1
|
Leonel JW, Ciurleo GCV, Formiga AM, Vasconcelos TDMF, de Andrade MH, Feitosa WLQ, Sobreira-Neto AA, Portugal CG, Morais LM, Marinho SC, Gomes EDABM, Feitosa EDAAF, Sobreira EST, Oriá RB, Sobreira-Neto MA, Braga-Neto P. Long COVID: neurological manifestations - an updated narrative review. Dement Neuropsychol 2024; 18:e20230076. [PMID: 38425701 PMCID: PMC10901563 DOI: 10.1590/1980-5764-dn-2023-0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/21/2023] [Indexed: 03/02/2024] Open
Abstract
Infection with the SARS-CoV-2 virus can lead to neurological symptoms in the acute phase and in the Long COVID phase. These symptoms usually involve cognition, sleep, smell disorders, psychiatric manifestations, headache and others. This condition is more commonly described in young adults and women. This symptomatology can follow severe or mild cases of the disease. The importance of this issue resides in the high prevalence of neurological symptoms in the Long COVID phase, which entails significant morbidity in this population. In addition, such a condition is associated with high health care costs, with some estimates hovering around 3.7 trillion US dollars. In this review, we will sequentially describe the current knowledge about the most prevalent neurological symptoms in Long COVID, as well as their pathophysiology and possible biomarkers.
Collapse
|
2
|
Birberg Thornberg U, Andersson A, Lindh M, Hellgren L, Divanoglou A, Levi R. Neurocognitive deficits in COVID-19 patients five months after discharge from hospital. Neuropsychol Rehabil 2023; 33:1599-1623. [PMID: 36239662 DOI: 10.1080/09602011.2022.2125020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 09/11/2022] [Indexed: 10/17/2022]
Abstract
This observational cohort study explored objective neurocognitive deficits in COVID-19 patients five months after discharge, and any associations with demographic factors and disease severity indicators. Medical notes of all COVID-19 patients admitted to hospital in Region Östergötland, Sweden, March-May 2020, were reviewed. After applying exclusion criteria, 433 patients were screened by telephone. Of these, 185 patients reported persistent and concerning post-COVID-19 problems, including but not restricted to cognitive functions, and were invited to a clinical evaluation. The Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and Colour-Word Interference Test (CWIT) were used to assess immediate memory, visuo-spatial function, language, attention, delayed memory, and executive function. A total of 133 patients had valid test performances. Mean RBANS Global Cognition Score was 83.4, with 37% scoring below cut-off (1.5 SD). Deficits in Attention and Memory indices were most common, each affecting approximately 30% of the patients. After adjustment for sex, language, level of education and premorbid function, neurocognitive performance was positively associated with length of hospital stay, but not with the disease severity indicators WHO CPS and CRP. Findings support that comprehensive neuropsychological assessment should be performed when patients report post-COVID-19 symptoms that affect daily life.
Collapse
Affiliation(s)
- Ulrika Birberg Thornberg
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Agnes Andersson
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Malin Lindh
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Lovisa Hellgren
- Department of Rehabilitation Medicine, Region Jönköping County, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Anestis Divanoglou
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Richard Levi
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| |
Collapse
|
3
|
Tsiaras Y, Kitsakis N, Papadopoulou E, Karanikas E, Kourbetis D, Aretouli E. Neuropsychological Profile of Hospitalized Patients Due to COVID-19: Clinical and Inflammatory Correlates. Arch Clin Neuropsychol 2023; 38:1564-1577. [PMID: 37210601 DOI: 10.1093/arclin/acad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2023] [Indexed: 05/22/2023] Open
Abstract
OBJECTIVES In the present study, we investigated the pattern of cognitive difficulties in hospitalized patients due to COVID-19 and its relation with the clinical features of the disease. METHOD Forty hospitalized patients with COVID-19 [mean age: 46.98 years (SD = 9.30); mean years of education: 13.65 (SD = 2.07) and 40 sex-, age- and education-matched healthy controls completed a set of neuropsychological measures administered by telephone. Participants' premorbid intellectual skills and patients' anxiety and depressive symptoms were also evaluated. The association of COVID-19-related biomarkers [oxygen saturation (SpO2), C-reactive protein (CRP), D-dimer and ferritin levels] with neuropsychological performances was examined with a series of hierarchical multiple linear regression analyses, after controlling for demographic and clinical characteristics, psychological distress and premorbid intellectual skills. RESULTS Patients performed worse than healthy participants on measures of verbal memory, attention and working memory. SpO2 levels were associated with patients' performance on verbal and working memory, whereas CRP levels were associated with performance on verbal memory, abstract reasoning and verbal fluency, after controlling for demographic and clinical characteristics. Ferritin levels predicted performance on the verbal fluency test, whereas D-dimer levels did not predict any of the neuropsychological measures. CONCLUSIONS Cognitive difficulties in verbal memory, attention and working memory were noted in patients with COVID-19. Markers of hyperinflammation predicted patients' performance above and beyond demographic characteristics, duration of symptoms, length of hospitalization and psychological distress.
Collapse
Affiliation(s)
- Yiannis Tsiaras
- Psychiatric Department, 424 General Military Hospital, Thessaloniki, Greece
- School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Nikolaos Kitsakis
- Psychiatric Department, 424 General Military Hospital, Thessaloniki, Greece
| | - Eleftheria Papadopoulou
- Cognitive Neuroscience Lab, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki Greece
| | | | | | - Eleni Aretouli
- School of the Social Sciences, University of Ioannina, Ioannina, Greece
- Cognitive Neuroscience Lab, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki Greece
| |
Collapse
|
4
|
Chaudhary R, Rohilla M, Chauhan S, Saini M, Aman S, Singla H, bibi A, Ahmed S, Shriwastav S, Kaur N, Dev J, Chalotra R, Singh TG, Mehta S. The pandemic's unseen wounds: COVID-19's profound effects on mental health. Ann Med Surg (Lond) 2023; 85:4954-4963. [PMID: 37811101 PMCID: PMC10552974 DOI: 10.1097/ms9.0000000000001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/12/2023] [Indexed: 10/10/2023] Open
Abstract
Objective This review aims to explore the impact of the COVID-19 pandemic on mental health, with a focus on the physiological and psychological consequences, including comorbidities. The goal is to understand the direct and indirect populations affected by mental distress and identify potential interventions. Methodology A comprehensive literature search was conducted using various databases, including Google Scholar, ResearchGate, ScienceDirect, PubMed, PLoS One, and Web of Science. The search utilized relevant keywords to investigate the direct and indirect impacts of COVID-19 on mental health. The selected articles were critically evaluated and analyzed to identify key findings and insights. Main findings Mental health, being an intrinsic component of overall well-being, plays a vital role in physiological functioning. The COVID-19 pandemic, caused by the emergence of the novel SARS-CoV-2 virus, has had a devastating global impact. Beyond the respiratory symptoms, individuals recovering from COVID-19 commonly experience additional ailments, such as arrhythmia, depression, anxiety, and fatigue. Healthcare professionals on the frontlines face an elevated risk of mental illness. However, it is crucial to recognize that the general population also grapples with comparable levels of mental distress. Conclusion The COVID-19 pandemic has underscored the significance of addressing mental health concerns. Various strategies can help mitigate the impact, including counselling, fostering open lines of communication, providing mental support, ensuring comprehensive patient care, and administering appropriate medications. In severe cases, treatment may involve the supplementation of essential vitamins and antidepressant therapy. By understanding the direct and indirect impacts of COVID-19 on mental health, healthcare providers and policymakers can develop targeted interventions to support individuals and communities affected by the pandemic. Continued research and collaborative efforts are essential to address this pervasive issue effectively.
