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Cognitive Deficits in the Acute Phase of COVID-19: A Review and Meta-Analysis. J Clin Med 2023; 12:jcm12030762. [PMID: 36769410 PMCID: PMC9917639 DOI: 10.3390/jcm12030762] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
This meta-analysis was conducted to quantify the risk of patients exhibiting cognitive deficits in the acute phase of COVID-19 at the time of the first variants (i.e., before the vaccine) and quantify the potential vulnerability of older patients and those who experienced more severe respiratory symptoms. To this end, we searched the LitCovid and EMBASE platforms for articles, including preprints, and included all studies (n = 48) that featured a measurement of cognition, which encompassed 2233 cases of COVID-19. Of these, 28 studies reported scores on global cognitive efficiency scales administered in the acute phase of COVID-19 (up to 3 months after infection). We were able to perform a meta-analysis of proportions on 24 articles (Npatients = 943), and a logistic regression on 18 articles (Npatients = 518). The meta-analysis for proportion indicated that 52.31% of patients with COVID-19 exhibited cognitive deficits in the acute phase. This high percentage, however, has to be interpreted taking in consideration the fact that the majority of patients were hospitalized, and some presented neurological complications, such as encephalopathy. A bootstrap procedure with random resampling revealed that an age of 59 was the threshold at which one would be more prone to present cognitive deficits. However, the severity of respiratory symptoms did not influence the scores on a global cognitive efficiency scale. Overall, our results indicated that neuropsychological deficits were a major consequence of the acute phase of the first forms of COVID-19.
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Smyth J, Umapathysivam K, Hendrix I, Grantham H, Arendts G, Visvanathan R. Review article: Roles of activities of daily living and frailty assessments for residents of residential aged care services in emergency department transfers: A scoping review. Emerg Med Australas 2022; 34:675-686. [DOI: 10.1111/1742-6723.14055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/13/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Affiliation(s)
- James Smyth
- Emergency Department The Queen Elizabeth Hospital Adelaide South Australia Australia
| | | | - Ivanka Hendrix
- Pharmacy Department The Queen Elizabeth Hospital Adelaide South Australia Australia
| | - Hugh Grantham
- School of Nursing, Midwifery and Paramedicine Curtin University Perth Western Australia Australia
| | - Glenn Arendts
- Department of Emergency Medicine, Medical School The University of Western Australia Perth Western Australia Australia
- Centre for Clinical Research in Emergency Medicine Harry Perkins Institute of Medical Research Perth Western Australia Australia
| | - Renuka Visvanathan
- School of Medicine The University of Adelaide Adelaide South Australia Australia
- Aged and Extended Care Services The Queen Elizabeth Hospital Adelaide South Australia Australia
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Degarege A, Naveed Z, Kabayundo J, Brett-Major D. Heterogeneity and Risk of Bias in Studies Examining Risk Factors for Severe Illness and Death in COVID-19: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:563. [PMID: 35631084 PMCID: PMC9147100 DOI: 10.3390/pathogens11050563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 05/02/2022] [Accepted: 05/05/2022] [Indexed: 02/07/2023] Open
Abstract
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I2, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis (n = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
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Affiliation(s)
- Abraham Degarege
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA; (Z.N.); (J.K.); (D.B.-M.)
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Rodriguez-Sanchez I, Rodriguez-Mañas L, Laosa O. Long COVID-19: The Need for an Interdisciplinary Approach. Clin Geriatr Med 2022; 38:533-544. [PMID: 35868671 PMCID: PMC8934714 DOI: 10.1016/j.cger.2022.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Isabel Rodriguez-Sanchez
- Geriatrics Department, Hospital Clínico San Carlos, c/ Profesor Martín Lagos s/n, 28040-Madrid, Spain
| | - Leocadio Rodriguez-Mañas
- Servicio de Geriatría, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.5, 28905-Getafe, Spain; Centro de Investigación Biomédica en Red "Fragilidad y Envejecimiento Saludable" (CIBERFES), Instituto de Salud Carlos III, c/ Sinesio Delgado, 10, 28029-Madrid, Spain.
