Cranial Catastrophe Beyond Respiratory Symptoms: COVID-19’s Hidden Neurological Damage Revealed by MRI DTI Tractography
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Emerging evidence suggests that coronavirus disease 2019 (Covid-19) can significantly affect cranial nerves, resulting in various neurological complications. Predominant issues include anosmia, ageusia, and severe headaches. This study involved 30 recovered Covid-19 patients who underwent MRI Tractography with a Superconductor 1.5 Tesla machine and Diffusion Tensor Imaging (DTI). We analyzed correlations between gender, age, Covid-19 symptoms, pathological findings, diffusion metrics, motor and cognitive functions, and other clinical characteristics. Probabilistic constrained spherical deconvolution tractography and tract quantification were performed following diffusion tensor parameters, utilizing fiber tracking methods and fractional anisotropy (FA) metrics. Tractography reconstructions of cranial nerves were successfully achieved in all patients. Affected cranial nerves showed decreased FA and disrupted fibers, with lower axonal density in clinically recovered patients. Patients with moderate and severe symptoms had lower FA in the cranial nerves and slightly more brain abnormalities. Motor and cognitive deficits were prevalent among recovered patients. This study demonstrates that DTI provides essential qualitative and quantitative insights into the pathophysiology underlying neurological disorders in Covid-19 patients. These insights can be used to improve clinical outcomes and quality of life for patients’ post-recovery.
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