Throughout the course of the COVID-19 pandemic, we continue to learn about the enduring symptoms and disability faced by many survivors of SARS-CoV-2. In their prospective cohort study of 242 survivors of severe COVID-19 in New York City, Dr. Frontera et al. reported that a majority (87%) suffer from some degree of ongoing cognitive, psychiatric, or functional disability 12 months after hospitalization. In response, Dr. Machado referenced neuroimaging data that associate SARS-CoV-2 with structural brain changes—notably a reduction in gray matter volume—which may account for some of these lasting cognitive symptoms. The exchange between Dr. Machado and the investigators further emphasizes the effects of hypoxemia and the inflammatory sequelae of SARS-CoV-2 infection as mediators of chronic brain dysfunction. In addition, Dr. Frontera drew some parallels to the downstream effects of SARS-CoV-2 infection and Alzheimer disease pathology, which warrant further exploration.
