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Clift AK, Ranger TA, Patone M, Coupland CA, Hatch R, Thomas K, Hippisley-Cox J, Watkinson P. Neuropsychiatric Ramifications of Severe COVID-19 and Other Severe Acute Respiratory Infections. JAMA Psychiatry. 2022 Jul 1;79(7):690-698. PubMed.
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University of Pittsburgh
Braga et al. conducted an interesting study to test if microglial activation, measured by a TSPO PET tracer, is linked to persistent depressive and cognitive symptoms presented by some patients after acute COVID-19 infection.
The authors performed gold-standard PET arterial input function quantification and their regional total distribution volume (VT) results appear robust despite the small sample size. The inclusion of actual brain images and binding potentials (k3/k4) would have provided a better understanding of the role of off-target and non-displaceable tracers on the groups. The clinical impact of the PET results was supported by an association between TSPO VT in the basal ganglia and a motor performance test.
In summary, this pilot study suggests that COVID-19 may cause sustained and potentially harmful microglial activation after acute symptoms. I concur with the authors that further study of this as a target for alleviating COVID-related long-lasting neuropsychiatric symptoms could be beneficial. If the authors had access to the patients’ CSF, it would increase the likelihood of identifying specific proteins involved in the microglial activation process as potential therapeutic targets.
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