Long Coronavirus Disease and the Brain: Molecular Neuroimaging Insights into Neurologic and Psychiatric Sequelae

Eric Guedj; Alexandre Cionca; Julie A Péron; Cyrus Ayubcha; Frédéric Assal; Tatiana Horowitz; Abass Alavi

doi:10.1016/j.cpet.2024.09.013

Long Coronavirus Disease and the Brain: Molecular Neuroimaging Insights into Neurologic and Psychiatric Sequelae

PET Clin. 2025 Jan;20(1):39-55. doi: 10.1016/j.cpet.2024.09.013. Epub 2024 Oct 30.

Authors

Eric Guedj¹, Alexandre Cionca², Julie A Péron³, Cyrus Ayubcha⁴, Frédéric Assal⁵, Tatiana Horowitz⁶, Abass Alavi⁷

Affiliations

¹ Biophysics and Nuclear Medicine, Aix Marseille University, Marseille, France; APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, Marseille, France; Nuclear Medicine Department, CERIMED, Marseille, France. Electronic address: eric.guedj@univ-amu.fr.
² Neuro-X Institute, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.
³ Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland; Neurology Division, Geneva University Hospitals, Geneva, Switzerland.
⁴ Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
⁵ Neurology Division, Geneva University Hospitals, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
⁶ Biophysics and Nuclear Medicine, Aix Marseille University, Marseille, France; APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, Marseille, France; Nuclear Medicine Department, CERIMED, Marseille, France.
⁷ Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.

PMID: 39482218
DOI: 10.1016/j.cpet.2024.09.013

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has led to a variety of health challenges, with "long COVID" emerging as a widespread and debilitating post-acute syndrome among a considerable number of infected patients. This PET review synthesizes current evidence of the neurologic and psychiatric sequelae of COVID. This review also explores the pathophysiological mechanisms of these results, including astrocyte dysfunction and glutamate dysregulation, as well as the multimodal comparison to MR imaging findings. The findings underscore the potential for long-term brain injury. Additionally, the authors discuss the role of advanced imaging multimodal techniques in diagnosing, monitoring, and guiding treatment strategies for long COVID.

Keywords: Brain; COVID; Long COVID; Molecular neuroimaging; Psychiatric sequelae.

Publication types

Review

MeSH terms

Brain* / diagnostic imaging
COVID-19* / complications
COVID-19* / diagnostic imaging
Humans
Magnetic Resonance Imaging / methods
Mental Disorders / diagnostic imaging
Neuroimaging* / methods
Positron-Emission Tomography / methods
Post-Acute COVID-19 Syndrome*
SARS-CoV-2*