Collapse
Affiliation(s)
| | - Manni Rohilla
- Chitkara College of Pharmacy, Chitkara University
- Swami Vivekanand College of Pharmacy, Rajpura, Punjab
| | | | - Monika Saini
- M.M. College of Pharmacy
- Swami Vivekanand College of Pharmacy, Rajpura, Punjab
| | - Shahbaz Aman
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | | | | | | | - Shalini Shriwastav
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | - Narinder Kaur
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | - Jai Dev
- Department of Microbiology, M.M. Institute of Medical Science and Research, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana
| | - Rishabh Chalotra
- Department of Pharmacology, Central University of Punjab, Bathinda, India
| | | | - Sachin Mehta
- Birat Medical college Teaching Hospital, Kathmandu University, Nepal
| |
Collapse
|
5
|
Chollet F, Planton M, Sailler L, De Almeida S, Alvarez M, Pariente J. [Neurological forms of long COVID in adults: Critical approach]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2023:S0001-4079(23)00187-5. [PMID: 37363154 PMCID: PMC10282979 DOI: 10.1016/j.banm.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023]
Abstract
Now recognized by health authorities, long COVID is identified as a frequent condition complicating the evolution of SARS-CoV-2 infection. Its polymorphic and sometimes disconcerting clinical expression raises questions about its mechanism. Patterns of clinical expression suggest extensive involvement of the nervous system through an almost ubiquitous cognitive complaint. This article reviews the neurological symptoms and forms of these patients, and the neuropsychological explorations aimed at objectifying a cognitive deficit. The studies published until now confronted with the clinical mode of expression, did not make it possible to define a deficit neuropsychological profile at the level of the groups, and evoked more a functional impairment than a lesion. However, each series mentions a small number of patients in whom a cognitive deficit is objectified. The uncertainties about the causes of the prolonged forms of COVID, the heterogeneity of the published studies, and the virtual absence of temporal evolution data should make one cautious about the interpretation of these data but should in no way delay or prevent taking into account care of these patients.
Collapse
Affiliation(s)
- François Chollet
- Département de neurologie, CHU de Toulouse, hôpital Pierre-Paul-Riquet, place Baylac, 31059 Toulouse cedex, France
| | - Mélanie Planton
- Département de neurologie, CHU de Toulouse, hôpital Pierre-Paul-Riquet, place Baylac, 31059 Toulouse cedex, France
| | - Laurent Sailler
- Service de médecine interne, CHU de Toulouse, hôpital Purpan, place Baylac, 31059 Toulouse cedex, France
| | - Sébastien De Almeida
- Service de médecine interne, CHU de Toulouse, hôpital Purpan, place Baylac, 31059 Toulouse cedex, France
| | - Muriel Alvarez
- Service des maladies infectieuses, CHU de Toulouse, hôpital Purpan, place Baylac, 31059 Toulouse cedex, France
| | - Jérémie Pariente
- Département de neurologie, CHU de Toulouse, hôpital Pierre-Paul-Riquet, place Baylac, 31059 Toulouse cedex, France
| |
Collapse
|
6
|
İyit N, Sevim F, Kahraman ÜM. Investigating the impact of CO 2 emissions on the COVID-19 pandemic by generalized linear mixed model approach with inverse Gaussian and gamma distributions. OPEN CHEM 2023. [DOI: 10.1515/chem-2022-0301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Abstract
Carbon dioxide (CO2) rate within the atmosphere has been rising for decades due to human activities especially due to usage of fuel types such as coal, cement, flaring, gas, oil, etc. Especially in 2020, COVID-19 pandemic caused major economic, production, and energy crises all around the world. As a result of this situation, there was a sharp decrease in the global CO2 emissions depending on the fuel types used during this pandemic. The aim of this study was to explore the effects of “CO2 emissions due to the fuel types” on “percentage of deaths in total cases” attributed to the COVID-19 pandemic using generalized linear model and generalized linear mixed model (GLMM) approaches with inverse Gaussian and gamma distributions, and also to obtain global statistical inferences about 169 World Health Organization member countries that will disclose the impact of the CO2 emissions due to the fuel types during this pandemic. The response variable is taken as “percentage of deaths in total cases attributed to the COVID-19 pandemic” calculated as “(total deaths/total confirmed cases attributed to the COVID-19 pandemic until December 31, 2020)*100.” The explanatory variables are taken as “production-based emissions of CO2 from different fuel types,” measured in tonnes per person, which are “coal, cement, flaring, gas, and oil.” As a result of this study, according to the goodness-of-fit test statistics, “GLMM approach with gamma distribution” called “gamma mixed regression model” is determined as the most appropriate statistical model for investigating the impact of CO2 emissions on the COVID-19 pandemic. As the main findings of this study, 1 t CO2 emissions belonging to the fuel types “cement, coal, flaring, gas, and oil” per person cause increase in deaths in total cases attributed to the COVID-19 pandemic by 2.8919, 2.6151, 2.5116, 2.5774, and 2.5640%, respectively.
Collapse
Affiliation(s)
- Neslihan İyit
- Statistics Department, Science Faculty, Selcuk University , Konya , Turkey
| | - Ferhat Sevim
- Statistics Department, Science Faculty, Selcuk University , Konya , Turkey
| | - Ümran Münire Kahraman
- Business Administration Department, Faculty of Political Sciences, Necmettin Erbakan University , Konya , Turkey
| |
Collapse
|
7
|
Kirchberger I, Peilstöcker D, Warm TD, Linseisen J, Hyhlik-Dürr A, Meisinger C, Goßlau Y. Subjective and Objective Cognitive Impairments in Non-Hospitalized Persons 9 Months after SARS-CoV-2 Infection. Viruses 2023; 15:256. [PMID: 36680296 PMCID: PMC9865483 DOI: 10.3390/v15010256] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Studies on cognitive problems of persons with mild COVID-19 courses are still lacking. This study aimed to determine the frequency and associated factors of subjective and objective cognitive problems after COVID-19 in non-hospitalized persons. Study participants were examined at the University Hospital of Augsburg from 04/11/2020 to 26/05/2021. The Wechsler Adult Intelligence Scale (WAIS) IV digit span, Stroop Color and Word Test (SCWT), Regensburger verbal fluency test (RWT) and, subjective ratings of memory and concentration were applied. Of the 372 participants (mean age 46.8 ± 15.2 years, 54.3% women, median time after infection 9.1 months), 24.9% reported concentration and 21.9% memory problems. Overall, 55.6% of the participants had at least a mild negative alteration in any cognitive test. The strongest impairments were found regarding memory functions (41.1% mild alterations, 6.2% distinct impairments) and verbal fluency (12.4% mild alterations, 5.4% distinct impairments). SCWT showed negative alterations in no more than 3.0% of the participants. Level of school education, age, and depressiveness emerged as significantly related to the cognitive tests. The number of complaints and depressiveness were significantly associated with subjective memory and concentration problems. It is important to identify mild cognitive impairment in non-hospitalized COVID-19 patients early to offer them effective interventions.
