OBJECTIVE: Many patients with long COVID experience neurological and psychological symptoms. Signal abnormalities on MR images in the corpus callosum have been reported. Knowledge about the metabolic profile in the splenium of the corpus callosum (CCS) may contribute to a better understanding of the pathophysiology of long COVID. MATERIALS AND METHODS: Eighty-one subjects underwent proton MR spectroscopy examination. The metabolic concentrations of total N-acetylaspartate (NAA), choline-containing compounds (Cho), total creatine (Cr), myo-inositol (mI), and NAA/Cho in the CCS were statistically compared in the group of patients containing 58 subjects with positive IgG COVID-19 antibodies or positive SARS-CoV-2 qPCR test at least two months before the MR and the group of healthy controls containing 23 subjects with negative IgG antibodies. RESULTS: An age-dependent effect of SARS-CoV-2 on Cho concentrations in the CCS has been observed. Considering the subjective threshold of age = 40 years, older patients showed significantly increased Cho concentrations in the CCS than older healthy controls (p = 0.02). NAA, Cr, and mI were unchanged. All metabolite concentrations in the CCS of younger post-COVID-19 patients remained unaffected by SARS-CoV-2. Cho did not show any difference between symptomatic and asymptomatic patients (p = 0.91). DISCUSSION: Our results suggest that SARS-CoV-2 disproportionately increases Cho concentration in the CCS among older post-COVID-19 patients compared to younger ones. The observed changes in Cho may be related to the microstructural reorganization in the CCS also reported in diffusion measurements rather than increased membrane turnover. These changes do not seem to be related to neuropsychological problems of the post-COVID-19 patients. Further metabolic studies are recommended to confirm these observations.

• Keywords
• COVID-19, Metabolism, Proton MR spectroscopy, The splenium of the corpus callosum,
• MeSH
• Choline * metabolism   MeSH
• Corpus Callosum * diagnostic imaging   metabolism   MeSH
• COVID-19 * diagnostic imaging   metabolism   MeSH
• Adult MeSH
• Inositol metabolism   MeSH
• Creatine * metabolism   MeSH
• Aspartic Acid * analogs & derivatives   metabolism   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Spectroscopy methods   MeSH
• Proton Magnetic Resonance Spectroscopy * methods   MeSH
• SARS-CoV-2 * MeSH
• Aged MeSH
• Case-Control Studies MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Names of Substances
• Choline * MeSH
• Inositol MeSH
• Creatine * MeSH
• Aspartic Acid * MeSH
• N-acetylaspartate MeSH Browser