Banca de QUALIFICAÇÃO: David Alves de Araujo Junior

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : David Alves de Araujo Junior
DATE: 07/12/2022
TIME: 14:00
LOCAL: Plataforma Teams
TITLE:

“IMAGING ASSESSMENT OF THE NEUROLOGICAL EFFECTS RELATED TO SARS-COV-2 INFECTION DURING PREGNANCY AND POST-NATAL PERIOD”

KEY WORDS:

Covid-19, neuroimaging, pediatric neurodevelopmen

PAGES: 40
BIG AREA: Ciências da Saúde
AREA: Medicina
SUMMARY:

Background: COVID-19 infection and perinatal neurological outcomes are still not completely understood, but there is recent evidence of white matter disease and impaired neurodevelopment in newborns after maternal SARS-Cov-2 infection. This is supposed to occur not only because of direct effects of viral infection in neuronal cells, but also by triggering a cascade of multiple reactions, leading to systemic inflammation, glial cells / myelin involvement and regional hypoxia / microvasculature disruption. The consequences of the maternal and fetal inflammatory response in the central nervous system of newborns have not been completely studied to date. Methods: We conducted a longitudinal prospective cohort study, from June 2020 to December 2021, with follow-up of newborns from mothers exposed and not exposed to SARS-CoV-2 infection during pregnancy. Brain analysis was composed of data from transcranial neurosonography with grayscale and Doppler studies (color and spectral). Children were also assessed with ultrasound-based brain Elastography (shear-wave mode), in specific regions of interest (ROIs): deep white matter, superficial white matter, corpus callosum, basal ganglia, and cortical grey matter. We included neurological and psychomotor evaluation scale evaluation (Bayley III) and statistically analyzed the relationship between neuroimaging findings and neurodevelopmental scales. Results: A total of 219 children were assessed, of which 201 newborns of mothers exposed to SARS-CoV-2 infection and 18 healthy controls. Neurosonographic evaluation was performed at 6 months of chronological age and evidenced 18 grayscale and 21 Doppler altered exams. Predominant findings were hyper echogenicity of deep brain white matter and basal ganglia (caudate nuclei / thalamus), and reduction in resistivity and pulsatility index of intracranial arterial flow. Anterior brain circulation (MCA and Pericallosal arteries) displayed wider range of flow variation than posterior circulation (basilar artery). Shear-wave US Elastography analysis demonstrated a reduction of stiffness values in SARS-CoV-2 exposed group, overall, in the deep whitter matter coefficients. Conclusion: SARS-CoV-2 infection during pregnancy and the perinatal period has proofed to be related to brain deep white matter predominant involvement and adverse neurodevelopmental outcomes. Morphological alterations may be subtle, and functional studies as Doppler and Elastography, when associated, have shown to be a valuable tool in identifying more accurately the patients at risk of neurological damag

BANKING MEMBERS:
Externa à Instituição - NORMA SELMA SANTOS COSTA - UNIFOR
Interna - 2731816 - JULIANA FORTE MAZZEU DE ARAUJO
Interna - 819.774.921-34 - LICIA MARIA HENRIQUE DA MOTA - UnB
Externa à Instituição - NATÁLIA TORRES GIACOMIN PITMAN - UFMA