2024, Number 3
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Med Int Mex 2024; 40 (3)
Post-COVID-19 syndrome associated with cerebral vasoreactivity
Sotelo NC, Dávila SD, Suárez CJA, García LVH
Language: Spanish
References: 19
Page: 179-190
PDF size: 241.58 Kb.
ABSTRACT
Objective: To evaluate the effect of SARS-CoV-2 infection on changes in cerebral
vasoreactivity in patients meeting the criteria for post-COVID-19 syndrome.
Materials and Methods: A case-control, analytical, cross-sectional, descriptive,
retrospective, observational study, in which information were collected from digital
clinical file of patients with history of having entered to the Internal Medicine of General
Hospital Tlahuac from September to December 2020, with COVID-19-positive test by
PCR. Cerebral vasoreactivity was measured using transcranial Doppler ultrasonography,
with a temporal window approach, without lateral predominance, to record baseline
and 10-second post-30-second voluntary apnea flow velocities in the middle cerebral
artery. This assessment was conducted on patients meeting the definition of post-
COVID-19 syndrome, while control measurements were taken on medical residents
and healthcare workers with a history of SARS-CoV-2 infection.
Results: Sixty-two patients with an average age of 42 years were studied. They were
divided into two groups. Group 1 with 20 patients with post-COVID-19 syndrome
and group 2 with 42 patients without the syndrome. Lower systolic and diastolic velocities
were observed in the post-COVID-19 syndrome group, both at baseline and
post-apnea. Additionally, reduced systolic and diastolic vasoreactivity in patients with
post-COVID-19 syndrome was found.
Conclusions: Post-COVID-19 syndrome was associated with decreased cerebral
vasoreactivity, independent of sex, age, and comorbidities.
REFERENCES
Gao Y. Biology of vascular smooth muscle: vasoconstrictionand dilatation. 1st ed. Beijing: Springer; 2017.
Chung CC, Pimentel D, Jordan A, Hao Y, et al. Inflammationassociateddeclines in cerebral vasoreactivity and cognitionin type 2 diabetes. Neurology 2015; 85: 450-458. doi:10.1212/WNL.0000000000001820.
Hajjar I, Marmerelis V, Shin D, Chui H. Assessment ofcerebrovascular reactivity during resting state breathingand its correlation with cognitive function in hypertension.Cerebrovasc Dis 2014; 38: 10-6. doi: 10.1159/000365349.
Attaway A, Scheraga R, Bhimraj A, Biehl M, et al. Severecovid-19 pneumonia: pathogenesis and clinical management.BMJ 2021; 372: 436. doi: 10.1136/bmj.n436.
Joost Wiersinga W, Rhodes A, Cheng A, Peacock S, et al.Pathophysiology, transmission, diagnosis, and treatmentof coronavirus disease 2019 (COVID-19): A review. JAMA2020; 324: 782-793. doi:10.1001/jama.2020.12839
Lei Y, Zhang J, Schiavon C, He M, et al. SARS-CoV-2 spikeprotein impairs endothelial function via downregulationof ACE 2. Circ Res 2021; 128 (9): 1323-1326. https://doi.org/10.1161/CIRCRESAHA.121.318902.
Cuevas-García C. ACVLBR. The neurology of COVID-19.Rev Alerg Méx 2020; 67: 4. DOI: 10.29262/ram.v67i4.828.
Kanberg N, Ashton N, Andersson L, Yilmaz A, et al. Neurochemicalevidence of astrocytic and neuronal injurycommonly found in COVID-19. Neurology 2020; 95: e1754-e1759. doi: 10.1212/WNL.0000000000010111.
Thakur K, Happy E, Glendinning M, Al-Dalahmah I, e al.COVID-19 neuropathology at Columbia University IrvingMedical Center/New York Presbyterian Hospital. Brain2021; 144: 2696-2708. doi: 10.1093/brain/awab148.
Solomon IH, Normandin E, Bhattacharyya S, Mukerji S, etal. Neuropathological features of Covid-19. N Engl J Med2020; 383: 989-992. doi: 10.1056/NEJMc2019373.
Kandemirli SG, Dogan L, Sarikaya ST, Kara S, et al. Findingsin patients in the intensive care unit with COVID-19 infection.Radiology 2020; 297 (1): E232-E235. doi: 10.1148/radiol.2020201697. 2020; 297(E232-E235).
Radmanesh A, Derman A, Lui Y, Raz E, et al. COVID-19-associateddiffuse leukoencephalopathy and microhemorrhages.Radiology 2020; 297: E223-E227. doi: 10.1148/radiol.2020202040.
Agarwal S, Jain R, Dogra S, Krieger P, et al. Cerebral microbleedsand leukoencephalopathy in critically ill patientswith COVID-19. Stroke. 2020 ; 51: 2649-2655. doi: 10.1161/STROKEAHA.120.030940.
Connors JM, Levy JH. Thromboinflammation and thehypercoagulability of COVID-19. J Thromb Haemost 2020;18: 1559-1561. doi: 10.1111/jth.14849.
Ling M, Jin H, Wang M, Hu Y, et al. Neurologic manifestationsof hospitalized patients with coronavirus disease2019 in Wuhan, China. JAMA Neurol 2020; 77: 683-690.doi: 10.1001/jamaneurol.2020.1127.
Zhao H, Shen D, Zhou H, Liu J, et al. Guillain-Barre syndromeassocated with SARS-CoV-2 infection: causality or coincidence.Lancet Neurol 2020; 19: 383-384. doi: 10.1016/S1474-4422(20)30109-5.
Carod-Artal FJ. Post-COVID-19 syndrome: epidemiology,diagnostic criteria and pathogenic mechanismsinvolved. Rev Neurol 2021; 72: 384-396. doi: 10.33588/rn.7211.2021230.
Purkayastha S, Sorond F. Transcranial Doppler ultrasound:technique and application. Semin Neurol 2012; 32: 411-20.doi: 10.1055/s-0032-1331812.
Marcic M, Marcic L, Marcic B, Capkun V, et al. Cerebralvasoreactivity evaluated by transcranial color doppler andbreath-holding test in patients after SARS-CoV-2 infection.J Pers Med 2021; 11: 379. doi: 10.3390/jpm11050379.