Relationship between Lung and Brain Injury in COVID-19 Patients: A Hyperpolarized Xe-129-MRI-based 8-Month Follow-Up

Although the lungs are the primary organ involved, increasing evidence supports the neuroinvasive potential of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study investigates the potential relationship between coronavirus disease (COVID-19)-related deterioration of brain structure and the degree of damage to lung function. Nine COVID-19 patients were recruited in critical condition from Jin Yin-tan Hospital (Wuhan, China) who had been discharged between 4 February and 27 February 2020. The demographic, clinical, treatment, and laboratory data were extracted from the electronic medical records. All patients underwent chest CT imaging, Xe-129 gas lung MRI, and H-1 brain MRI. Four of the patients were followed up for 8 months. After nearly 12 months of recovery, we found no significant difference in lung ventilation defect percentage (VDP) between the COVID-19 group and the healthy group (3.8 +/- 2.1% versus 3.7 +/- 2.2%) using Xe-129 MRI, and several lung-function-related parameters-such as gas-blood exchange time (T)-showed improvement (42.2 ms versus 32.5 ms). Combined with H-1 brain MRI, we found that the change in gray matter volume (GMV) was strongly related to the degree of pulmonary function recovery-the greater the increase in GMV, the higher degree of pulmonary function damage.