Longitudinal Alterations in Morphological Brain Networks and Cognitive Function in Common-Type COVID-19: A 3-Month Follow-Up Study

Ying Liu^1,2Bei Peng²Haixia Qin²Kaixuan Zhou²Shihuan Lin²Yinqi Lai²Lingyan Liang²Gaoxiong Duan²Xiaocheng Li²Xiaoyan Zhou²Yi Chen Wei²Qingping Zhang²Jinli Huang²Yan Zhang²Jiazhu Huang²Ruijing Sun²Sijing Tuo²Yuxin Chen^2*Demao Deng^2*

• ¹Department of Radiology, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China
• ²Department of Radiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China

Purpose: To investigate the morphological network and cognitive function of patients with common-type coronavirus disease 2019 (COVID-19) during the acute phase, and examine dynamic changes at 3-month follow-up. Methods: At baseline, high-resolution T1-weighted imaging was conducted in 35 patients with COVID-19 and 40 healthy controls; 22 patients were reassessed at 3 months. All patients underwent cognitive assessments. Individual morphological brain networks were constructed using grey matter volume similarity, and topological properties were analyzed using graph theory. We used an independent sample t-test at baseline and a paired sample t-test to compare the 3-month follow-up with the acute phase, with false discovery rate corrections (p < 0.05). Results: In the acute phase, patients exhibited increased subcortical network (SCN) connectivity, and reduced connectivity between the frontoparietal network (FPN) and limbic network (LN), the SCN and dorsal/ventral attention network (DAN/VAN), and the LN and DAN. At follow-up, SCN connectivity remained elevated, with partial recovery in SCN-DAN/VAN and LN-DAN connectivity, and significant FPN-LN improvements. Enhanced global efficiency and reduced path length indicated improved network integration. Additionally, digit symbol substitution test and verbal fluency test scores improved over time. Conclusion: COVID-19 induces short-term disruptions in cognition-related morphological subnetworks, with subcortical networks compensating for these changes. Significant recovery in FPN-LN connectivity and partial restoration of other networks highlight the plasticity of the brain and suggest that FPN-LN connectivity is a potential neuroimaging marker for cognitive recovery.