Investigation of the long-term autonomic effects of COVID-19 using multimodal physiological monitoring and neuroimaging

Since the outbreak of the COVID pandemic a year ago, it has become evident that the effects of the virus are not limited to the respiratory system and that several other organs, including the brain, heart, liver, skin and kidneys can be affected. COVID-19 causes a very wide range of symptoms, including neurological symptoms with some of these symptoms persisting several months after disease onset. Of particular interest are its effects on the brain. To this end, imaging has been used to study the effects of COVID on the brain and the results have suggested that many individuals suffer widespread damage in their brain tissue and that the extent of this damage is usually (but not always) related to the severity of the respiratory symptoms. The mechanisms that cause brain damage are also not understood yet. Importantly, almost all previous studies that have used neuroimaging to study the effects of COVID on the brain have used anatomical images, i.e. they have focused on brain structure. However, investigating the potential effects of COVID on brain function is also of great importance and yields significant potential for complementing anatomical studies. In this context, the main aim of the proposed work is to use neuroimaging to study brain function in COVID survivors. We will collect functional magnetic resonance imaging (fMRI) data both during resting conditions, as well as during inhalation of carbon dioxide and controlled breathing, when subjects will be instructed to breath at a specific rhythm and hold their breath. This will give us the opportunity to directly assess whether the processing of respiratory stimuli in the brain is affected by COVID. We will also collect anatomical images from all subjects and assess whether COVID effects on brain function and structure are related to each other. Besides enhancing our knowledge on the wide range of COVID symptoms, the proposed will contribute towards better, individualized short-term and long-term therapies.