Collapse
Affiliation(s)
- Inge Kirchberger
- Epidemiology, Faculty of Medicine, University of Augsburg, University Hospital of Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology—IBE, LMU Munich, 81377 Munich, Germany
| | - Daniela Peilstöcker
- Epidemiology, Faculty of Medicine, University of Augsburg, University Hospital of Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
| | - Tobias D. Warm
- Vascular Surgery, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany
| | - Jakob Linseisen
- Epidemiology, Faculty of Medicine, University of Augsburg, University Hospital of Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology—IBE, LMU Munich, 81377 Munich, Germany
| | - Alexander Hyhlik-Dürr
- Vascular Surgery, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany
| | - Christine Meisinger
- Epidemiology, Faculty of Medicine, University of Augsburg, University Hospital of Augsburg, Stenglinstraße 2, 86156 Augsburg, Germany
| | - Yvonne Goßlau
- Vascular Surgery, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany
| |
Collapse
|
8
|
Perrottelli A, Sansone N, Giordano GM, Caporusso E, Giuliani L, Melillo A, Pezzella P, Bucci P, Mucci A, Galderisi S. Cognitive Impairment after Post-Acute COVID-19 Infection: A Systematic Review of the Literature. J Pers Med 2022; 12:2070. [PMID: 36556290 PMCID: PMC9781311 DOI: 10.3390/jpm12122070] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
The present study aims to provide a critical overview of the literature on the relationships between post-acute COVID-19 infection and cognitive impairment, highlighting the limitations and confounding factors. A systematic search of articles published from 1 January 2020 to 1 July 2022 was performed in PubMed/Medline. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only studies using validated instruments for the assessment of cognitive impairment were included. Out of 5515 screened records, 72 studies met the inclusion criteria. The available evidence revealed the presence of impairment in executive functions, speed of processing, attention and memory in subjects recovered from COVID-19. However, several limitations of the literature reviewed should be highlighted: most studies were performed on small samples, not stratified by severity of disease and age, used as a cross-sectional or a short-term longitudinal design and provided a limited assessment of the different cognitive domains. Few studies investigated the neurobiological correlates of cognitive deficits in individuals recovered from COVID-19. Further studies with an adequate methodological design are needed for an in-depth characterization of cognitive impairment in individuals recovered from COVID-19.
Collapse
Affiliation(s)
| | | | - Giulia Maria Giordano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, 80138 Naples, Italy
| | | | | | | | | | | | | | | |
Collapse
|
9
|
Solodukhin AV, Seryy AV, Varich LA, Bryukhanov YI, Zhikharev AY. Cognitive Behavioral Psychotherapy after COVID-19: Opportunities and Prospects. BULLETIN OF KEMEROVO STATE UNIVERSITY 2022. [DOI: 10.21603/2078-8975-2022-24-4-420-429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article reviews domestic and foreign studies on cognitive behavioral therapy techniques in treating cognitive disorders in former COVID-19 patients. Coronavirus-induced cognitive disorders include damage to the nervous system as a result of respiratory distress syndrome, cytokine storm, cerebral vascular thrombosis, direct exposure to SARS-Cov2, and inadequate immune response. Concomitant mental illnesses include autistic disorders, dementia, cognitive decline, eating disorders, suicidal behavior, anxiety, depression, post-traumatic stress, insomnia, etc. Diagnostic methods usually take into account a complex violation of mental activities, e.g., short memory span, attention deficiency, slow thinking, and various affective disorders. As a result, diagnostic methods can be divided into several areas: neuropsychological diagnostics of cognitive functions (MMSE, MOCA, FAB), identification of inadequate attitudes and behavior (WCQ, SPB, DAS), identification of violations of daily activity (The Barthel Scale), identification of psychological and psychiatric issues (Hospital Anxiety and Depression Scale, State-Trait Anxiety Inventory, Hamilton Rating Scale for Depression). Psychological care for former COVID-19 patients relies on some basic principles. Cognitive behavioral psychotherapy techniques aim at correcting cognitive distortions, teaching relaxation and self-regulation, improving problem-solving skills, and restoring cognitive functions.
Collapse
|
10
|
Neurocognitive Outcome Following Recovery from Severe Acute Respiratory Syndrome - Coronavirus-1 (SARS-CoV-1). J Int Neuropsychol Soc 2022; 28:891-901. [PMID: 34488921 DOI: 10.1017/s1355617721001107] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Severe acute respiratory syndrome (SARS) is a highly contagious viral respiratory illness associated with hypoxia and dyspnea. Many of those who contracted and recovered from SARS during the 2002-2003 outbreak reported persistent physical, psychological, and cognitive difficulties. Here, we investigated the residual influences of SARS on cognition for a subset of healthcare professionals who recovered and were referred for neuropsychological evaluation through their workplace insurance. METHOD Twenty-eight healthcare professionals were evaluated on neuropsychological and mood functioning approximately 1.5 years post-recovery from a severe respiratory illness. Test scores were compared with age-matched normative data, and correlations were examined between mood, self-report memory scales, subjective complaints (e.g., poor concentration, pain, fatigue), illness severity (i.e., length of hospitalization, oxygen use during hospital stay), and cognitive performance. RESULTS Participants performed within age expectations on the majority of cognitive measures including overall memory ability. Although processing speed was generally within normal limits, 43% showed significant speed-accuracy trade-offs favoring accuracy over maintaining speed. Deficits were observed on measures of complex attention, such as working memory and the ability to sustain attention under conditions of distraction. Participants endorsed poorer memory ability than same-age peers on a meta-memory measure and mild to moderate depression and anxiety symptoms. Objective test performance was largely uncorrelated with self-reports, mood, or illness severity, except for moderate correlations between complex attention and participants' subjective ratings of Everyday Task-Oriented Memory. CONCLUSIONS These findings demonstrate specific long-term cognitive deficits associated with SARS and provide further evidence of the cognitive effects of hypoxic illnesses.
