Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization

Maxime Taquet; Zuzanna Skorniewska; Adam Hampshire; James D. Chalmers; Ling Pei Ho; Alex Horsley; Michael Marks; Krisnah Poinasamy; Betty Raman; Olivia C. Leavy; Matthew Richardson; Omer Elneima; Hamish J.C. McAuley; Aarti Shikotra; Amisha Singapuri; Marco Sereno; Ruth M. Saunders; Victoria C Harris; Linzy Houchen-Wolloff; Neil J. Greening; Parisa Mansoori; Ewen M. Harrison; Annemarie B. Docherty; Nazir I. Lone; Jennifer Quint; Naveed Sattar; Christopher E. Brightling; Louise V. Wain; Rachael E. Evans; John R. Geddes; Paul J. Harrison; PHOSP-COVID Collaborative Group

doi:10.1038/s41591-023-02525-y

Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization

Maxime Taquet (Lead / Corresponding author), Zuzanna Skorniewska, Adam Hampshire, James D. Chalmers, Ling Pei Ho, Alex Horsley, Michael Marks, Krisnah Poinasamy, Betty Raman, Olivia C. Leavy, Matthew Richardson, Omer Elneima, Hamish J.C. McAuley, Aarti Shikotra, Amisha Singapuri, Marco Sereno, Ruth M. Saunders, Victoria C Harris, Linzy Houchen-Wolloff, Neil J. GreeningParisa Mansoori, Ewen M. Harrison, Annemarie B. Docherty, Nazir I. Lone, Jennifer Quint, Naveed Sattar, Christopher E. Brightling, Louise V. Wain, Rachael E. Evans, John R. Geddes, Paul J. Harrison (Lead / Corresponding author), PHOSP-COVID Collaborative Group

Research output: Contribution to journal › Article › peer-review

43 Citations (Scopus)

232 Downloads (Pure)

Abstract

Post-COVID cognitive deficits, including ‘brain fog’, are clinically complex, with both objective and subjective components. They are common and debilitating, and can affect the ability to work, yet their biological underpinnings remain unknown. In this prospective cohort study of 1,837 adults hospitalized with COVID-19, we identified two distinct biomarker profiles measured during the acute admission, which predict cognitive outcomes 6 and 12 months after COVID-19. A first profile links elevated fibrinogen relative to C-reactive protein with both objective and subjective cognitive deficits. A second profile links elevated D-dimer relative to C-reactive protein with subjective cognitive deficits and occupational impact. This second profile was mediated by fatigue and shortness of breath. Neither profile was significantly mediated by depression or anxiety. Results were robust across secondary analyses. They were replicated, and their specificity to COVID-19 tested, in a large-scale electronic health records dataset. These findings provide insights into the heterogeneous biology of post-COVID cognitive deficits.

Original language	English
Pages (from-to)	2498-2508
Number of pages	11
Journal	Nature Medicine
Volume	29
Issue number	10
Early online date	31 Aug 2023
DOIs	https://doi.org/10.1038/s41591-023-02525-y
Publication status	Published - Oct 2023

Keywords

Neurological manifestations
Viral infection

ASJC Scopus subject areas

General Biochemistry,Genetics and Molecular Biology

Access to Document

10.1038/s41591-023-02525-yLicence: CC BY

Final Published VersionFinal published version, 23.2 MBLicence: CC BY

Cite this

Taquet, M., Skorniewska, Z., Hampshire, A., Chalmers, J. D., Ho, L. P., Horsley, A., Marks, M., Poinasamy, K., Raman, B., Leavy, O. C., Richardson, M., Elneima, O., McAuley, H. J. C., Shikotra, A., Singapuri, A., Sereno, M., Saunders, R. M., Harris, V. C., Houchen-Wolloff, L., ... PHOSP-COVID Collaborative Group (2023). Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization. Nature Medicine, 29(10), 2498-2508. https://doi.org/10.1038/s41591-023-02525-y

@article{277bc8de2b5543b28ee6f64374d09946,

title = "Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization",

abstract = "Post-COVID cognitive deficits, including {\textquoteleft}brain fog{\textquoteright}, are clinically complex, with both objective and subjective components. They are common and debilitating, and can affect the ability to work, yet their biological underpinnings remain unknown. In this prospective cohort study of 1,837 adults hospitalized with COVID-19, we identified two distinct biomarker profiles measured during the acute admission, which predict cognitive outcomes 6 and 12 months after COVID-19. A first profile links elevated fibrinogen relative to C-reactive protein with both objective and subjective cognitive deficits. A second profile links elevated D-dimer relative to C-reactive protein with subjective cognitive deficits and occupational impact. This second profile was mediated by fatigue and shortness of breath. Neither profile was significantly mediated by depression or anxiety. Results were robust across secondary analyses. They were replicated, and their specificity to COVID-19 tested, in a large-scale electronic health records dataset. These findings provide insights into the heterogeneous biology of post-COVID cognitive deficits.",

