Prolonged cognitive deficits after COVID-19 (original) (raw)
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Long-Lasting Cognitive Abnormalities after COVID-19
Brain Sciences
Considering the mechanisms capable of causing brain alterations in COVID-19, we aimed to study the occurrence of cognitive abnormalities in the months following hospital discharge. We recruited 38 (aged 22–74 years; 27 males) patients hospitalized for complications of SARS-CoV-2 infection in nonintensive COVID units. Participants underwent neuropsychological testing about 5 months after hospital discharge. Of all patients, 42.1% had processing speed deficits, while 26.3% showed delayed verbal recall deficits. Twenty-one percent presented with deficits in both processing speed and verbal memory. Bivariate analysis revealed a positive correlation between the lowest arterial oxygen partial pressure (PaO2) to fractional inspired oxygen (FiO2) (P/F) ratio during hospitalization and verbal memory consolidation performance (SRT-LTS score, r = 0.404, p = 0.027), as well as a positive correlation between SpO2 levels upon hospital arrival and delayed verbal recall performance (SRT-D score, rs...
Brain, Behavior, & Immunity - Health, 2020
Background: Cognitive manifestations associated with the severity of a novel coronavirus (COVID-19) infection are unknown. An early detection of neuropsychological manifestations could modify the risk of subsequent irreversible impairment and further neurocognitive decline. Methods: In our single-center cohort study, we included all consecutive adult patients, aged between 20 and 60 years old with confirmed COVID-19 infection. Neuropsychological assessment was performed by the same trained neuropsychologist from April, 22nd through June 16th, 2020. Patients with previous known cognitive impairment, any central nervous system or psychiatric disease were excluded. Demographic, clinical, pharmacological and laboratory data were extracted from medical records. Results: Thirty-five patients met inclusion criteria and were included in the study. Patients presenting headache, anosmia, dysgeusia, diarrhea and those who required oxygen therapy had lower scores in memory, attention and executive function subtests as compared to asymptomatic patients. Patients with headache and clinical hypoxia scored lower in the global Cognitive Index (P ¼ 0.002, P ¼ 0.010). A T score lower than 30 was observed in memory domains, attention and semantic fluency (2 [5.7%]) in working memory and mental flexibility (3 [8.6%]) and in phonetic fluency (4 [11.4%]). Higher scores in anxiety and depression (P ¼ 0.047, P ¼ 0.008) were found in patients with cognitive complaints. Conclusions: In our cohort of COVID-19 patients neurologic manifestations were frequent, including cognitive impairment. Neurological symptoms during infection, diarrhea and oxygen therapy were risk factors for neurocognitive impairment. Cognitive complaints were associated with anxiety and depression. * Corresponding author. Hospital Universitari MútuaTerrassa, plaça dels drets humans n 1 (planta-3 despatx. 324),
Clinical features and cognitive sequelae in COVID-19: a retrospective study on N=152 patients
Neurological Sciences
Background The novel human coronavirus (SARS-CoV-2) shows neurotropism and systemically affects the central nervous system (CNS). Cognitive deficits have been indeed reported as both short-and long-term sequelae of SARS-CoV-2 infection. However, the association between these disturbances and background/disease-related clinical features remains elusive. This work aimed at exploring how post-infective cognitive status relates to clinical/treatment outcomes by controlling for premorbid/current risk factors for cognitive deficits. Methods Cognitive measures (Mini-Mental State Examination, MMSE) of N=152 COVID-19 patient were retrospectively assessed in relation to disease severity, intensive care unit (ICU) admission, steroidal treatment, and occurrence of other viral/bacterial infections by controlling for remote/recent/COVID-19-related risk factors for cognitive deficits (at-risk vs. not-at-risk: Neuro+ vs. Neuro−). Results Descriptively, impaired MMSE performances were highly prevalent in mild-to-moderate patients (26.3%). ICUadmitted patients made more errors (p=.021) on the MMSE than those not admitted when partialling out risk factors and age-the latter negatively influencing performances. When addressing Neuro− patients only, steroidal treatment appears to improve MMSE scores among those suffering from other infections (p=.025). Discussion Cognitive sequelae of COVID-19 are likely to arise from a complex interplay between background/clinical premorbid features and disease-related/interventional procedures and outcomes. Mild-to-moderate patients requiring assistive ventilation who however are not admitted to an ICU are more likely to suffer from cognitive deficits-despite their etiology remaining elusive.
Critical Care
Background Cognitive impairment has emerged as a common post-acute sequela of coronavirus disease 2019 (COVID-19). We hypothesised that cognitive impairment exists in patients after COVID-19 and that it is most severe in patients admitted to the intensive care unit (ICU). Methods This prospective controlled cohort study of 213 participants performed at the Helsinki University Hospital and the University of Helsinki, Finland, comprised three groups of patients—ICU-treated (n = 72), ward-treated (n = 49), and home-isolated (n = 44)—with confirmed COVID-19 between March 13 and December 31, 2020, participating in a comprehensive neuropsychological evaluation six months after the acute phase. Our study included a control group with no history of COVID-19 (n = 48). Medical and demographic data were collected from electronic patient records and interviews carried out four months after the acute phase. Questionnaires filled six months after the acute phase provided information about change ...
