{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T23:29:11Z","timestamp":1783553351983,"version":"3.55.0"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>The clinical manifestations and effects on the brain of the SARS-CoV-2 Omicron variant in the acute postinfection phase remain unclear.<\/jats:p><\/jats:sec>Objective<\/jats:title>To investigate the pathophysiological mechanisms underlying clinical symptoms and changes to gray matter and subcortical nuclei among male patients after Omicron infection and to provide an imaging basis for early detection and intervention.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>In this cohort study, a total of 207 men underwent health screening magnetic resonance imaging scans between August 28 and September 18, 2022; among them, 98 provided complete imaging and neuropsychiatric data. Sixty-one participants with Omicron infection were reevaluated after infection (January 6 to 14, 2023). Neuropsychiatric data, clinical symptoms, and magnetic resonance imaging data were collected in the acute post-Omicron period, and their clinical symptoms were followed up after 3 months. Gray matter indexes and subcortical nuclear volumes were analyzed. Associations between changes in gray matter and neuropsychiatric data were evaluated with correlation analyses.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Gray matter thickness and subcortical nuclear volume change data were compared before and after Omicron infection.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The gray matter indexes and subcutaneous nuclear volume were generated from the 3-dimensional magnetization-prepared rapid acquisition gradient echo and were calculated with imaging software.<\/jats:p><\/jats:sec>Results<\/jats:title>Ninety-eight men underwent complete baseline data collection; of these, 61 (mean [SD] age, 43.1\u2009[9.9] years) voluntarily enrolled in post-Omicron follow-up and 17 (mean [SD] age, 43.5\u2009[10.0] years) voluntarily enrolled in 3-month follow-up. Compared with pre-Omicron measures, Beck Anxiety Inventory scores were significantly increased (median, 4.50 [IQR, 1.00-7.00] to 4.00 [IQR, 2.00-9.75]; P<\/jats:italic>\u2009=\u2009.006) and depressive distress scores were significantly decreased (median, 18.00 [IQR, 16.00-20.22] to 16.00 [IQR, 15.00-19.00]; P<\/jats:italic>\u2009=\u2009.003) at the acute post-Omicron follow-up. Fever, headache, fatigue, myalgia, cough, and dyspnea were the main symptoms during the post-Omicron follow-up; among the participants in the 3-month follow-up, fever (11 [64.7%] vs 2 [11.8%]; P<\/jats:italic>\u2009=\u2009.01), myalgia (10 [58.8%] vs 3 (17.6%]; P<\/jats:italic>\u2009=\u2009.04), and cough (12 [70.6%] vs 4 [23.5%]; P<\/jats:italic>\u2009=\u2009.02) were significantly improved. The gray matter thickness in the left precuneus (mean [SD], 2.7 [0.3] to 2.6 [0.2] mm; P<\/jats:italic>\u2009&amp;lt;\u2009.001) and right lateral occipital region (mean [SD], 2.8 [0.2] to 2.7 [0.2] and 2.5 [0.2] to 2.5 [0.2] mm; P<\/jats:italic>\u2009&amp;lt;\u2009.001 for both) and the ratio of the right hippocampus volume to the total intracranial volume (mean [SD]. 0.003 [0.0003] to 0.003 [0.0002]; P<\/jats:italic>\u2009=\u2009.04) were significantly reduced in the post-Omicron follow-up. The febrile group had reduced sulcus depth of the right inferior parietal region compared with the nonfebrile group (mean [SD], 3.9 [2.3] to 4.8 [1.1]; P<\/jats:italic>\u2009=\u2009.048. In the post-Omicron period, the thickness of the left precuneus was negatively correlated with the Beck Anxiety Inventory scores (r<\/jats:italic>\u2009=\u2009\u22120.39; P<\/jats:italic>\u2009=\u2009.002; false discovery rate P<\/jats:italic>\u2009=\u2009.02), and the ratio of the right hippocampus to the total intracranial volume was positively correlated with the Word Fluency Test scores (r<\/jats:italic>\u2009=\u20090.34; P<\/jats:italic>\u2009=\u2009.007).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of male patients infected with the Omicron variant, the duration of symptoms in multiple systems after infection was short. Changes in gray matter thickness and subcortical nuclear volume injury were observed in the post-Omicron period. These findings provide new insights into the emotional and cognitive mechanisms of an Omicron infection, demonstrate its association with alterations to the nervous system, and verify an imaging basis for early detection and intervention of neurological sequelae.