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Abstract #4876

Decreased water exchange rate across blood-brain barrier 6-12 months after admission for COVID-19 pneumonia

Frances Robertson1, Jacqueline Hoare1, Betty Kadenge1, Sarah Heany1, and Ernesta Meintjes1
1University of Cape Town, Cape Town, South Africa

Synopsis

Keywords: Arterial Spin Labelling, COVID-19

Motivation: A proportion of patients admitted to hospital with SARS-CoV-2 infection have cognitive deficits that persist for several months. However, the mechanisms behind persistent neurological symptoms are unclear. Blood-brain barrier (BBB) dysfunction is a possible underlying cause.

Goal(s): We aimed to investigate BBB permeability in participants previously admitted to hospital with SARS-CoV-2 infection (post-acute COVID-19).

Approach: We used a diffusion-prepared pseudo-continuous arterial spin labelling (DP-pCASL) to quantify water exchange rate in post-acute COVID-19 participants and controls.

Results: Post-acute COVID-19 participants demonstrated lower whole brain water exchange rates across the BBB than controls, but no differences in arterial transit time or cerebral blood flow.

Impact: This is the first study to report reduced water exchange across the blood brain barrier in the context of post-acute infection with SARS-CoV-2. This may implicate glymphatic system dysfunction as a mechanism for neurological symptoms associated with long COVID-19.

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