Dynamics of changes of cognitive status in patients with unspecified post-COVID-19 condition

Abstract

Objective. To study the dynamics of changes in cognitive status in combination with spectroscopy data in patients with the post-COVID-19 condition. Materials and methods. Study design: prospective, cohort, completed; study period: 2024-2025. 28 patients (10 men and 18 women; median age – 48 [47,5; 55,5] years old) with clinical manifestations of the condition after COVID-19 were examined. A control group consisted of 12 healthy individuals (median age – 43 [36;48] years old, 7 women and 5 men). All subjects filled a checklist of post-COVID-19 conditions twice (with inclusion in the study and 6-9 months later), the Mini-Mental State Examination (MMSE), the A.M. Veyn autonomic questionnaire, and the Spielberger-Khanin questionnaire. To objectify the disorders, all the examined subjects underwent two magnetic resonance brain tomography (MRI) scans in a 3D pulse sequence with a slice thickness of 1 mm and a square matrix in various scanning planes, as well as multivoxel spectroscopy. A mathematical analysis was performed using the STATISTICA 10.0 software package. The images were generated using RStudio 2026.01.1. Results. In patients with the condition after COVID-19, no improvement in functional status was detected upon repeated examination according to the data of filling out the checklist (9 [6;12] points and 9 [6;12] points, p=0.98) MMSE (28 [26.5; 29] points and 28 [27; 29] points, p=0.24), the A.M.Wein questionnaire (33 [27.5; 52] points and repeated 33.5 [22.5; 51] points, p=0.84), personal (40 [37;44] and repeated 45 [41;45], p=1.0) and reactive anxiety (50 [47;53] and again 49 [47;58], p=0.72). Distribution of patients by severity subgroups revealed a deterioration in subjective neurological status (χ2=11.1759, df=4, p=0,24662). The data from MRI spectroscopy did not reveal any significant dynamics in the indicators, while the inter-zone differences were smoothed out based on the analysis of the N-acetylaspartate/creatinine ratio in the anterior regions of the precentral gyrus on the left (p=0.93) and right (p=0.63), and the choline/creatinine ratio in the anterior regions of the cingulate gyrus on the right (p=0.138). Conclusion. In patients with post-COVID-19 conditions during dynamic observation an aggravation of the subjective neurological status in the absence of positive dynamics of cognitive and vegetative status indicators and data from brain MRI spectroscopy was revealed.