biostudies-literatureRua CUniversity of Oxford Medical Sciences Division COVID-19 Research Response FundCambridge Centre for Parkinson-PlusNIHR Oxford Biomedical Research CentreMedical Research CouncilNIHR Cambridge Biomedical Research CentreNational Institute for Health Research (NIHR)NIHR Oxford Health Biomedical Research CentreWellcome TrustBHF Centre of Research Excellence, OxfordAcademy of Medical Sciences/The Health Foundation Clinician Scientist Fellowship4121-4130https://www.ebi.ac.uk/biostudies/studies/S-EPMC7616766biostudies-literatureUnknown147(12)Post-mortem studies have shown that patients dying from severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection frequently have pathological changes in their CNS, particularly in the brainstem. Many of these changes are proposed to result from para-infectious and/or post-infection immune responses. Clinical symptoms such as fatigue, breathlessness, and chest pain are frequently reported in post-hospitalized coronavirus disease 2019 (COVID-19) patients. We propose that these symptoms are in part due to damage to key neuromodulatory brainstem nuclei. While brainstem involvement has been demonstrated in the acute phase of the illness, the evidence of long-term brainstem change on MRI is inconclusive. We therefore used ultra-high field (7 T) quantitative susceptibility mapping (QSBrain : a journal of neurologyQuantitative susceptibility mapping at 7 T in COVID-19: brainstem effects and outcome associations.PMC7616766103838203139/Z/16/ZNIHR203312BRC-1215-20008225924/Z/22/Z098436/Z/12/B2202580009118MC_UU_00030/14NIHR203316BRC-1215-20014Outtrim JGMenon DKLupson VCErsche KDStamatakis EAPattinson KManktelow ANewcombe VFJChatfield DAClare SRowe JBSawcer SJNeubauer SBullmore ETMcDonald RQiu LWilliams GBRodgers CTClarke WTCassar MRua CEzra MRaman BfalseQuantitative susceptibility mapping at 7 T in COVID-19: brainstem effects and outcome associations.Post-mortem studies have shown that patients dying from severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection frequently have pathological changes in their CNS, particularly in the brainstem. Many of these changes are proposed to result from para-infectious and/or post-infection immune responses. Clinical symptoms such as fatigue, breathlessness, and chest pain are frequently reported in post-hospitalized coronavirus disease 2019 (COVID-19) patients. We propose that these symptoms are in part due to damage to key neuromodulatory brainstem nuclei. While brainstem involvement has been demonstrated in the acute phase of the illness, the evidence of long-term brainstem change on MRI is inconclusive. We therefore used ultra-high field (7 T) quantitative susceptibility mapping (QS2024-01-01T00:00:00Z2024 Dec2025-04-04T02:26:43.925Z2025-04-04T02:26:43.925ZS-EPMC76167663937520710.1093/brain/awae215