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.45626","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T16:31:43Z","timestamp":1701361903000},"page":"e2345626","source":"Crossref","is-referenced-by-count":10,"title":["Gray Matter Thickness and Subcortical Nuclear Volume in Men After SARS-CoV-2 Omicron Infection"],"prefix":"10.1001","volume":"6","author":[{"given":"Yanyao","family":"Du","sequence":"first","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"},{"name":"Clinical Research Center for Medical Imaging in Hunan Province, Changsha, China"},{"name":"Department of Radiology Quality Control Center, Hunan Province, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sihong","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuxin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanjing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijie","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longtao","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huiting","family":"Zhang","sequence":"additional","affiliation":[{"name":"MR Scientific Marketing, Siemens Healthineers Ltd, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Guo","sequence":"additional","affiliation":[{"name":"MR Application, Siemens Healthineers Ltd, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Second Xiangya Hospital of Central South University, Changsha, China"},{"name":"Clinical Research Center for Medical Imaging in Hunan Province, Changsha, China"},{"name":"Department of Radiology Quality Control Center, Hunan Province, Changsha, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"issue":"2","key":"zoi231328r2","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1038\/s41590-021-01104-y","article-title":"Pathological sequelae of long-haul COVID.","volume":"23","author":"Mehandru","year":"2022","journal-title":"Nat Immunol"},{"key":"zoi231328r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2022.114969","article-title":"Two-year follow-up of brain structural changes in patients who recovered from COVID-19: a prospective study.","volume":"319","author":"Du","year":"2023","journal-title":"Psychiatry Res"},{"issue":"7","key":"zoi231328r4","doi-asserted-by":"publisher","first-page":"1576","DOI":"10.4103\/1673-5374.327361","article-title":"Survivors of COVID-19 exhibit altered amplitudes of low frequency fluctuation in the brain: a resting-state functional magnetic resonance imaging study at 1-year follow-up.","volume":"17","author":"Du","year":"2022","journal-title":"Neural Regen Res"},{"issue":"1","key":"zoi231328r5","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2021.103259","article-title":"Patterns and clinical outcomes of olfactory and gustatory disorders in six months: prospective study of 1031 COVID-19 patients.","volume":"43","author":"Teaima","year":"2022","journal-title":"Am J Otolaryngol"},{"issue":"11","key":"zoi231328r6","doi-asserted-by":"publisher","first-page":"1953","DOI":"10.1093\/cid\/ciab703","article-title":"Twelve-month systemic consequences of coronavirus disease 2019 (COVID-19) in patients discharged from hospital: a prospective cohort study in Wuhan, China.","volume":"74","author":"Liu","year":"2022","journal-title":"Clin Infect Dis"},{"issue":"5","key":"zoi231328r7","doi-asserted-by":"publisher","first-page":"2142","DOI":"10.1093\/brain\/awac384","article-title":"Multimodal neuroimaging in post-COVID syndrome and correlation with cognition.","volume":"146","author":"D\u00edez-Cirarda","year":"2023","journal-title":"Brain"},{"issue":"10270","key":"zoi231328r8","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1016\/S0140-6736(20)32656-8","article-title":"6-Month consequences of COVID-19 in patients discharged from hospital: a cohort study.","volume":"397","author":"Huang","year":"2021","journal-title":"Lancet"},{"issue":"5","key":"zoi231328r9","doi-asserted-by":"publisher","first-page":"1830","DOI":"10.1093\/brain\/awab435","article-title":"Persistent white matter changes in recovered COVID-19 patients at the 1-year follow-up.","volume":"145","author":"Huang","year":"2022","journal-title":"Brain"},{"issue":"2","key":"zoi231328r10","doi-asserted-by":"publisher","first-page":"724","DOI":"10.7150\/thno.79902","article-title":"Dynamic white matter changes in recovered COVID-19 patients: a two-year follow-up study.","volume":"13","author":"Huang","year":"2023","journal-title":"Theranostics"},{"issue":"10","key":"zoi231328r11","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/S2215-0366(20)30287-X","article-title":"Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study.","volume":"7","author":"Varatharaj","year":"2020","journal-title":"Lancet Psychiatry"},{"issue":"2","key":"zoi231328r12","doi-asserted-by":"publisher","first-page":"E242","DOI":"10.1148\/radiol.2020202222","article-title":"Brain MRI findings in severe COVID-19: a retrospective observational