Thesis
Evaluation of Long COVID: lung pathophysiology and its relationship with cognitive dysfunction
University of Iowa
Master of Science (MS), University of Iowa
Spring 2025
DOI: 10.25820/etd.007899
Abstract
The COVID-19 pandemic led to millions of infections, impacting global health and causing widespread social and economic disruption. While the acute respiratory effects of COVID-19 were initially the primary focus, a growing body of research has observed that a certain subset of those infected were not recovering, commonly referred to as Long COVID. It is believed that there are subclinical disease processes during acute infection that leads to lingering symptoms, primarily in the respiratory and central nervous systems. The heterogeneity of symptoms and the mostly normal clinical presentation of Long COVID has led to a need for better understanding of the underlying disease mechanisms, in particular how the respiratory pathophysiology may impact cognitive dysfunction.
Magnetic resonance imaging (MRI) of the lungs has the potential to investigate the complex mechanisms of Long COVID by using gas contrast agents. Hyperpolarized xenon-129 (129Xe) has the capability to non-invasively image lung function, including both ventilation and gas exchange. Metrics derived from 129Xe MRI have been used in studying a variety of chronic diseases including asthma, chronic obstructive pulmonary disease, cystic fibrosis, and interstitial lung disease. In the context of COVID-19 and Long COVID, 129Xe MRI has already been used to show ventilation and gas exchange abnormalities, demonstrating that this imaging technique is sensitive to pulmonary injury. Combining 129Xe MRI with cognitive testing and brain MRI has the potential to offer new insights into Long COVID.
In this work, we study a population of patients with Long COVID using pulmonary function testing, cognitive assessment, 129Xe pulmonary MRI, and structural and functional brain MRI. We establish associations between 129Xe MRI measures of lung function to cognitive function and brain perfusion. These data suggest a functional link between impaired lung function and cognitive dysfunction in Long COVID.
Details
- Title: Subtitle
- Evaluation of Long COVID: lung pathophysiology and its relationship with cognitive dysfunction
- Creators
- Keegan R. Staab
- Contributors
- Sean B. Fain (Advisor)Alejandro P. Comellas (Committee Member)Karin F. Hoth (Committee Member)Sajan G. Lingala (Committee Member)Osama I. Saba (Committee Member)
- Resource Type
- Thesis
- Degree Awarded
- Master of Science (MS), University of Iowa
- Degree in
- Biomedical Engineering
- Date degree season
- Spring 2025
- DOI
- 10.25820/etd.007899
- Publisher
- University of Iowa
- Number of pages
- x, 39 pages
- Copyright
- Copyright 2025 Keegan R. Staab
- Grant note
- This work was financially supported by The American Lung Association COVID-19 and Emerging Respiratory Viruses Research Award and the National Institute of Health Clinical and Translational Science Award program grant UM1TR004403. I also received support from the Roy J Carver Department of Biomedical Engineering by receiving the KB Chandran Travel Award.
- Language
- English
- Date submitted
- 04/29/2025
- Description illustrations
- Illustrations, tables, graphs, charts
- Description bibliographic
- Includes bibliographical references (pages 33-36).
- Public Abstract (ETD)
The COVID-19 pandemic caused millions of infections, affecting global health and leading to social and economic disruption. Some people who were infected with COVID-19 continue to have lingering symptoms, most commonly fatigue, shortness of breath, and brain fog, even though they should’ve recovered. When this happens, it is broadly referred to as Long COVID. These symptoms can vary and often occur without despite normal clinical test results, making it hard to understand the condition. Magnetic resonance imaging (MRI) can help explore the complex effects of Long COVID on both the lungs and brain. Lung function from MRI can be measured using xenon gas as a contrast agent. Xenon has been used to study lung diseases like asthma and COPD, and has also revealed abnormalities in patients with Long COVID. This study combines MRI of the lungs with cognitive testing and MRI of the brain to provide new insights into how the lung and brain are functioning in people with Long COVID. This study also investigates the interaction between the two organ systems to determine. It was observed that people with Long COVID self-reported lung and brain deficits, but performed normal on lung imaging and cognitive tests. Despite this, there were multiple relationships between lung and brain function. These results help gain a deeper understanding of Long COVID and offers insight into how lung damage may affect symptoms of brain fog.
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering
- Record Identifier
- 9984831021102771
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