• Henriikka Ollila, Janne Pihlajamaa, Juha Martola, Linda Kuusela, Kaj Blennow, Henrik Zetterberg, Viljami Salmela, Laura Hokkanen, Marjaana Tiainen, and Johanna Hästbacka.
• Department of Perioperative, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. Electronic address: henriikka.ollila@helsinki.fi.
• J Crit Care. 2024 Apr 1; 80: 154502154502.

BackgroundCOVID-19 patients suffered from neurological symptoms in the acute phase. Whether this led to long-term consequences was unknown. We studied long-term brain MRI findings in ICU-treated COVID-19 patients and compared them with findings in groups with less severe acute disease.Materials And MethodsIn this prospective cohort study, 69 ICU-treated, 46 ward-treated, and 46 home-isolated patients, as well as 53 non-COVID-19 controls, underwent brain MRI six months after acute COVID-19. Plasma neurofilament light chain (NfL), a biomarker of neuroaxonal injury, was measured simultaneously.ResultsIschaemic infarctions existed in 5.8% of ICU-treated patients. Cerebral microbleeds (CMBs) existed in 27 (39.1%) ICU-treated, 13 (28.3%) ward-treated, 8 (17.4%) home-isolated COVID-19 patients, and 12 (22.6%) non-COVID controls. Patients with CMBs were older (p < 0.001), had a higher level of plasma NfL (p = 0.003), and higher supplementary oxygen days (p < 0.001). In multivariable analysis, age (OR 1.06, 95% CI 1.02-1.09) and supplementary oxygen days (OR 1.07, 95% CI 1.02-1.13) were associated with CMBs. The ICU group showed prevalent distribution of CMBs in deep regions.ConclusionAge and supplementary oxygen days were independently associated with CMBs; COVID-19 status showed no association. Accumulation of risk factors in the ICU group may explain the higher prevalence of CMBs.Trial RegistrationClinicalTrials.govNCT04864938, registered February 9, 2021.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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