Análise longitudinal de perfil inflamatório e comprometimento cognitivo em indivíduos com COVID-19 leve a moderado

Abstract

Post-COVID syndrome manifests as a post-infection condition by SARS-CoV-2, characterized by persistent and multifaceted symptoms affecting patients regardless of the initial severity of the infection. In this thirty-month prospective observational cohort study, we evaluated the long-term cognitive symptoms of post-COVID conditions in individuals with mild COVID-19 cases and examined cytokine levels as potential biomarkers for neuroinflammation. The analysis included 216 participants with an average of 17 years of schooling, of which 82.88% maintained normal cognitive performance, while 17.12% showed persistent cognitive impairment. Cytokines such as IL-1 alpha, IP-10 (CXCL10), and NGF beta were associated with an increased chance of cognitive impairment, while IL-6, IL-21, VEGFD, and PIGF-1 were associated with a reduced chance of impairment. Network analysis revealed complex interactions among these cytokines, suggesting a dual role in their inflammatory and anti-inflammatory functions. The findings are consistent with previous studies identifying COVID-19 as a potential factor for cognitive decline, even in mild cases. The positive correlation between IL-6 and IL-1 alpha reinforces the hypothesis of an amplified inflammatory cycle. Network analysis reveals interactions among cytokines that can act as both pro-inflammatory and anti-inflammatory, depending on the context and maturity of the immune system. The persistence of pro-inflammatory cytokines may be associated with cognitive impairment in post-COVID-19 patients. Detailed analysis of interactions suggests the need for therapeutic approaches that modulate the inflammatory response to prevent or mitigate cognitive impairment. The research highlights the importance of continuous and multidimensional monitoring to fully understand the neurocognitive ramifications of COVID-19 and guide future therapeutic interventions.