study.","volume":"297","author":"Kremer","year":"2020","journal-title":"Radiology"},{"issue":"2","key":"zoi231328r13","doi-asserted-by":"publisher","first-page":"E119","DOI":"10.1148\/radiol.2020201187","article-title":"COVID-19-associated acute hemorrhagic necrotizing encephalopathy: imaging features.","volume":"296","author":"Poyiadji","year":"2020","journal-title":"Radiology"},{"issue":"1","key":"zoi231328r14","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1186\/s13054-016-1376-4","article-title":"The neurological and cognitive consequences of hyperthermia.","volume":"20","author":"Walter","year":"2016","journal-title":"Crit Care"},{"issue":"3","key":"zoi231328r16","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1016\/S0896-6273(02)00569-X","article-title":"Whole brain segmentation: automated labeling of neuroanatomical structures in the human brain.","volume":"33","author":"Fischl","year":"2002","journal-title":"Neuron"},{"issue":"1","key":"zoi231328r17","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1093\/cercor\/bhg087","article-title":"Automatically parcellating the human cerebral cortex.","volume":"14","author":"Fischl","year":"2004","journal-title":"Cereb Cortex"},{"key":"zoi231328r18","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.113172","article-title":"Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: clinical implications for US young adult mental health.","volume":"290","author":"Liu","year":"2020","journal-title":"Psychiatry Res"},{"issue":"12","key":"zoi231328r19","doi-asserted-by":"publisher","first-page":"7475","DOI":"10.1038\/s41380-021-01223-w","article-title":"Post-traumatic stress symptoms in COVID-19 survivors: a self-report and brain imaging follow-up study.","volume":"26","author":"Tu","year":"2021","journal-title":"Mol Psychiatry"},{"key":"zoi231328r20","doi-asserted-by":"publisher","first-page":"594","DOI":"10.1016\/j.bbi.2020.07.037","article-title":"Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors.","volume":"89","author":"Mazza","year":"2020","journal-title":"Brain Behav Immun"},{"key":"zoi231328r21","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.bbi.2021.02.021","article-title":"Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: effect of inflammatory biomarkers at three-month follow-up.","volume":"94","author":"Mazza","year":"2021","journal-title":"Brain Behav Immun"},{"key":"zoi231328r22","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.sleep.2020.12.034","article-title":"Prevalence of and risk factors associated with sleep disturbances among HPCD exposed to COVID-19 in China.","volume":"80","author":"Yang","year":"2021","journal-title":"Sleep Med"},{"issue":"1","key":"zoi231328r23","doi-asserted-by":"publisher","first-page":"7363","DOI":"10.1038\/s41467-022-35240-2","article-title":"Post-COVID medical complaints following infection with SARS-CoV-2 Omicron vs Delta variants.","volume":"13","author":"Magnusson","year":"2022","journal-title":"Nat Commun"},{"issue":"10335","key":"zoi231328r24","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1016\/S0140-6736(22)00327-0","article-title":"Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of Omicron and Delta variant dominance: a prospective observational study from the ZOE COVID Study.","volume":"399","author":"Menni","year":"2022","journal-title":"Lancet"},{"issue":"11","key":"zoi231328r25","doi-asserted-by":"publisher","first-page":"1930","DOI":"10.1093\/cid\/ciad045","article-title":"Severe fatigue and persistent symptoms at 3 months following severe acute respiratory syndrome coronavirus 2 infections during the pre-Delta, Delta, and Omicron time periods: a multicenter prospective cohort study.","volume":"76","author":"Gottlieb","year":"2023","journal-title":"Clin Infect Dis"},{"issue":"10323","key":"zoi231328r26","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/S0140-6736(22)00017-4","article-title":"Early assessment of the clinical severity of the SARS-CoV-2 Omicron variant in South Africa: a data linkage study.","volume":"399","author":"Wolter","year":"2022","journal-title":"Lancet"},{"issue":"2","key":"zoi231328r27","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1111\/cns.14050","article-title":"Multiple sclerosis as a model to investigate SARS-CoV-2 effect on brain atrophy.","volume":"29","author":"Rebsamen","year":"2023","journal-title":"CNS Neurosci Ther"},{"issue":"7907","key":"zoi231328r28","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1038\/s41586-022-04569-5","article-title":"SARS-CoV-2 is associated with changes in brain structure in UK Biobank.","volume":"604","author":"Douaud","year":"2022","journal-title":"Nature"},{"issue":"8","key":"zoi231328r29","doi-asserted-by":"publisher","DOI":"10.1172\/JCI147329","article-title":"Long-term microstructure and cerebral blood flow changes in patients recovered