To determine whether there is adifference in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values in white matter pathways in the subacute period after COVID-19 infection and to evaluate the correlation between diffusion tensor imaging (DTI) metrics and laboratory findings. The study included 64 healthy controls and 91patients. Patients were classified as group1 (all patients, n = 91), group2 (outpatients, n = 58), or group3 (inpatients, n = 33). The ADC and FA values were calculated from 10distinct neuroanatomic localizations; DTI values were compared between groups. Decreased FA values in the cingulum, corpus callosum splenium and genu (CCS-CCG), forceps major, inferior fronto-occipital fasciculus (IFOF), and middle cerebellar peduncle (MCP) observed in group1 compared with the control group. Group1 showed elevated ADC values in CCG. Lower FA and higher ADC values in CCG were shown in group3. The FA values for CCS, IFOF, and MCP in group3 were lower than those in the control group. Group3 had the highest ADC values in the CCS. Additionally, the FA values of the CCG were lower in group3 than in group2. Oxygen saturation levels and FA values in the CCG and SFOF exhibited apositive correlation. We speculate that DTI changes in white matter pathways may be associated with axonal damage and demyelination due to impaired white matter integrity following COVID-19 infection during the subacute period. Our study showed with DTI findings that there is microstructural damage in white matter pathways in the subacute period of COVID-19 infection and that this damage is related to oxygen saturation levels. Many studies in the literature show that microstructural damage in white matter pathways can lead to clinical neurocognitive dysfunction. We suggest that these cases require more comprehensive studies investigating whether chronic white matter damage is reversible and examining its relationship with neurocognitive dysfunctions in the future. Neurological involvement is not rare in COVID-19 infection. We examined various white matter pathways with DTI during the subacute period of COVID-19 infection. We showed changes in DTI parameters indicating adecrease in white matter integrity and microstructural damage in the subacute period follow-up of cases with COVID-19. We found that there was apositive correlation between oxygen saturation levels and decreased FA values in white matter tracts.
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