Collapse
|
11
|
Vialatte de Pémille C, Ray A, Michel A, Stefano F, Yim T, Bruel C, Zuber M. Prevalence and prospective evaluation of cognitive dysfunctions after SARS due to SARS-CoV-2 virus. The COgnitiVID study. Rev Neurol (Paris) 2022; 178:802-807. [PMID: 35610098 PMCID: PMC9123423 DOI: 10.1016/j.neurol.2022.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 01/08/2023]
Abstract
OBJECTIVE COVID-19 due to SARS-CoV-2 virus is a new cause of severe acute respiratory syndrome (SARS). Little is known about the short-term cognitive prognosis for these patients. We prospectively evaluated basic cognitive functions shortly after care in the intensive care unit (ICU) and three months later in post-ICU COVID-19 patients. MATERIAL AND METHODS We performed a prospective single-center study in our institution in Paris. Patients with SARS-CoV-2 SARS were prospectively recruited via our ICU. Patients were evaluated using standardized cognitive tests at baseline and at three months' follow-up. Our primary endpoint was the evolution of the following five global tests: MMSE, FAB, oral naming test, Dubois five words test and MADRS. RESULTS We explored 13 patients at baseline and follow-up. All patients had cognitive impairment at baseline but they all improved at three months, significantly on two of the five global tests after Bonferroni correction for multiple testing: MMSE (median 18 (IQR [15-22]) and 27 (IQR [27-29]) respectively, P=0.002) and FAB test (median 14 (IQR [14-17]) and 17 (IQR [17,18]) respectively, P=0.002). CONCLUSIONS We report here the first longitudinal data on short-term cognitive impairment after intensive care in COVID-19 patients. We found acute and short-term cognitive impairment but significant improvement at three months. This pattern does not seem to differ from other causes of post-intensive care syndrome.
Collapse
Affiliation(s)
- C Vialatte de Pémille
- Neurological department, groupe hospitalier Paris Saint-Joseph, Paris, France; Université Paris Cité, Paris, France.
| | - A Ray
- Neurological department, groupe hospitalier Paris Saint-Joseph, Paris, France; Université Paris Cité, Paris, France
| | - A Michel
- Neurological department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - F Stefano
- Neurological department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - T Yim
- Neurological department, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - C Bruel
- Intensive care unit, groupe hospitalier Paris Saint-Joseph, Paris, France
| | - M Zuber
- Neurological department, groupe hospitalier Paris Saint-Joseph, Paris, France; Université Paris Cité, Paris, France
| |
Collapse
|
12
|
Wang J, Liang S, Yu M, Gong Z. COVID-19 from the perspective of otorhinolaryngology: An analysis of bibliometrics. Front Public Health 2022; 10:1002686. [PMID: 36211675 PMCID: PMC9539910 DOI: 10.3389/fpubh.2022.1002686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/06/2022] [Indexed: 01/27/2023] Open
Abstract
Background Since it began in December 2019, the coronavirus disease 2019 (COVID-19) outbreak has not been completely contained. COVID-19 has attracted the interest of nations throughout the globe. The global coronavirus outbreak has had an especially devastating effect on otolaryngology. The virus is commonly associated with otorhinolaryngological symptoms. COVID-19 research is becoming more common in otorhinolaryngology. Although various studies on covid-19-related Otorhinolaryngology manifestations have been published, there has been no bibliometric analysis of these articles concentrating on COVID-19-related Otorhinolaryngology research. Methods Original publications on Otolaryngological symptoms on COVID-19 were extracted from the Social Sciences Citation Index (SSCI) and the Science Citation Index-Expanded (SCI-E) databases in Clarivate Analytics' Web of Science Core Collection (WoSCC) between January 2020 and May 2022. CiteSpace and VOSviewer were utilized to detect and assess the research focus and trends in this field by extracting the country/region, institution, author, journal, references, and keywords related to this topic. Results A total of 631 journals from 97 countries were included in the total of 1,528 articles. Most of the articles on this topic were published in the United States, which had the most citations and the highest H-index. Huazhong University of Science and Technology is the institution with the largest number of articles in the research of COVID-19-related Otorhinolaryngology diseases. Claire Hopkins was the most prolific author belonging to Guy's and St. Thomas' NHS Foundation Trust. Huang CL from Jin Yin-tan Hospital received the most citations among all authors. The most cited article was Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, which was created by Huang CL. Most of the studies relating to COVID-19 and Otorhinolaryngology diseases were published in the European Archives of Oto-Rhino-Laryngology. Conclusion COVID-related research in the field of otorhinolaryngology has been studied in terms of descriptive quantitative metrics, which show that academics from around the world are working together to combat this pandemic.
Collapse
Affiliation(s)
- Ji Wang
- Department of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Sai Liang
- Department of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Ming Yu
- Laryngology and Otology, the Affiliated Baiyun Hospital of Guizhou Medical University, Guiyang, China,*Correspondence: Ming Yu
| | - Zhengpeng Gong
- Department of Clinical Medicine, Guizhou Medical University, Guiyang, China,Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China,Zhengpeng Gong
| |
Collapse
|
13
|
Devita M, Di Rosa E, Iannizzi P, Bianconi S, Contin SA, Tiriolo S, Ghisi M, Schiavo R, Bernardinello N, Cocconcelli E, Balestro E, Cattelan AM, Leoni D, Volpe B, Mapelli D. Risk and Protective Factors of Psychological Distress in Patients Who Recovered From COVID-19: The Role of Cognitive Reserve. Front Psychol 2022; 13:852218. [PMID: 35719579 PMCID: PMC9204198 DOI: 10.3389/fpsyg.2022.852218] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/05/2022] [Indexed: 01/06/2023] Open
Abstract
Recent studies reported the development of psychological distress symptoms in patients who recovered from COVID-19. However, evidence is still scarce and new data are needed to define the exact risk and protective factors that can explain the variability in symptoms manifestation. In this study, we enrolled 257 patients who recovered from COVID-19 and we evaluated the levels of psychological distress through the Symptoms Checklist-90-R scale. Data concerning illness-related variables were collected from medical records, while the presence of subjective cognitive difficulties, both before and after the illness, as well as the level of the cognitive reserve (CR), were assessed over a clinical interview. Results revealed that being female and reporting the presence of subjective cognitive difficulties after COVID-19 were associated with higher levels of psychological distress. At the same time, being admitted to the hospital and having a high CR were protective factors. Adding new information to this emerging research field, our results highlight the importance of a complete psychological and cognitive assessment in patients with COVID-19.
