We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
The kynurenine pathway relates to post‐acute COVID‐19 objective cognitive impairment and PASC.
- Authors
Cysique, Lucette A.; Jakabek, David; Bracken, Sophia G.; Allen‐Davidian, Yasmin; Heng, Benjamin; Chow, Sharron; Dehhaghi, Mona; Staats Pires, Ananda; Darley, David R.; Byrne, Anthony; Phetsouphanh, Chansavath; Kelleher, Anthony; Dore, Gregory J.; Matthews, Gail V.; Guillemin, Gilles J.; Brew, Bruce J.
- Abstract
Objective: To determine the prevalence and natural history of post‐acute COVID‐19 objective cognitive impairment and function, and their relationship to demographic, clinical factors, post‐acute sequelae of COVID‐19 (PASC), and biomarkers. Methods: A total of 128 post‐acute COVID‐19 patients (age = 46 ± 15; 42% women, acute disease severity: not hospitalized: 38.6% mild: 0–1 symptoms, 52% 2+ symptoms; 9.4% hospitalized) completed standard cognition, olfaction, and mental health examinations 2‐, 4‐, and 12‐month post diagnosis. Over the same time frame, WHO‐defined PASC was determined. Blood cytokines, peripheral neurobiomarkers, and kynurenine pathway (KP) metabolites were measured. Objective cognitive function was demographically/practice corrected, and impairment prevalence was determined using the evidence‐based Global Deficit Score method to detect at least mild cognitive impairment (GDS > 0.5). Linear mixed effect regression models with time effect (month post diagnosis) evaluated the relationships to cognition. Results: Across the 12‐month study period, mild to moderate cognitive impairment ranged from 16% to 26%, and 46.5% were impaired at least once. Impairment associated with poorer work capacity (p < 0.05), and 2‐month objectively tested anosmia (p < 0.05). PASC with (p = 0.01) and without disability (p < 0.03) associated with acute COVID‐19 severity. KP measures showed prolonged activation (2 to 8 months) (p < 0.0001) linked to IFN‐beta in those with PASC. Of the blood analytes, only the KP metabolites (elevated quinolinic acid, 3‐hydroxyanthranilic acid, kynurenine, the kynurenine/tryptophan ratio) associated (p < 0.001) with poorer cognitive performance and greater likelihood of impairment. PASC, independent of disability associated with abnormal kynurenine/tryptophan (p < 0.03). Interpretation: The kynurenine pathway relates to post‐acute COVID‐19 objective cognitive impairment and PASC, thereby enabling biomarker and therapeutic possibilities.
- Subjects
KYNURENINE; COGNITION disorders; QUINOLINIC acid; MILD cognitive impairment; COVID-19; SMELL disorders
- Publication
Annals of Clinical & Translational Neurology, 2023, Vol 10, Issue 8, p1338
- ISSN
2328-9503
- Publication type
Article
- DOI
10.1002/acn3.51825