Higher Limbic and Basal Ganglia volumes in surviving COVID-negative patients and the relations to fatigue.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused a global pandemic. Among several systemic abnormalities, little is known about the critical attack on the central nervous system (CNS). Several patient reports with multiple pathologies â€" ischemic strokes, mild infarcts, encephalitis, cerebro-vascular abnormalities, cerebral inflammation, and loss of consciousness, indicate CNS involvement. However, due to limited neuroimaging studies, conclusive group level effects are scarce in the literature and replication studies are necessary to verify if these effects persist in surviving acute-COVID patients. Furthermore, recent reports indicate fatigue is highly prevalent among slowly recovering patients. How early structural changes relate to fatigue need to be investigated. Our goal was to address this by scanning COVID subjects two weeks after hospital discharge. We hypothesized these surviving patients will demonstrate altered gray matter volume (GMV) when compared to healthy controls and further demonstrate correlation of GMV with fatigue. Voxel-based morphometry was applied to T1-weighted MRI images between 46 patients with COVID and 32 healthy controls. Significantly higher GMV in the Limbic System and Basal Ganglia regions were observed in surviving COVID-19 patients when compared to healthy controls. Moreover, within the patient group, there was a significant positive correlation between GMV and self-reported fatigue scores during work, within the ventral Basal Ganglia and Ventromedial Prefrontal Cortex regions. Therefore, our results align with both single case acute patient reports and current group level neuroimaging findings. Finally, we newly report a positive correlation of GMV with fatigue in COVID survivors.