Collapse
Affiliation(s)
- Maria Devita
- Department of General Psychology, University of Padua, Padua, Italy
| | - Elisa Di Rosa
- Department of General Psychology, University of Padua, Padua, Italy
| | - Pamela Iannizzi
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Sara Bianconi
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Sara Anastasia Contin
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Simona Tiriolo
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padua, Padua, Italy
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Rossana Schiavo
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Nicol Bernardinello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Elisabetta Cocconcelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Elisabetta Balestro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | | | - Davide Leoni
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Biancarosa Volpe
- Unitá Operativa Complessa (UOC) Hospital Psychology, Padua University Hospital, Padua, Italy
| | - Daniela Mapelli
- Department of General Psychology, University of Padua, Padua, Italy
| |
Collapse
|
14
|
Palladini M, Bravi B, Colombo F, Caselani E, Di Pasquasio C, D'Orsi G, Rovere-Querini P, Poletti S, Benedetti F, Mazza MG. Cognitive remediation therapy for post-acute persistent cognitive deficits in COVID-19 survivors: A proof-of-concept study. Neuropsychol Rehabil 2022:1-18. [PMID: 35583357 DOI: 10.1080/09602011.2022.2075016] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
ABSTRACTCognitive impairments figure prominently in COVID-19 survivors. Cognitive remediation therapy (CRT) improves functional outcomes reducing long-term cognitive deficits in several neurological and psychiatric conditions. Our case-control study investigates the efficacy of a CRT programme administered to COVID-19 survivors in the post-acute phase of the illness. Seventy-three COVID-19 survivors presenting cognitive impairments at one-month follow-up were enrolled. Among them, 15 patients were treated with a two-month CRT programme, and 30 non-treated patients were matched conditional to their baseline cognitive functioning. Cognitive functions were assessed before and after treatment. Depression and quality of life were also evaluated. Mixed model ANOVA revealed a significant effect over time of the CRT programme on global cognitive functioning (F = 4.56, p = 0.039), while no significant effect was observed in the untreated group. We observed a significant effect of the improvement in verbal fluency (χ2 = 7.20, p = 0.007) and executive functions (χ2 = 13.63, p < 0.001) on quality of life. A positive significant correlation was found between depressive symptomatology and verbal fluency (r = -0.35), working memory (r = -0.44), psychomotor coordination (r = -0.42), and executive functions (r = -0.33). Our results could pave the way to a plausible innovative treatment targeting cognitive impairments and ameliorating the quality of life of COVID-19 survivors.
Collapse
Affiliation(s)
- Mariagrazia Palladini
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
| | - Beatrice Bravi
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
| | - Federica Colombo
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
| | - Elisa Caselani
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Camilla Di Pasquasio
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Greta D'Orsi
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy
| | - Patrizia Rovere-Querini
- Vita-Salute San Raffaele University, Milano, Italy.,Division of Immunology, Transplantation and Infectious Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Poletti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,Vita-Salute San Raffaele University, Milano, Italy
| | - Francesco Benedetti
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,Vita-Salute San Raffaele University, Milano, Italy
| | - Mario Gennaro Mazza
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, IRCCS Scientific Institute Ospedale San Raffaele, Milano, Italy.,PhD Program in Cognitive Neuroscience, University Vita-Salute San Raffaele, Milan, Italy
| |
Collapse
|
15
|
Liu YH, Chen Y, Wang QH, Wang LR, Jiang L, Yang Y, Chen X, Li Y, Cen Y, Xu C, Zhu J, Li W, Wang YR, Zhang LL, Liu J, Xu ZQ, Wang YJ. One-Year Trajectory of Cognitive Changes in Older Survivors of COVID-19 in Wuhan, China: A Longitudinal Cohort Study. JAMA Neurol 2022; 79:509-517. [PMID: 35258587 PMCID: PMC8905512 DOI: 10.1001/jamaneurol.2022.0461] [Citation(s) in RCA: 122] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Importance Determining the long-term impact of COVID-19 on cognition is important to inform immediate steps in COVID-19 research and health policy. Objective To investigate the 1-year trajectory of cognitive changes in older COVID-19 survivors. Design, Setting, and Participants This cohort study recruited 3233 COVID-19 survivors 60 years and older who were discharged from 3 COVID-19-designated hospitals in Wuhan, China, from February 10 to April 10, 2020. Their uninfected spouses (N = 466) were recruited as a control population. Participants with preinfection cognitive impairment, a concomitant neurological disorder, or a family history of dementia were excluded, as well as those with severe cardiac, hepatic, or kidney disease or any kind of tumor. Follow-up monitoring cognitive functioning and decline took place at 6 and 12 months. A total of 1438 COVID-19 survivors and 438 control individuals were included in the final follow-up. COVID-19 was categorized as severe or nonsevere following the American Thoracic Society guidelines. Main Outcomes and Measures The main outcome was change in cognition 1 year after patient discharge. Cognitive changes during the first and second 6-month follow-up periods were assessed using the Informant Questionnaire on Cognitive Decline in the Elderly and the Telephone Interview of Cognitive Status-40, respectively. Based on the cognitive changes observed during the 2 periods, cognitive trajectories were classified into 4 categories: stable cognition, early-onset cognitive decline, late-onset cognitive decline, and progressive cognitive decline. Multinomial and conditional logistical regression models were used to identify factors associated with risk of cognitive decline. Results Among the 3233 COVID-19 survivors and 1317 uninfected spouses screened, 1438 participants who were treated for COVID-19 (691 male [48.05%] and 747 female [51.95%]; median [IQR] age, 69 [66-74] years) and 438 uninfected control individuals (222 male [50.68%] and 216 female [49.32%]; median [IQR] age, 67 [66-74] years) completed the 12-month follow-up. The incidence of cognitive impairment in survivors 12 months after discharge was 12.45%. Individuals with severe cases had lower Telephone Interview of Cognitive Status-40 scores than those with nonsevere cases and control individuals at 12 months (median [IQR]: severe, 22.50 [16.00-28.00]; nonsevere, 30.00 [26.00-33.00]; control, 31.00 [26.00-33.00]). Severe COVID-19 was associated with a higher risk of early-onset cognitive decline (odds ratio [OR], 4.87; 95% CI, 3.30-7.20), late-onset cognitive decline (OR, 7.58; 95% CI, 3.58-16.03), and progressive cognitive decline (OR, 19.00; 95% CI, 9.14-39.51), while nonsevere COVID-19 was associated with a higher risk of early-onset cognitive decline (OR, 1.71; 95% CI, 1.30-2.27) when adjusting for age, sex, education level, body mass index, and comorbidities. Conclusions and Relevance In this cohort study, COVID-19 survival was associated with an increase in risk of longitudinal cognitive decline, highlighting the importance of immediate measures to deal with this challenge.
