Long-Term Neuropsychiatric Sequelae of COVID-19 in An Open Population: A Prospective Pilot Study
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nandiniLong-Term Neuropsychiatric Sequelae of COVID-19 in An Open Population: A Prospective Pilot Study
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nandiniNO ACCESS Article Publication Date: 19 May 2025
Long-Term Neuropsychiatric Sequelae of COVID-19 in
an Open Population: A Prospective Pilot Study
, Hanna Samara Martínez-Jiménez, M.Sc. , Manuel Arroyo-Landín, M.Sc. , Gladis Fragoso, Ph.D. , María Chávez-Canales, Ph.D. ,
Zeltzin González Rosas, M.Sc.
Marisela Hernández, Ph.D. , Marcos Francisco Rosetti, Ph.D. , Juan Carlos López-Alvarenga, M.D., Ph.D. , Edda Sciutto, Ph.D. , and Graciela Cárdenas, M.D., Ph.D.
AUTHORS INFO & AFFILIATIONS
Publication: The Journal of Neuropsychiatry and Clinical Neurosciences In Advance https://doi.org/10.1176/appi.neuropsych.20240040
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Abstract
Objective:
COVID-19 has been associated with a wide range of systemic and neurological complications, known as
long COVID or postacute sequelae of COVID-19 (PASC). Such sequelae can be observed among all infected
individuals, even among those with a mild disease course. Dysbiosis, a common condition associated with
low-grade inflammation, has been proposed as a potential mechanism of PASC by altering levels of
circulating lipopolysaccharide (LPS) and the tryptophan pathway metabolites kynurenine and quinolinic
acid, known to affect neurocognitive function. The authors evaluated the evolution of neurological,
neurocognitive, and neuropsychiatric COVID-19 sequelae and their relationship with circulating LPS and
kynurenine and quinolinic acid levels.
Methods:
A prospective, longitudinal, and analytical study was conducted. Neurological, neurocognitive, and
neuropsychiatric assessments of participants who had recovered from COVID-19 and did not require
hospitalization during the acute stages of the infection were performed. Peripheral levels of LPS and
tryptophan metabolites were measured 1, 3, 6, and 12 months after infection.
Results:
Of 95 participants recruited, 67 COVID-19–convalescent individuals and 20 COVID-19–free individuals were
included. Significantly higher occurrences of asthenia, olfaction and taste alterations, headache, memory
dysfunction, and systemic symptoms such as dyspnea, cough, and periodontal diseases were found among
participants in the COVID-19–convalescent group compared with participants in the comparison group. A
significant decrease in kynurenine levels, which correlated with cognitive impairment, was observed among
PASC convalescents.
Conclusions:
Significant neurocognitive and neuropsychiatric impairments were observed among COVID-19–
convalescent individuals, along with decreased kynurenine levels, which recovered during a 12-month
follow-up period.
