Abstract #4726

WEAKER POST-COVID BOLD-CSF COUPLING IS ASSOCIATED WITH ACUTE INFLAMMATION AND COAGULATION IN COVID-19 ICU SURVIVORS

Noa van der Knaap^1,2,3, Eva M. van Heese^4,5, Laura D. Lewis^6,7,8, Bas C.T. van Bussel^2,9,10, Iwan C.C. van der Horst^2,9, Marcel J.H. Ariës^2,3, Jacobus F.A. Jansen^1,3,11, and Merel M. van der Thiel^1,3

¹Department of Radiology & Nuclear Medicine, Maastricht University Medical Center, Maastricht, Netherlands, ²Department of Intensive Care, Maastricht University Medical Center, Maastricht, Netherlands, ³Mental Health & Neuroscience Research Institute, Maastricht University, Maastricht, Netherlands, ⁴Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands, ⁵Neurodegeneration, Amsterdam Neuroscience, Amsterdam, Netherlands, ⁶Department of Electrical Engineering and Computer Sciences, Massachusetts Institute of Technology, Cambridge, MA, United States, ⁷Institute for Medical Engineering and Sciences, Massachusetts Institute of Technology, Cambridge, MA, United States, ⁸Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States, ⁹Cardiovascular Disease Research Institute, Maastricht University, Maastricht, Netherlands, ¹⁰Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands, ¹¹Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands

Synopsis

Keywords: Neurofluids, COVID-19, inflammation

Motivation: The cerebral waste clearance system may be involved in ‘long COVID’. Inflammation and/or hypercoagulation could affect cerebrovascular drivers of cerebrospinal fluid (CSF) (i.e., neurofluid dynamics) and influence the clearance system.

Goal(s): To explore the relationship between acute inflammation and coagulation and post-COVID neurofluid dynamics in COVID-19 ICU survivors.

Approach: Post-COVID neurofluid dynamics were assessed through BOLD-CSF coupling in COVID-19 ICU survivors using resting-state fMRI and correlated with acute inflammation (C-reactive protein-to-albumin-ratio (CAR) and fibrinogen-to-albumin-ratio (FAR)) and coagulation markers (FAR).

Results: Weaker post-COVID BOLD-CSF coupling correlated with higher median FAR and CAR during ICU stay, but not at ICU admission.

Impact: Weaker post-COVID BOLD-CSF coupling correlated with increased inflammation and hypercoagulation during ICU stay in COVID-19 ICU survivors. This may affect post-COVID neurofluid dynamics and cerebral waste clearance, possibly contributing to long COVID.

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