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulting in coronavirus disease 2019 (COVID-19), has caused a pandemic. There is now considerable evidence that neuropsychological functions could be affected. We further tested this hypothesis on a sample of post COVID-19 patients, who, initially, had been severely affected.METHODS: We tested 22 post COVID-19 patients who, after the intensive care unit, were submitted to our rehabilitation unit to be treated for severe post COVID-19 sequelae. All patients were assessed with a comprehensive neuropsychological battery including measures assessing perceptual, attentive, mnestic, linguistic, and executive functions, and overall cognitive status. The patients were also administered rehabilitation measures including scales for investigating aerobic capacity/endurance deficits, dyspnea, and fatigue. RESULTS: Our findings revealed that evidence of neuropsychological disorders on post COVID-19 patients was very limit...
Cognitive impact on patients with COVID-19 infection
The Egyptian Journal of Bronchology
Background SARS‐COV‐2 infection reframed medical knowledge in many aspects, yet there is still a lot to be discovered. Coronavirus disease 19 (COVID-19) can cause neuropsychiatric, psychological, and psychosocial impairments. Literature regarding the cognitive impact of COVID-19 is still limited. This study aims to evaluate cognitive function, anxiety, and depression among patients with coronavirus disease 19. Methods Sixty COVID-19 patients were recruited and sub-grouped according to the site of care into three groups, home isolation, ward, and RICU, and compared with 60 matched control participants. Entire clinical history, O2 saturation, mini-mental state examination (MMSE), Hamilton’s anxiety (HAM-A), and depression rating scales (HAM-D) were assessed. Results MMSE showed significantly lowest results for the ICU group, with a value of 21.65 ± 3.52. Anxiety levels were the highest for the ICU group, with a highly significant difference vs. the home isolation group (42.45 ± 4.85 v...
Cognitive impairment associated with COVID-19: a literature review
São Paulo Medical Journal, 2021
Background: SARS-CoV-2 is capable of causing neurological symptoms of the CNS in addition to respiratory and gastrointestinal symptoms. Early knowledge of the possible cognitive functions compromised by the infection will allow the health system to anticipate and create measures to minimize irreversible damage. Objectives: to analyze the cognitive impairment associated with COVID-19, taking into account its pathophysiological mechanisms and their short and long-term consequences. Methods: Narrative review of 62 articles, based on an active search on the PubMed, Google Scholar, Jama and American Academy of Neurology research platforms. Results: Cognitive impairment can be present both during and after infection. The main risk factors for cognitive impairments in the short term are: other neurological symptoms (headache, anosmia, dysgeusia); diarrhea and oxygen therapy. The main cognitive functions affected were memory, attention, executive functions (mental flexibility) and language ...
Frequent neurocognitive deficits after recovery from mild COVID-19
Brain Communications, 2020
Neuropsychiatric complications associated with coronavirus disease 2019 caused by the Coronavirus SARS-CoV-2 (COVID-19) are increasingly appreciated. While most studies have focussed on severely affected individuals during acute infection, it remains unclear whether mild COVID-19 results in neurocognitive deficits in young patients. Here, we established a screening approach to detect cognitive deficiencies in post-COVID-19 patients. In this cross-sectional study, we recruited 18 mostly young patients 20–105 days (median, 85 days) after recovery from mild to moderate disease who visited our outpatient clinic for post-COVID-19 care. Notably, 14 (78%) patients reported sustained mild cognitive deficits and performed worse in the Modified Telephone Interview for Cognitive Status screening test for mild cognitive impairment compared to 10 age-matched healthy controls. While short-term memory, attention and concentration were particularly affected by COVID-19, screening results did not co...
2020
IntroductionCOVID-19 complications can include neurological, psychiatric, psychological, and psychosocial impairments. Little is known on the consequences of SARS-COV-2 on cognitive functions of patients in the sub-acute phase of the disease. We aimed to investigate the impact of COVID-19 on cognitive functions of patients admitted to the COVID-19 Rehabilitation Unit of the San Raffaele Hospital (Milan, Italy).Material and Methods87 patients admitted to the COVID-19 Rehabilitation Unit from March 27th to June 20th 2020 were included. Patients underwent Mini Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Functional Independence Measure (FIM). Data were divided in 4 groups according to the respiratory assistance in the acute phase: Group1 (orotracheal intubation), Group2 (non-invasive ventilation using Biphasic Positive Airway Pressure), Group3 (Venturi Masks), Group4 (no oxygen therapy). Follow-ups were performed at one...
Cognitive impairment and risk factors in post COVID-19 hospitalized patients
Dementia and Geriatric Cognitive Disorders Extra
Introduction: Numerous reports regarding cognitive deficits after the coronavirus disease 2019 (COVID-19) described as “brain fog” have been published. However, the clinical presentations and risk factors of post COVID-19 cognitive impairment are controversial. This study aimed to assess a) the prevalence of cognitive impairment after COVID-19 hospitalization, b) characteristics of the cognitive deficits, c) risk factors of post COVID-19 cognitive impairment, and d) comparison of cognitive function between post COVID-19 patients and healthy people. Methods: The study comprised 34 SARS-CoV-2 infected patients, admitted to Neurological Institute of Thailand during the peak of COVID-19 pandemic in 2021-2022. These patients came for neuropsychological and clinical evaluations at two weeks follow-up visit. The cognitive impairment and characteristics were measured by TMSE and MoCA. Clinical risk factors and post COVID-19 cognitive impairment were assessed. The comparison of cognitive fun...