Abstract Background and Objectives: The long-term neurological consequences of COVID-19 remain unclear. Although several retrospective studies suggest microstructural and functional brain changes following infection, prospective neuroimaging and neuropsychological evaluations are limited. This study aimed to describe brain MRI and cognitive outcomes in neurologically asymptomatic individuals who recovered from moderate to severe COVID-19. Methods: This case series included 14 Filipino patients, aged 50–71, assessed within three weeks post-discharge. All participants had no prior neurologic disease, were non-insulin-dependent diabetics, and underwent brain MRI, Clinical Dementia Rating (CDR), and the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery. Box plot analysis was used to explore patterns of cognitive performance, which were compared with imaging findings. Results: Most participants demonstrated cognitive impairment on CERAD testing (mean 70.86; median 71.5; IQR 66.75–77.0), with one scoring in the normal range, two in the mild cognitive impairment range, and eleven in the dementia range. MoCA-P scores ranged from 11 to 27 (mean 19.79). Four participants had CDR scores of 0.5–1. MRI abnormalities were common: only one participant had a normal scan, while others showed microvascular ischemic changes, temporal or global cortical atrophy, or infarcts. Two individuals developed new neurological events during follow-up, including a pontine perforator infarct and a unilateral tremor. Lower CERAD scores were generally associated with higher atrophy and ischemic burden. Domain-level analysis showed greatest impairment in memory, recall, and verbal fluency. Conclusion: Neurologically asymptomatic survivors of moderate to severe COVID-19 may exhibit cognitive deficits and MRI abnormalities shortly after recovery. Although these changes may reflect a combination of age-related factors, vascular comorbidities, and possible post-infectious effects, the absence of baseline imaging limits causal interpretation. Larger longitudinal studies integrating neuroimaging, neuropsychological assessment, and biomarkers are needed to clarify the trajectory and mechanisms of post-COVID cognitive changes.
Ty et al. (Thu,) studied this question.