keywords = "Neurological manifestations, Viral infection",

author = "Maxime Taquet and Zuzanna Skorniewska and Adam Hampshire and Chalmers, {James D.} and Ho, {Ling Pei} and Alex Horsley and Michael Marks and Krisnah Poinasamy and Betty Raman and Leavy, {Olivia C.} and Matthew Richardson and Omer Elneima and McAuley, {Hamish J.C.} and Aarti Shikotra and Amisha Singapuri and Marco Sereno and Saunders, {Ruth M.} and Harris, {Victoria C} and Linzy Houchen-Wolloff and Greening, {Neil J.} and Parisa Mansoori and Harrison, {Ewen M.} and Docherty, {Annemarie B.} and Lone, {Nazir I.} and Jennifer Quint and Naveed Sattar and Brightling, {Christopher E.} and Wain, {Louise V.} and Evans, {Rachael E.} and Geddes, {John R.} and Harrison, {Paul J.} and {PHOSP-COVID Collaborative Group}",

note = "Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = oct,

doi = "10.1038/s41591-023-02525-y",

language = "English",

volume = "29",

pages = "2498--2508",

journal = "Nature Medicine",

issn = "1078-8956",

publisher = "Nature Research",

number = "10",

}

Taquet, M, Skorniewska, Z, Hampshire, A, Chalmers, JD, Ho, LP, Horsley, A, Marks, M, Poinasamy, K, Raman, B, Leavy, OC, Richardson, M, Elneima, O, McAuley, HJC, Shikotra, A, Singapuri, A, Sereno, M, Saunders, RM, Harris, VC, Houchen-Wolloff, L, Greening, NJ, Mansoori, P, Harrison, EM, Docherty, AB, Lone, NI, Quint, J, Sattar, N, Brightling, CE, Wain, LV, Evans, RE, Geddes, JR, Harrison, PJ & PHOSP-COVID Collaborative Group 2023, 'Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization', Nature Medicine, vol. 29, no. 10, pp. 2498-2508. https://doi.org/10.1038/s41591-023-02525-y

TY - JOUR

T1 - Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization

AU - Taquet, Maxime

AU - Skorniewska, Zuzanna

AU - Hampshire, Adam

AU - Chalmers, James D.

AU - Ho, Ling Pei

AU - Horsley, Alex

AU - Marks, Michael

AU - Poinasamy, Krisnah

AU - Raman, Betty

AU - Leavy, Olivia C.

AU - Richardson, Matthew

AU - Elneima, Omer

AU - McAuley, Hamish J.C.

AU - Shikotra, Aarti

AU - Singapuri, Amisha

AU - Sereno, Marco

AU - Saunders, Ruth M.

AU - Harris, Victoria C

AU - Houchen-Wolloff, Linzy

AU - Greening, Neil J.

AU - Mansoori, Parisa

AU - Harrison, Ewen M.

AU - Docherty, Annemarie B.

AU - Lone, Nazir I.

AU - Quint, Jennifer

AU - Sattar, Naveed

AU - Brightling, Christopher E.

AU - Wain, Louise V.

AU - Evans, Rachael E.

AU - Geddes, John R.

AU - Harrison, Paul J.

AU - PHOSP-COVID Collaborative Group

PY - 2023/10

Y1 - 2023/10

N2 - Post-COVID cognitive deficits, including ‘brain fog’, are clinically complex, with both objective and subjective components. They are common and debilitating, and can affect the ability to work, yet their biological underpinnings remain unknown. In this prospective cohort study of 1,837 adults hospitalized with COVID-19, we identified two distinct biomarker profiles measured during the acute admission, which predict cognitive outcomes 6 and 12 months after COVID-19. A first profile links elevated fibrinogen relative to C-reactive protein with both objective and subjective cognitive deficits. A second profile links elevated D-dimer relative to C-reactive protein with subjective cognitive deficits and occupational impact. This second profile was mediated by fatigue and shortness of breath. Neither profile was significantly mediated by depression or anxiety. Results were robust across secondary analyses. They were replicated, and their specificity to COVID-19 tested, in a large-scale electronic health records dataset. These findings provide insights into the heterogeneous biology of post-COVID cognitive deficits.

AB - Post-COVID cognitive deficits, including ‘brain fog’, are clinically complex, with both objective and subjective components. They are common and debilitating, and can affect the ability to work, yet their biological underpinnings remain unknown. In this prospective cohort study of 1,837 adults hospitalized with COVID-19, we identified two distinct biomarker profiles measured during the acute admission, which predict cognitive outcomes 6 and 12 months after COVID-19. A first profile links elevated fibrinogen relative to C-reactive protein with both objective and subjective cognitive deficits. A second profile links elevated D-dimer relative to C-reactive protein with subjective cognitive deficits and occupational impact. This second profile was mediated by fatigue and shortness of breath. Neither profile was significantly mediated by depression or anxiety. Results were robust across secondary analyses. They were replicated, and their specificity to COVID-19 tested, in a large-scale electronic health records dataset. These findings provide insights into the heterogeneous biology of post-COVID cognitive deficits.

KW - Neurological manifestations

KW - Viral infection

UR - http://www.scopus.com/inward/record.url?scp=85169162384&partnerID=8YFLogxK

U2 - 10.1038/s41591-023-02525-y

DO - 10.1038/s41591-023-02525-y

M3 - Article

C2 - 37653345

AN - SCOPUS:85169162384

SN - 1078-8956

VL - 29

SP - 2498

EP - 2508

JO - Nature Medicine

JF - Nature Medicine

IS - 10

ER -

Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

PHOS-COVID (Joint with University of Leicester)

Cite this

Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Projects

PHOS-COVID (Joint with University of Leicester)

Cite this