Collapse
Affiliation(s)
- Yu-Hui Liu
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yang Chen
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Qing-Hua Wang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Ling-Ru Wang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Li Jiang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Ying Yang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Xian Chen
- Department of Anaesthesiology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Ying Li
- Department of Ophthalmology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yuan Cen
- Department of Orthopedics, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Cheng Xu
- Department of Oncology, General Hospital of the Central Theatre Command of the People's Liberation Army, Wuhan, China
| | - Jie Zhu
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Wei Li
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Ye-Ran Wang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Li-Li Zhang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Juan Liu
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Zhi-Qiang Xu
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yan-Jiang Wang
- Department of Neurology and Centre for Clinical Neuroscience, Daping Hospital, Third Military Medical University, Chongqing, China
| |
Collapse
|
16
|
Moretta P, Ambrosino P, Lanzillo A, Marcuccio L, Fuschillo S, Papa A, Santangelo G, Trojano L, Maniscalco M. Cognitive Impairment in Convalescent COVID-19 Patients Undergoing Multidisciplinary Rehabilitation: The Association with the Clinical and Functional Status. Healthcare (Basel) 2022; 10:480. [PMID: 35326958 PMCID: PMC8950669 DOI: 10.3390/healthcare10030480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/01/2022] [Accepted: 03/01/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cognitive impairment has been reported in the aftermath of severe acute respiratory syndrome due to coronavirus 2 (SARS-CoV-2) infection. We investigated the possible association between cognitive impairment and the main clinical and functional status variables in a cohort of convalescent COVID-19 patients without premorbid diseases potentially affecting cognition. METHODS We consecutively screened for inclusion of convalescent COVID-19 patients referring to a post-acute care facility for pulmonary rehabilitation. All the enrolled patients were assessed for cognitive functions. We also investigated features of psychological distress (anxiety, depression, symptoms of posttraumatic stress disorder and quality of life) and cardiac and pulmonary functional status. RESULTS The 63 enrolled patients (mean age 59.82 ± 10.78, male gender = 47) showed a high frequency of depressive symptoms (76.2%) and anxiety (55.5%), and a high prevalence of symptoms of posttraumatic stress disorder (PTSD, 44.4%). About half of the total sample showed reduced cognitive efficiency (RCE, 44.4%) in the domains of spatial and verbal long-term memory and executive functions. Patients with RCE more frequently showed alteration of blood pressure (BP) circadian rhythm (p = 0.01), higher levels of D-Dimer (p = 0.03), had experienced a severe illness (p = 0.02), had longer disease duration (p = 0.04), more clinically relevant symptoms of PTSD (p = 0.02), more frequent cognitive complaints (p = 0.002), higher anxiety scores (p = 0.01) and lower quality of life (p = 0.02) than patients with normal cognitive efficiency. CONCLUSIONS Our findings indicated a possible association between the RCE after COVID-19 and some cardiological variables, including some indirect measures of a residual autonomic disorder, such as the presence of an altered BP circadian rhythm. Future research studies with large samples are needed to provide valid conclusions.
Collapse
Affiliation(s)
- Pasquale Moretta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurological Rehabilitation Unit of Telese Terme Institute, 82037 Telese Terme, Italy; (A.L.); (L.M.)
| | - Pasquale Ambrosino
- Istituti Clinici Scientifici Maugeri IRCCS, Cardiac Rehabilitation Unit of Telese Terme Institute, 82037 Telese Terme, Italy;
| | - Anna Lanzillo
- Istituti Clinici Scientifici Maugeri IRCCS, Neurological Rehabilitation Unit of Telese Terme Institute, 82037 Telese Terme, Italy; (A.L.); (L.M.)
| | - Laura Marcuccio
- Istituti Clinici Scientifici Maugeri IRCCS, Neurological Rehabilitation Unit of Telese Terme Institute, 82037 Telese Terme, Italy; (A.L.); (L.M.)
| | - Salvatore Fuschillo
- Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Unit of Telese Terme Institute, 82037 Telese Terme, Italy; (S.F.); (M.M.)
| | - Antimo Papa
- Istituti Clinici Scientifici Maugeri IRCCS, Cardiac Rehabilitation Unit of Telese Terme Institute, 82037 Telese Terme, Italy;
| | - Gabriella Santangelo
- Department of Psychology, Università della Campania Luigi Vanvitelli, 81100 Caserta, Italy; (G.S.); (L.T.)
| | - Luigi Trojano
- Department of Psychology, Università della Campania Luigi Vanvitelli, 81100 Caserta, Italy; (G.S.); (L.T.)
| | - Mauro Maniscalco
- Istituti Clinici Scientifici Maugeri IRCCS, Pulmonary Rehabilitation Unit of Telese Terme Institute, 82037 Telese Terme, Italy; (S.F.); (M.M.)
| |
Collapse
|
17
|
Babnik K, Staresinic C, Lep Ž. Some of the workforce face post COVID after the acute phase of the illness: The employer’s supportive role. HUMAN SYSTEMS MANAGEMENT 2022. [DOI: 10.3233/hsm-220003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: A considerable proportion of workers that recover from an acute phase of COVID-19 are confronted with post COVID-19 symptoms of varying severity and duration. Employers have an important role in addressing this new condition. OBJECTIVE: The aim of this study was to review organisational practises that could help employees suffering from long COVID-19 return to work and to link these suggestions to theoretical frameworks from the field of work and organisational psychology. METHODS: Since scientific publications on post COVID-19 are published daily, but sound empirical studies are still scarce, the synthesis of the scientific and professional literature was performed in the form of a narrative review. RESULTS: The results were organised according to the healthy workplace model and explained through the lens of the job demands-resources theory. The role of the employer has three aspects: collaboration, instructional pillars, and key actors. The main guidelines for implementation of the policies are an individualised approach, flexibility, and support. Supportive policies, practises, and relationships might have a direct impact on workers’ psychological resources. CONCLUSIONS: The model could help employers understand the conditions and necessary adaptations for workers with post COVID-19, as well as advance research in work and organisational psychology.
Collapse
Affiliation(s)
- Katarina Babnik
- Department of Psychology, University of Ljubljana, Faculty of Arts, Ljubljana, Slovenia
| | - Claire Staresinic
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Žan Lep
- Department of Psychology, University of Ljubljana, Faculty of Arts, Ljubljana, Slovenia
| |
Collapse
|
18
|
Whiteside DM, Basso MR, Naini SM, Porter J, Holker E, Waldron EJ, Melnik TE, Niskanen N, Taylor SE. Outcomes in post-acute sequelae of COVID-19 (PASC) at 6 months post-infection Part 1: Cognitive functioning. Clin Neuropsychol 2022; 36:806-828. [PMID: 35130818 DOI: 10.1080/13854046.2022.2030412] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Long-term cognitive sequelae of COVID-19 have not been extensively studied. This study provides initial results on cognitive outcomes in Post-Acute Sequelae of COVID-19 (PASC).Participants and Methods: This study examined 53 consecutive outpatients diagnosed with COVID-19. Four participants were excluded due to performance validity test failure. All participants had positive COVID-19 tests, reported cognitive concerns, and completed neuropsychological tests to assess performance validity, attention/working memory, processing speed, memory, language, visual-spatial, executive functioning, motor, and emotional functioning. The sample was mostly white (89.8%), female (83.7%), and never hospitalized (69.4%) for COVID-19. RESULTS Analyses indicated no mean scores in the Impaired range (>2 standard deviations [SD] below normative mean) on objective cognitive testing and a low base rate of Impaired test scores. Higher (>20%) base rates of Borderline performance (1-2 SDs below normative mean) were found on some measures. There was also evidence for frequently elevated mean scores on mood measures which correlated with some cognitive measures and the number of Borderline scores per participants. CONCLUSIONS The results were noteworthy for infrequent Impaired scores, and significant correlations between cognition and mood/anxiety measures, but not between cognitive performance and premorbid vascular risk factors, psychiatric diagnoses, or COVID-19 disease severity. Results suggest that psychological distress was prominent in PASC and related to objective cognitive performance, but objective cognitive performance was unrelated to cognitive complaints. Other contributing factors may include fatigue/sleep issues. Neurologically based cognitive deficits were not suggested by the results.During the COVID-19 pandemic, researchers and clinicians have gained considerable knowledge of the SARS-CoV-2 virus that causes the COVID-19 illness. Research has implicated COVID-19 in a variety of neurological and psychiatric issues (Taquet et al., 2021) including stroke, depression/anxiety, and more rarely intracranial hemorrhage and psychotic disorders. Further, various vascular risk factors such as hypertension, diabetes, hyperlipidemia, and obstructive sleep apnea (OSA) have been associated with more severe COVID-19 symptoms (Bauer et al., 2021; Luk et al., 2021; Mishra et al., 2020; Saxena et al., 2021). Additionally, while many patients recover from COVID-19 in a few weeks, a substantial number continue to experience physical (e.g., fatigue, shortness of breath, cough, palpitations) and cognitive (e.g., "brain fog", concentration and memory complaints) symptoms for a considerable period (Raveendran et al., 2021). It has also been suggested that patients themselves, via social media, contributed to reifying the phenomenon of "Long COVID-19" or post-acute sequelae of SARS-CoV-2 infection (PASC; Callard & Perego, 2021). However, very limited research exists that directly investigates the cognitive sequelae of COVID-19 infection, particularly in the long term. The current study aims to address this limitation in the literature.
