2025 American Academy of Neurology Abstract Website

Objective:

To compare neuroinflammation biomarkers and cognitive scores in patients living with Post-Acute Sequelae of SARS-CoV-2 (PACS) based on the quantitative neurological symptoms reported.

Background:

Patients presenting more symptoms in the long term after acute COVID infection are more likely to have an active pathological process, which may worsen cognition and lead to long-term impairment.

Design/Methods:

This longitudinal study followed 214 patients hospitalized with severe COVID-19 for up to 12 months post-infection. Neurological symptoms were assessed using a standardized survey, while cognitive function was evaluated using BrainCheck at 3/6 and 12 months. Neuroinflammatory markers were collected during hospitalization at 3/6 and 12 months. Patients were stratified into two groups based on reported neurological symptoms at each f/u: Group 1 (0-1 symptom) and Group 2 (2-6 symptoms). The study compared cognitive outcomes and neuroinflammatory markers between these groups and analyzed changes in neuroinflammatory markers over time.

Results:

Groups did not differ significantly regarding cognitive outcomes at 3/6 months and 12 months. However, higher levels of neuroinflammation markers such as GFAP, MCP1, and MDA were seen in those with more symptoms. Those whose symptoms worsened over the 12-month period experienced an increase in the inflammatory marker Eotaxin.

Conclusions:

The number of neurological symptoms in the post-acute phase of COVID-19 did not significantly impact long-term cognitive outcomes in patients. However, differences in neuroinflammatory marker levels in more symptomatic patients suggest a complex relationship between symptoms, inflammation, and cognitive function that isn't fully reflected in cognitive test results alone.