Evidence map›Paper›PMID 37318955›Full record

ArticleAnnals of clinical and translational neurology2023

The kynurenine pathway relates to post-acute COVID-19 objective cognitive impairment and PASC.

Lucette A Cysique, David Jakabek, Sophia G Bracken, Yasmin Allen-Davidian, Benjamin Heng, Sharron Chow, Mona Dehhaghi, Ananda Staats Pires, David R Darley, Anthony Byrne and 6 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of clinical and translational neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06821087 (Evaluating the Neuromodulatory Effect of Ketamine in Long COVID), which is not on this map. Cited by 28 papers.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed
4.2field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06821087 phase2completednot on this mapstarted 2025, after this paper: background citation

Evaluating the Neuromodulatory Effect of Ketamine in Long COVID: A Pilot Study Targeting Fatigue and Neurocognitive Symptoms

TypeinterventionalSponsorUniversity of Texas at AustinRan2025 to 2026Enrolled20ConditionsLong COVIDArmsKetamine only
3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 43 citations in OpenAlex.

  1. Article
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  7. Neuroimmune pathophysiology of long COVID.Psychiatry and clinical neurosciences · 2025
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  20. Resistance training's impact on blood biomarkers and cognitive function in older adults with low and high risk of mild cognitive impairment: a randomized controlled trial.European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 4 institutions in 3 countries.

Lucette A CysiquePeter Duncan Neuroscience Research Unit, St. Vincent's Centre for Applied Medical Research, Darlinghurst, New South Wales, Australia.
David JakabekNeurology Department, St. Vincent's Hospital, Darlinghurst, New South Wales, Australia.
Sophia G BrackenSchool of Psychology, UNSW, Sydney, New South Wales, Australia.
Yasmin Allen-DavidianPeter Duncan Neuroscience Research Unit, St. Vincent's Centre for Applied Medical Research, Darlinghurst, New South Wales, Australia.
Benjamin HengMacquarie Medical School, Macquarie University, Sydney, New South Wales, Australia.
Sharron ChowMacquarie Medical School, Macquarie University, Sydney, New South Wales, Australia.
Mona DehhaghiMacquarie Medical School, Macquarie University, Sydney, New South Wales, Australia.
Ananda Staats PiresMacquarie Medical School, Macquarie University, Sydney, New South Wales, Australia.
David R DarleyFaculty of Medicine, UNSW, Sydney, New South Wales, Australia.
Anthony ByrneFaculty of Medicine, UNSW, Sydney, New South Wales, Australia.
Chansavath PhetsouphanhKirby Institute, UNSW, Sydney, New South Wales, Australia.
Anthony KelleherKirby Institute, UNSW, Sydney, New South Wales, Australia.
Gregory J DoreKirby Institute, UNSW, Sydney, New South Wales, Australia.
Gail V MatthewsKirby Institute, UNSW, Sydney, New South Wales, Australia.
Gilles J GuilleminMacquarie Medical School, Macquarie University, Sydney, New South Wales, Australia.
Bruce J BrewPeter Duncan Neuroscience Research Unit, St. Vincent's Centre for Applied Medical Research, Darlinghurst, New South Wales, Australia.ORCID 0000-0003-0622-1392
UNSW Sydney · AUMacquarie University · AUSecond Military Medical University · CNJES & Co · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the prevalence and natural history of post-acute COVID-19 objective cognitive impairment and function, and their relationship to demographic, clinical factors, post-acute sequelae of COVID-19 (PASC), and biomarkers.

methodsA total of 128 post-acute COVID-19 patients (age = 46 ± 15; 42% women, acute disease severity: not hospitalized: 38.6% mild: 0-1 symptoms, 52% 2+ symptoms; 9.4% hospitalized) completed standard cognition, olfaction, and mental health examinations 2-, 4-, and 12-month post diagnosis. Over the same time frame, WHO-defined 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-based Global Deficit Score method to detect at least mild cognitive impairment (GDS > 0.5). Linear mixed effect regression models with time effect (month post diagnosis) evaluated the relationships to cognition.

resultsAcross the 12-month 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 (p < 0.05), and 2-month objectively tested anosmia (p < 0.05). PASC with (p = 0.01) and without disability (p < 0.03) associated with acute COVID-19 severity. KP measures showed prolonged activation (2 to 8 months) (p < 0.0001) linked to IFN-beta in those with PASC. Of the blood analytes, only the KP metabolites (elevated quinolinic acid, 3-hydroxyanthranilic acid, kynurenine, the kynurenine/tryptophan ratio) associated (p < 0.001) with poorer cognitive performance and greater likelihood of impairment. PASC, independent of disability associated with abnormal kynurenine/tryptophan (p < 0.03).

interpretationThe kynurenine pathway relates to post-acute COVID-19 objective cognitive impairment and PASC, thereby enabling biomarker and therapeutic possibilities.

Indexed as

Cognitive DysfunctionCOVID-19AdultBiomarkersFemaleHumansKynurenineMaleMiddle AgedPost-Acute COVID-19 SyndromeTryptophanBiomarkersKynurenineTryptophan

Identifiers

PMID37318955
PMCPMC10424655
OpenAlexW4380871530

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.