health.

Chemical Senses ; 46, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-1665926


The olfactory bulb (OB) plays a key role in olfactory processing;its volume is important for diagnosis, prognosis and treatment of patients with olfactory loss, e.g. due to a Covid-19 infection, neurodegenerative diseases or other causes. So far, measurements of OB volume have been limited to quantification of manually segmented OBs, which makes its application in large scale clinical studies infeasible. The aim of this study was to evaluate the potential of our previously developed automatic OB segmentation method for clinical measurements of OB volume. The method employs convolutional neural networks that localize the OBs and subsequently automatically segment them (Noothout et al., 2021). In previous work, we showed that this method accurately segmented the OBs resulting in a Dice coefficient above 0.8 and average symmetrical surface distance below 0.24 mm. Volumes determined from manual and automatic segmentations were highly correlated (r=0.79, p<0.001) and the method was able to recognize the absence of an OB. Here, we included MRI scans of 181 patients with olfactory loss from the Dutch Smell and Taste Center. OB volumes were computed from automatic segmentations as described above. Using a multiple linear regression model, OB volumes were related to clinical outcome measures. Age, duration and etiology of olfactory loss, and olfactory ability significantly predicted OB volume (F(5, 172) = 11.348, p<0.001, R2 = .248). The results demonstrate that our previously described method for automatic segmentation and quantification of the OB can be applied in both research and clinical populations. Its use may lead to more insight in and application of the OB in diagnosis, prognosis and treatment of olfactory loss. We aim to extend our research to other populations of patients with olfactory loss.