Glial activation among individuals with neurological post-acute sequelae of coronavirus disease 2019: A positron emission tomography study of brain fog using [18F]-FEPPA

Glial activation among individuals with neurological post-acute sequelae of coronavirus disease 2019: A positron emission tomography study of brain fog using [18F]-FEPPA

Background: This study examined the regional distribution of glial activation in essential workers with neurological post-acute sequelae of coronavirus disease 2019 (COVID-19) infections (N-PASC). Methods: We injected ≤185 MBq of [18F]-FEPPA as an intravenous bolus and positron-emission tomography o...

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Bibliographic Details
Main Authors: Sean A.P. Clouston, Paul Vaska, Tesleem Babalola, John Gardus, III, Chuan Huang, Nicola Soriolo, Ashley Fontana, Christine DeLorenzo, Ramin Parsey, Benjamin J. Luft
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Brain, Behavior, & Immunity - Health
Subjects:
Post-acute sequelae of COVID-19
Respiratory infection
Glial activation
Translocator protein
Essential Workers
Positron emission tomography
Online Access:http://www.sciencedirect.com/science/article/pii/S2666354625000031
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Summary:Background: This study examined the regional distribution of glial activation in essential workers with neurological post-acute sequelae of coronavirus disease 2019 (COVID-19) infections (N-PASC). Methods: We injected ≤185 MBq of [18F]-FEPPA as an intravenous bolus and positron-emission tomography over 2 h. To measure distribution volume (VT) we recruited 24 essential workers (14 N-PASC, 10 Never-COVID-19 Controls, of whom 22 successfully placed arterial lines). Individuals with low binding affinity were excluded from this study, and VT was adjusted for translocator protein genotype. Analyses that passed the false discovery rate are reported. Results: Participants at midlife survived mild to moderate COVID-19 without hospitalization but reported onset of post-acute sequelae of COVID-19 (PASC) for, on average, 22 months before undergoing neuroimaging. Hippocampal VT was higher (VT = 1.70, 95% C.I. = [1.30–2.21], p = 0.001) in participants with persistent brain fog after COVID-19, reflecting an increase of 10.58 mL/cm3 in VT (area under the receiver-operating curve, AUC = 0.95 [0.85–1.00]). At a cutoff of 10.6, sensitivity/specificity/accuracy were 0.88/0.93/0.91. Conclusion: The results from this study imply that neuroimmune response is a distinct and identifiable characteristic of brain fog after COVID-19. Results suggest that [18F]-FEPPA could be used to support N-PASC diagnosis.
ISSN:2666-3546

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