| | - Olga Laosa
- Servicio de Geriatría, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.5, 28905-Getafe, Spain; Geriatric Research Group, Biomedical Research Foundation at Hospital Universitario de Getafe, Carretera de Toledo, Km 12.5, 28905-Getafe, Spain
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Grau-López L, Daigre C, Palma-Alvarez RF, Sorribes-Puertas M, Serrano-Pérez P, Quesada-Franco M, Segura L, Coronado M, Ramos-Quiroga JA, Colom J. COVID-19 Lockdown and Consumption Patterns among Substance Use Disorder Outpatients: A Multicentre Study. Eur Addict Res 2022; 28:243-254. [PMID: 35038702 PMCID: PMC8805052 DOI: 10.1159/000521425] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022]
Abstract
INTRODUCTION COVID-19 has had a great impact on mental health in the general population. However, few studies have focused on patients with substance use disorders (SUDs). This research aimed to compare the clinical status and substance use patterns of SUD outpatients, before and during confinement due to the COVID-19 pandemic. METHODS This multicentre study recruited 588 patients (29.2% women; M age = 47.4 ± 11.7 years) in thirteen centres for addiction treatment in Catalonia, Spain. All subjects were evaluated with validated instruments and ad hoc questionnaires. The sample was divided into 3 groups according to how the substance consumption pattern changed during lockdown (maintained pattern, worsened pattern, and improved pattern). RESULTS More than 62% of the patients maintained or worsened their consumption pattern during confinement, and about 38% improved throughout this time. Diverse factors were associated with the changes in pattern like age, addiction severity, psychological distress during lockdown, social and familial issues, and therapeutic variables. CONCLUSION The home lockdown during the COVID-19 pandemic was associated with major implications for substance consumption and psychiatric distress among SUD outpatients. Considering this, the need to plan appropriate interventions in cases of similar health crises is highlighted.
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Affiliation(s)
- Lara Grau-López
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Constanza Daigre
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Raúl Felipe Palma-Alvarez
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Marta Sorribes-Puertas
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Pedro Serrano-Pérez
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Marta Quesada-Franco
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Lidia Segura
- Subdirecció general de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Marta Coronado
- Subdirecció general de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Addiction and Dual Diagnosis Section, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatry Group, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Joan Colom
- Subdirecció general de Drogodependències, Agència de Salut Pública de Catalunya, Barcelona, Spain
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Kastora S, Kounidas G, Perrott S, Carter B, Hewitt J, Myint PK. Clinical frailty scale as a point of care prognostic indicator of mortality in COVID-19: a systematic review and meta-analysis. EClinicalMedicine 2021; 36:100896. [PMID: 34036252 PMCID: PMC8141355 DOI: 10.1016/j.eclinm.2021.100896] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/19/2021] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND COVID-19 has resulted in the largest pandemic experienced since 1918, accounting for over 2 million deaths globally. Frail and older people are at the highest risk of mortality. The main objective of the present research was to quantify the impact of clinical frailty scale (CFS) by increasing severity of frailty and to identify other personal prognostic factors associated with increased mortality from COVID-19. METHODS This study offers a contemporary systematic review and meta-analysis to analyse the stratified mortality risk by increasing CFS sub-categories (1-3, 4-5 and 6-9). Databases searched included EMBASE, MEDLINE, CAB Abstracts, PsychInfo, and Web of Science with end-search restriction the 18th December 2020. Publications identified via MedRevix were followed up on the 23rd March 2021 in peer-reviewed database search, and citations were updated as published. Prospective and retrospective cohort studies which reported the association between CFS and COVID-19 mortality were included. Thirty-four studies were eligible for systematic review and seventeen for meta-analysis, with 81-87% (I2) heterogeneity. FINDINGS All studies [N: 34] included patients from a hospital setting, comprising a total of 18,042 patients with mean age 72.8 (Min: 56; Max: 86). The CFS 4-5 patient group had significantly increased mortality when compared to patients with CFS 1-3 [(RE) OR 1.95 (1.32 (95% CI), 2.87 (95% CI)); I2 81%; p = 0.0008]. Furthermore, CFS 6-9 patient group displayed an even more noticeable mortality increase when compared to patients with CFS 1-3 [(RE) OR 3.09 (2.03, 4.71); I2 87%; p<0.0001]. Generic inverse variance analysis of adjusted hazard ratio among included studies highlighted that CFS (p = 0.0001), male gender (p = 0.0009), National Early Warning Score (p = 0.0001), Ischaemic Heart Disease (IHD) (p = 0.07), Hypertension (HT) (p<0.0001), and Chronic Kidney Disease (CKD) (p = 0.0009) were associated with increased COVID-19 mortality. INTERPRETATION Our findings suggest a differential stratification of CFS scores in the context of COVID-19 infection, in which CFS 1-3 patients may be considered at lower risk, CFS 4-5 at moderate risk, and CFS 6-9 at high risk of mortality regardless of age. Overall, our study not only aims to alert clinicians of the value of CFS scores, but also highlight the multiple dimensions to consider such as age, gender and co-morbidities, even among moderately frail patients in relation to COVID-19 mortality. FUNDING None.
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Affiliation(s)
- Stavroula Kastora
- Medical Sciences & Nutrition, University of Aberdeen School of Medicine, Aberdeen, United Kingdom
| | - Georgios Kounidas
- Medical Sciences & Nutrition, University of Aberdeen School of Medicine, Aberdeen, United Kingdom
| | - Sarah Perrott
- Medical Sciences & Nutrition, University of Aberdeen School of Medicine, Aberdeen, United Kingdom
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Phyo Kyaw Myint
- Medical Sciences & Nutrition, University of Aberdeen School of Medicine, Aberdeen, United Kingdom
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