Fig. 1

Identification of long-term changes associated with COVID-19. a Data acquisition: Two cerebral MRI acquisitions were performed with a mean inter-scan interval of 3.2 years in patients with and without intermittent SARS-CoV-2 infection (n = 384 patients without SARS-CoV-2 infection and n = 401 patients with SARS-CoV-2 infection). The first MRI acquisitions were then compared to the second MRI acquisitions using multi-parametric analyses. b Changes associated with COVID-19: Longitudinal changes between control subjects and patients with SARS-CoV-2 infection comparing the first and second MRI acquisitions. Based on a hypothesis-driven analysis (n = 297 olfactory-related cerebral imaging-derived phenotypes [IDPs]) as well as an exploratory analysis of changes beyond the olfactory system (n = 2047 IDPs), the ten respective main findings indicative of impaired brain structure and function are illustrated: ratio brain volume/estimated total intracranial volume, brain volume without ventricles & supratentorial volume without ventricles (dark blue arrow); normalized cerebrospinal fluid (CSF) volume (green arrow); lateral ventricle volume (right; purple arrows); parahippocampal gyrus (left; dark yellow); temporal and frontal piriform cortex (light blue, with related functional networks); olfactory tubercle (pink, with related functional networks); anterior olfactory nucleus (green; with related functional networks, not highlighted in the figure); lateral orbitofrontal cortex (left; purple); rostral anterior cingulate cortex (left; light yellow); superior fronto-occipital fasciculus (brown, illustrated as schematic streamlines representative of fibers); and crus II of the cerebellum (not shown). Adapted from “Neuroscience” and “COVID-19” by BioRender.com (2022). Retrieved from https://app.biorender.com/biorender-templates