{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:16:11Z","timestamp":1786976171635,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1176660"],"award-info":[{"award-number":["1176660"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the prevalence and natural history of post\u2010acute COVID\u201019 objective cognitive impairment and function, and their relationship to demographic, clinical factors, post\u2010acute sequelae of COVID\u201019 (PASC), and biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 128 post\u2010acute COVID\u201019 patients (age\u2009=\u200946\u2009\u00b1\u200915; 42% women, acute disease severity: not hospitalized: 38.6% mild: 0\u20131 symptoms, 52% 2+ symptoms; 9.4% hospitalized) completed standard cognition, olfaction, and mental health examinations 2\u2010, 4\u2010, and 12\u2010month post diagnosis. Over the same time frame, WHO\u2010defined PASC was determined. Blood cytokines, peripheral neurobiomarkers, and kynurenine pathway (KP) metabolites were measured. Objective cognitive function was demographically\/practice corrected, and impairment prevalence was determined using the evidence\u2010based Global Deficit Score method to detect at least mild cognitive impairment (GDS\u2009&gt;\u20090.5). Linear mixed effect regression models with time effect (month post diagnosis) evaluated the relationships to cognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Across the 12\u2010month study period, mild to moderate cognitive impairment ranged from 16% to 26%, and 46.5% were impaired at least once. Impairment associated with poorer work capacity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), and 2\u2010month objectively tested anosmia (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). PASC with (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) and without disability (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.03) associated with acute COVID\u201019 severity. KP measures showed prolonged activation (2 to 8\u2009months) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001) linked to IFN\u2010beta in those with PASC. Of the blood analytes, only the KP metabolites (elevated quinolinic acid, 3\u2010hydroxyanthranilic acid, kynurenine, the kynurenine\/tryptophan ratio) associated (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) with poorer cognitive performance and greater likelihood of impairment. PASC, independent of disability associated with abnormal kynurenine\/tryptophan (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>The kynurenine pathway relates to post\u2010acute COVID\u201019 objective cognitive impairment and PASC, thereby enabling biomarker and therapeutic possibilities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.51825","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T12:24:55Z","timestamp":1686831895000},"page":"1338-1352","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["The kynurenine pathway relates to post\u2010acute\n                    <scp>COVID<\/scp>\n                    \u201019 objective cognitive impairment and\n                    <scp>PASC<\/scp>"],"prefix":"10.1002","volume":"10","author":[{"given":"Lucette A.","family":"Cysique","sequence":"first","affiliation":[{"name":"Peter Duncan Neuroscience Research Unit St. Vincent's Centre for Applied Medical Research Darlinghurst New South Wales Australia"},{"name":"School of Psychology UNSW Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jakabek","sequence":"additional","affiliation":[{"name":"Neurology Department St. Vincent's Hospital Darlinghurst New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia G.","family":"Bracken","sequence":"additional","affiliation":[{"name":"School of Psychology UNSW Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmin","family":"Allen\u2010Davidian","sequence":"additional","affiliation":[{"name":"Peter Duncan Neuroscience 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