A longstanding critical question in clinical neuroscience is how to determine which patients will develop new acute cerebral dysfunction (encephalopathy) and the neuroanatomical substrates of brain injury which, in some patients, progresses to dementia. 

It has been demonstrated that acute encephalopathy is the most common neurological complication of COVID-19. In the same cohort of patients at one year following hospital discharge, there are persistent cognitive deficits, particularly in those patients who had suffered prior COVID-19 encephalopathy. However, management strategies to reduce the risk of subsequent progressive cognitive impairment and progression to dementia are not established. 

Preliminary studies in a subset of patients with COVID-19 have identified putative structural neuroimaging changes in those with early cognitive impairment. However, there is now an urgent need to determine structural Image-Derived Phenotypes (IDPs) in those with ongoing cognitive impairment or progressive cognitive decline to identify the patients at risk of progression to neurodegenerative diagnoses.

My aim is to develop a structural neuroimaging biomarker of objective cognitive dysfunction in patients one year after COVID-19, to enable quantification of longitudinal recovery or progression trajectory. I will analyse the IDPs of structural T1 weighted MRI in correlation with cognitive assessment data in patients with COVID-19 at the one-year post infection time point, alongside matched controls.

Development of a neuroimaging biomarker which predicts post-infection cognitive impairment, cognitive decline, and progression to neurodegenerative diagnoses is critical to enable clinicians to identify patients at greatest risk and who are likely to benefit from early immunomodulatory therapies in addition to informing healthcare planning. This is not only relevant to COVID-19 but carries significant translational implication for other systemic infection induced cognitive syndromes.