from COVID-19 without neurological manifestations.","volume":"131","author":"Qin","year":"2021","journal-title":"J Clin Invest"},{"issue":"1","key":"zoi231328r30","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s13024-022-00529-9","article-title":"The route of SARS-CoV-2 to brain infection: have we been barking up the wrong tree?","volume":"17","author":"Butowt","year":"2022","journal-title":"Mol Neurodegener"},{"issue":"1","key":"zoi231328r31","doi-asserted-by":"publisher","DOI":"10.1128\/mbio.02920-22","article-title":"Do SARS-CoV-2 variants differ in their neuropathogenicity?","volume":"14","author":"Bauer","year":"2023","journal-title":"mBio"},{"issue":"2","key":"zoi231328r32","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1038\/s41593-020-00758-5","article-title":"Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19.","volume":"24","author":"Meinhardt","year":"2021","journal-title":"Nat Neurosci"},{"issue":"6","key":"zoi231328r33","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1007\/s00401-021-02314-2","article-title":"The olfactory nerve is not a likely route to brain infection in COVID-19: a critical review of data from humans and animal models.","volume":"141","author":"Butowt","year":"2021","journal-title":"Acta Neuropathol"},{"issue":"7902","key":"zoi231328r34","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1038\/s41586-022-04474-x","article-title":"Altered TMPRSS2 usage by SARS-CoV-2 Omicron impacts infectivity and fusogenicity.","volume":"603","author":"Meng","year":"2022","journal-title":"Nature"},{"key":"zoi231328r35","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2021.674123","article-title":"Expression of the ACE2 virus entry protein in the nervus terminalis reveals the potential for an alternative route to brain infection in COVID-19.","volume":"15","author":"Bilinska","year":"2021","journal-title":"Front Cell Neurosci"},{"key":"zoi231328r36","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1146\/genet.2015.49.issue-1","article-title":"Asymmetry of the brain: development and implications.","volume":"49","author":"Duboc","year":"2015","journal-title":"Annu Rev Genet"},{"key":"zoi231328r37","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.jpsychires.2021.03.030","article-title":"Brain circuitry underlying the ABC model of anxiety.","volume":"138","author":"Bystritsky","year":"2021","journal-title":"J Psychiatr Res"},{"issue":"2","key":"zoi231328r38","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/j.cpr.2007.05.002","article-title":"Neuroimaging studies of psychological interventions for mood and anxiety disorders: empirical and methodological review.","volume":"28","author":"Frewen","year":"2008","journal-title":"Clin Psychol Rev"},{"issue":"2","key":"zoi231328r39","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.virol.2006.01.049","article-title":"Human coronavirus OC43 infection induces chronic encephalitis leading to disabilities in BALB\/C mice.","volume":"349","author":"Jacomy","year":"2006","journal-title":"Virology"},{"issue":"3","key":"zoi231328r40","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1007\/s00401-002-0605-x","article-title":"Apoptosis and microglial activation in influenza encephalopathy.","volume":"105","author":"Nakai","year":"2003","journal-title":"Acta Neuropathol"},{"issue":"3","key":"zoi231328r41","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1016\/S0272-2712(02)00009-4","article-title":"Neuropathogenesis of central nervous system HIV-1 infection.","volume":"22","author":"Kolson","year":"2002","journal-title":"Clin Lab Med"},{"key":"zoi231328r42","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynstr.2021.100326","article-title":"Alterations of frontal-temporal gray matter volume associate with clinical measures of older adults with COVID-19.","volume":"14","author":"Duan","year":"2021","journal-title":"Neurobiol Stress"},{"key":"zoi231328r1","unstructured":"Global Initiative on Sharing Avian Influenza Data. SARS-CoV-2 lineage proportion chart in China. Accessed November 3, 2023. https:\/\/gisaid.org\/phylodynamics\/China-cn\/"},{"key":"zoi231328r15","unstructured":"FreeSurfer, version 6.0. Monte Carlo simulation cluster analysis. Accessed November 3, 2023. https:\/\/surfer.nmr.mgh.harvard.edu\/fswiki"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2812387\/du_2023_oi_231328_1700251882.63557.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T16:31:48Z","timestamp":1701361908000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2812387"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,30]]},"references-count":42,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2023.45626","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,30]]}}}