Journal Article

DZNE-2025-01507

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Longitudinal Monitoring of Brain Volume Changes After COVID-19 Infection Using Artificial Intelligence-Based MRI Volumetry.

Bendella, Z. (First author)DZNE* ; Widmann, C. N.DZNE* ; Kindler, C.Extern* ; Haase, R.DZNE* ; Sauer, M. ; Heneka, M.DZNE* ; Radbruch, A.DZNE* ; Schmeel, F. C. (Last author)DZNE*

2025
MDPI Basel

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Please use a persistent id in citations: doi:10.3390/diagnostics15243244

Abstract: Background/Objectives: SARS-CoV-2 infection has been linked to long-term neurological sequelae and structural brain alterations. Previous analyses, including baseline results from the COVIMMUNE-Clin study, showed brain volume reductions in COVID-19 patients. Longitudinal data on progression are scarce. This study examined brain volume changes 12 months after baseline MRI in individuals who have recovered from mild or severe COVID-19 compared with controls. Methods: In this IRB-approved cohort study, 112 out of 172 recruited age- and sex-matched participants (38 controls, 36 mild/asymptomatic 38 severe COVID-19) underwent standardized brain MRI 12 months after baseline. Volumetric analysis was performed using AI-based software (mdbrain). Regional volumes were compared between groups with respect to absolute and normalized values. Multivariate regression controlled for demographics. Results: After 12 months, a significant decline in right hippocampal volume was observed across all groups, most pronounced in severe COVID-19 (SEV: Δ = -0.32 mL, p = 0.001). Normalized to intracranial volume, the reduction remained significant (SEV: Δ = -0.0003, p = 0.001; ASY: Δ = -0.0001, p = 0.001; CTL: minimal reduction, Δ ≈ 0, p = 0.005). Minor reductions in frontal and parietal lobes (e.g., right frontal SEV: Δ = -1.35 mL, p = 0.001), largely fell within physiological norms. These mild regional changes are consistent with expected ageing-related variability and do not suggest pathological progression. No widespread progressive atrophy was detected. Conclusions: This study demonstrates delayed, severity-dependent right hippocampal atrophy in recovered COVID-19 patients, suggesting long-term vulnerability of this memory-related region. In contrast, no progression of atrophy in other areas was observed. These findings highlight the need for extended post-COVID neurological monitoring, particularly of hippocampal integrity and its cognitive relevance.

Keyword(s): COVID-19 ; SARS-CoV-2 ; artificial intelligence ; brain atrophy ; hippocampal volume ; magnetic resonance imaging

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Contributing Institute(s):

1. Clinical Neuroimaging (AG Radbruch)
2. Neuroinflammation, Biomarker (AG Heneka)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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