Collapse
Affiliation(s)
- Douglas M Whiteside
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Michael R Basso
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, NY, USA
| | - Savana M Naini
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA.,Department of Psychology, University of St. Thomas, Saint Paul, MN, USA
| | - James Porter
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Erin Holker
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Eric J Waldron
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Tanya E Melnik
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Natalie Niskanen
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Sarah E Taylor
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
19
|
Whiteside DM, Naini SM, Basso MR, Waldron EJ, Holker E, Porter J, Niskanen N, Melnik TE, Taylor SE. Outcomes in post-acute sequelae of COVID-19 (PASC) at 6 months post-infection part 2: Psychological functioning. Clin Neuropsychol 2022; 36:829-847. [PMID: 35098861 DOI: 10.1080/13854046.2022.2030411] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Limited research investigating the long-term psychological and emotional correlates of COVID-19 infection has been completed. The current study begins to address this limitation in patients experiencing Post-Acute Sequelae SARS-CoV-2 (PASC; e.g. "Long COVID"). Participants were 43 consecutive neuropsychological outpatients diagnosed with PASC and who completed the Personality Assessment Inventory (PAI). The sample was predominantly female (n = 36) and white (n = 32). Effect sizes compared to the normative mean T scores and base rates of elevated (T > 69) scores were calculated. PAI scales measuring somatic preoccupation and depression had large effect sizes and the highest base rates of scale elevations, with the mean T score at approximately the normative cutoff for clinical significance (T = 70). The Schizophrenia Thought Disorder subscale (SCZ-T) also had a large effect size and high base rate of elevation, likely reflecting cognitive concerns. Scales measuring anxiety had medium effect sizes. The other PAI scales generally had small to negligible effect sizes. There were no significant differences between hospitalized and non-hospitalized participants on the PAI. Overall, PAI scales measuring psychological distress, particularly somatic preoccupation and depression, were the most frequently elevated in the participants. The specific reasons for somatic preoccupation could not be determined in this study. Potential explanations include a vulnerability to distress in Long COVID patients, premorbid somatic preoccupation perhaps motivating these patients to seek clinical attention, or socioenvironmental factors leading some COVID patients to be somatically preoccupied with minor physiological changes and attribute those changes to COVID-19.
Collapse
Affiliation(s)
- Douglas M Whiteside
- Department of Rehabilitation Medicine, Neuropsychology Laboratory, University of Minnesota, Minneapolis, MN, USA
| | - Savana M Naini
- Department of Rehabilitation Medicine, Neuropsychology Laboratory, University of Minnesota, Minneapolis, MN, USA.,Graduate School of Professional Psychology, University of St. Thomas, St Paul, MN, USA
| | - Michael R Basso
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Eric J Waldron
- Department of Rehabilitation Medicine, Neuropsychology Laboratory, University of Minnesota, Minneapolis, MN, USA
| | - Erin Holker
- Department of Rehabilitation Medicine, Neuropsychology Laboratory, University of Minnesota, Minneapolis, MN, USA
| | - James Porter
- Department of Rehabilitation Medicine, Neuropsychology Laboratory, University of Minnesota, Minneapolis, MN, USA
| | - Natalie Niskanen
- Department of Rehabilitation Medicine, Neuropsychology Laboratory, University of Minnesota, Minneapolis, MN, USA
| | - Tanya E Melnik
- Department of Rehabilitation Medicine, Neuropsychology Laboratory, University of Minnesota, Minneapolis, MN, USA
| | - Sarah E Taylor
- Department of Rehabilitation Medicine, Neuropsychology Laboratory, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
20
|
Bungenberg J, Humkamp K, Hohenfeld C, Rust MI, Ermis U, Dreher M, Hartmann NK, Marx G, Binkofski F, Finke C, Schulz JB, Costa AS, Reetz K. Long COVID‐19: Objectifying most self‐reported neurological symptoms. Ann Clin Transl Neurol 2022; 9:141-154. [PMID: 35060361 PMCID: PMC8862437 DOI: 10.1002/acn3.51496] [Citation(s) in RCA: 73] [Impact Index Per Article: 36.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/07/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022] Open
Abstract
Objectives We aimed to objectify and compare persisting self‐reported symptoms in initially hospitalized and non‐hospitalized patients after infection with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) by applying clinical standardized measures. Methods We conducted a cross‐sectional study of adult patients with confirmed SARS‐CoV‐2 infection including medical history, neurological examination, blood markers, neuropsychological testing, patient‐reported outcome measures (PROMs), and brain magnetic resonance imaging (MRI). Results Fifty patients with persisting symptoms for at least 4 weeks were included and classified by initial hospitalization status. Median time from SARS‐CoV‐2 detection to investigation was 29.3 weeks (range 3.3–57.9). Although individual cognitive performance was generally within the normative range in both groups, mostly mild deficits were found in attention, executive functions, and memory. Hospitalized patients performed worse in global cognition, logical reasoning, and processes of verbal memory. In both groups, fatigue severity was associated with reduced performance in attention and psychomotor speed tasks (rs = −0.40, p < 0.05) and reduced quality of life (EQ5D, rs = 0.57, p < 0.001) and with more persisting symptoms (median 3 vs. 6, p < 0.01). PROMs identified fatigue, reduced sleep quality, and increased anxiety and depression in both groups but more pronounced in non‐hospitalized patients. Brain MRI revealed microbleeds exclusively in hospitalized patients (n = 5). Interpretation Regardless of initial COVID‐19 severity, an individuals' mental and physical health can be severely impaired in the long‐term limitedly objectified by clinical standard diagnostic with abnormalities primarily found in hospitalized patients. This needs to be considered when planning rehabilitation therapies and should give rise to new biomarker research.
