Cerebral Hypoperfusion and Vascular Impairment in Long COVID Patients with Cognitive Symptoms

Motivation: Many long COVID patients experience cognitive symptoms, potentially linked to reduced cerebral blood flow, which may result from microclots and other vascular or inflammatory mechanisms. Goal(s): To determine whether long COVID patients exhibit cerebral hypoperfusion patterns as measured by ASL. Approach: A cross-sectional design utilizing Arterial Spin Labeling (ASL) and structural images was employed in 125 Long COVID patients and 34 controls, analyzing CBF across 146 brain regions. Results: Significant reductions in CBF were found in frontal, temporal, and parietal regions as well several images with arterial transit artifacts (ATA). Impact: Our results indicate that cerebral hypoperfusion may serve as a biomarker to evaluate new treatments for long COVID, reinforcing the hypothesis that vascular dysfunction underlies its cognitive symptoms. This could improve diagnostic accuracy and guide targeted interventions.