436 - Evaluation the Impact of Coronavirus Disease 2019 (Covid-19) on Cranial Nerves Using MRI Tractography Diffusion Tensor Imaging: Study on Fiber Tracking and Fractional Anisotropy.

Most recovered Covid-19 cases are among individuals aged 15-64, the productive working-age group. People in this age range are generally involved in finishing their education, pursuing jobs, advancing their careers, starting families, and contributing to community development. There is growing evidence that Covid-19 can affect the cranial nerves. Several other studies conducted in various countries have identified complications in the brain and nervous system following Covid-19 infection. We investigated 30 recovered Covid-19 patients using MRI Tractography Diffusion Tensor Imaging. Researchers conducted a study from July 2020 to April 2023, selecting Brain MRI patient samples using purposive sampling. The study targeted patients aged 18 to 65 who had been infected with Covid-19, considering factors like age, weight, gender, comorbidities, Covid-19 test results, symptom severity, post-Covid-19 neurological disorders, and specific Brain MRI findings. Patients with underlying brain or head conditions such as cancer, metastasis, or psychological disorders were excluded. MRI imaging utilized a 1.5 Tesla 16-channel machine with T1WI, T2WI, 3D-FIESTA, and DTI. Image analysis was performed using Ready View DTI Fiber Tracking (FT), and Fractional Anisotropy (FA). Based on age categories, there is variation in the number of samples, where the age category with the highest number of samples is 26-35 years old, with 10 samples (33.3% of the total). The age categories with the second-highest number of samples are 36-45 years old and 46-55 years old, each with 7 samples (23.3% of the total). The age categories with the lowest number of samples are 17-25 years old and 56-65 years old, each with 3 samples (10% of the total). The data collected on the severity of Covid-19 symptoms in relation to pathological findings in post-recovery Brain MRI scans reveals significant differences. Among the samples, those with mild Covid-19 symptoms exhibited the highest number of pathological findings (12 samples). In contrary, samples without symptoms still showed a substantial number of pathological findings (9 samples), while samples with moderate symptoms had 8 samples with such findings. Remarkably, samples with severe Covid-19 symptoms exhibited a significantly lower incidence of pathological findings, with only 1 sample indicating such abnormalities. Samples experiencing neurological disturbances after recovering from Covid-19 are categorized into three indications: motoric, cognitive, and other neurological disorder indications. Out of the total samples, 16% exhibited cognitive disturbances, 25% experienced motoric disturbances, and 59% of the samples showed indications of other neurological disorders. In this study, we demonstrated that diffusion tensor imaging can provide essential qualitative and quantitative information to the understanding of pathophysiology underlying neurologist disorders of the patients which can be used to improve the clinical outcomes and quality of patient's life after recovered from Covid-19. Brain MRI results revealed significant pathological findings in Covid-19 patients. Notably, 14% had right-sided brain pathology, 10% had left-sided pathology, and a striking 76% had bilateral brain pathology. Most of these findings (79%) were categorized as circulatory system lesions, while 21% fell into other categories. Overall, the study suggests that brain pathology is common in Covid-19 patients after recovery. Fiber Tracking analysis showed disruptions in nerve fiber pathways associated with affected brain areas, including the prefrontal cortex, corpus callosum, and corticospinal tract. This disruption correlated with anosmia (loss of smell) in Covid-19 patients, highlighting changes in brain connectivity and nerve fiber pathways. Fractional Anisotropy analysis indicated reduced FA values in white matter brain tissue, potentially signifying nerve damage or dysfunction in regions related to cognitive and emotional functions. However, it's crucial to note that not all pathological findings directly correspond to neurological symptoms. Further research is needed to fully understand Covid-19′s neurological impact. In summary, Fiber Tracking and Fractional Anisotropy analyses provide valuable insights into nerve fiber changes in Covid-19 patients, linking them to neurological symptoms. While the direct relationship between these changes and Covid-19 requires more investigation, these techniques are useful for exploring the virus's neurological effects. [ABSTRACT FROM AUTHOR]