Fig. 2: BBB disruption in long COVID-associated brain fog.
a, Patient cohort for dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). b, Age distribution across cohorts (n = 10 recovered, n = 11 without brain fog (−), n = 11 with brain fog (+)). c, Time from COVID+ PCR test to scan across cohorts (n = 10 recovered, n = 11 without brain fog (−), n = 11 with brain fog (+)). Data were analyzed using a two-sided Kruskal–Wallis test with Dunn’s correction for multiple comparisons (P = 0.0157 without brain fog (−) versus recovered; P = 0.0004 with brain fog (+) versus recovered). d, Averaged BBB permeability maps in cases with and without brain fog. e, Quantification of the percentage of brain volume with leaky blood vessels in the cohort with brain fog compared to recovered cases (P = 0.0057) and cases without brain fog (P = 0.0004). Data were analyzed using a one-way analysis of variance with Tukey’s correction. f, Frequency distribution of the percentage of BBB-disrupted voxels in cases with and without brain fog. g, Representative BBB permeability maps at the level of the TLs, FLs and OLs showing enhanced BBB permeability in cases with brain fog. h–k, Quantification of regional BBB permeability in the right TL (P = 0.0095) (h), left TL (P = 0.0202) (i), right frontal cortex (P = 0.0123) (j) and left frontal cortex (P = 0.0047) (k). Data were analyzed using a two-sided Mann–Whitney U-test. The box plots display the minimum and maximum values (whiskers), median (solid line) and interquartile range (IQR) (upper and lower box). The violin plots show the median (solid line) and IQR (dashed lines); each data point represents one patient. Schematics in a were created with BioRender.com.