Collapse
Affiliation(s)
- Julia Bungenberg
- Department of Neurology RWTH Aachen University Aachen Germany
- JARA Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University Aachen Germany
| | - Karen Humkamp
- Department of Neurology RWTH Aachen University Aachen Germany
| | - Christian Hohenfeld
- Department of Neurology RWTH Aachen University Aachen Germany
- JARA Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University Aachen Germany
| | | | - Ummehan Ermis
- Department of Neurology RWTH Aachen University Aachen Germany
| | - Michael Dreher
- Department of Pneumonology and Internal Intensive Care Medicine RWTH University Hospital Aachen Germany
| | | | - Gernot Marx
- Department of Operative Intensive und Intermediate Care Medicine RWTH University Hospital Aachen Germany
| | - Ferdinand Binkofski
- Division of Clinical Cognitive Sciences, Department of Neurology RWTH Aachen University Aachen Germany
| | - Carsten Finke
- Department of Neurology Charité ‐ Universitätsmedizin Berlin Berlin Germany
| | - Jörg B. Schulz
- Department of Neurology RWTH Aachen University Aachen Germany
- JARA Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University Aachen Germany
| | - Ana Sofia Costa
- Department of Neurology RWTH Aachen University Aachen Germany
- JARA Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University Aachen Germany
| | - Kathrin Reetz
- Department of Neurology RWTH Aachen University Aachen Germany
- JARA Institute Molecular Neuroscience and Neuroimaging Forschungszentrum Jülich GmbH and RWTH Aachen University Aachen Germany
| |
Collapse
|
21
|
Damiano RF, Caruso MJG, Cincoto AV, de Almeida Rocca CC, de Pádua Serafim A, Bacchi P, Guedes BF, Brunoni AR, Pan PM, Nitrini R, Beach S, Fricchione G, Busatto G, Miguel EC, Forlenza OV. Post-COVID-19 psychiatric and cognitive morbidity: Preliminary findings from a Brazilian cohort study. Gen Hosp Psychiatry 2022; 75:38-45. [PMID: 35134702 PMCID: PMC8734055 DOI: 10.1016/j.genhosppsych.2022.01.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/31/2021] [Accepted: 01/04/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The present study aims to investigate the occurrence of psychiatric and cognitive impairments in a cohort of survivors of moderate or severe forms of COVID-19. METHOD 425 adults were assessed 6 to 9 months after hospital discharge with a structured psychiatric interview, psychometric tests and a cognitive battery. A large, multidisciplinary, set of clinical data depicting the acute phase of the disease, along with relevant psychosocial variables, were used to predict psychiatric and cognitive outcomes using the 'Least Absolute Shrinkage and Selection Operator' (LASSO) method. RESULTS Diagnoses of 'depression', 'generalized anxiety disorder' and 'post-traumatic stress disorder' were established respectively in 8%, 15.5% and 13.6% of the sample. After pandemic onset (i.e., within the previous year), the prevalence of 'depression' and 'generalized anxiety disorder' were 2.56% and 8.14%, respectively. Memory decline was subjectively reported by 51.1% of the patients. Psychiatric or cognitive outcomes were not associated with any clinical variables related to the severity of acute-phase disease, nor by disease-related psychosocial stressors. CONCLUSIONS This is the first study to access rates of psychiatric and cognitive morbidity in the long-term outcome after moderate or severe forms of COVID-19 using standardized measures. As a key finding, there was no significant association between clinical severity in the acute-phase of SARS-CoV-2 infection and the neuropsychiatric impairment 6 to 9 months thereafter.
Collapse
Affiliation(s)
- Rodolfo Furlan Damiano
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil.
| | - Maria Julia Guimarães Caruso
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | - Alissom Vitti Cincoto
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | - Cristiana Castanho de Almeida Rocca
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | - Antonio de Pádua Serafim
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | - Pedro Bacchi
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | - Bruno F. Guedes
- Departamento de Neurologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | - André R. Brunoni
- Centro de Pesquisas Clínicas e Epidemiológicas, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil,Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil,Departamento e Instituto de Psiquiatria, Laboratory of Neurosciences (LIM-27), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil,Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Pedro Mario Pan
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Ricardo Nitrini
- Departamento de Neurologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | - Scott Beach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Gregory Fricchione
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Geraldo Busatto
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | - Euripedes Constantino Miguel
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | - Orestes V. Forlenza
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil
| | | |
Collapse
|
22
|
Manera MR, Fiabane E, Pain D, Aiello EN, Radici A, Ottonello M, Padovani M, Wilson BA, Fish J, Pistarini C. Clinical features and cognitive sequelae in COVID-19: a retrospective study on N=152 patients. Neurol Sci 2022; 43:45-50. [PMID: 34779965 PMCID: PMC8591589 DOI: 10.1007/s10072-021-05744-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/11/2021] [Indexed: 01/08/2023]
Abstract
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%). ICU-admitted patients made less 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.
Collapse
Affiliation(s)
- Marina Rita Manera
- Istituti Clinici Scientifici Maugeri, IRCCS, Psychology Unit of Pavia Institute, Pavia, Italy
| | - Elena Fiabane
- Istituti Clinici Scientifici Maugeri, Department of Physical and Rehabilitation Medicine of Genova Nervi Institute, Genoa, Italy
| | - Debora Pain
- Istituti Clinici Scientifici Maugeri, IRCCS, Neurorehabilitation Department of Milano Institute, Milan, Italy
| | - Edoardo Nicolò Aiello
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alice Radici
- Istituti Clinici Scientifici Maugeri, IRCCS, Neurorehabilitation Department of Milano Institute, Milan, Italy
| | - Marcella Ottonello
- Istituti Clinici Scientifici Maugeri, Department of Physical and Rehabilitation Medicine of Genova Nervi Institute, Genoa, Italy
| | - Mariacristina Padovani
- Istituti Clinici Scientifici Maugeri, IRCCS, Psychology Unit of Pavia Institute, Pavia, Italy
| | - Barbara Ann Wilson
- Department of Clinical Neuropsychology & Clinical Health Psychology, St George’s University, London, UK
| | - Jessica Fish
- Institute of Health and Wellbeing, University Of Glasgow, Glasgow, UK
| | - Caterina Pistarini
- Istituti Clinici Scientifici Maugeri, IRCCS, Department of Neurorehabilitation of Pavia Institute, Pavia, Italy
| |
Collapse
|
23
|
Jaywant A, Vanderlind WM, Alexopoulos GS, Fridman CB, Perlis RH, Gunning FM. Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19. Neuropsychopharmacology 2021; 46:2235-2240. [PMID: 33589778 PMCID: PMC7884062 DOI: 10.1038/s41386-021-00978-8] [Citation(s) in RCA: 134] [Impact Index Per Article: 44.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/16/2021] [Accepted: 01/20/2021] [Indexed: 02/06/2023]
Abstract
Early reports and case series suggest cognitive deficits occurs in some patients with COVID-19. We evaluated the frequency, severity, and profile of cognitive dysfunction in patients recovering from prolonged COVID-19 hospitalization who required acute inpatient rehabilitation prior to discharge. We analyzed cross-sectional scores from the Brief Memory and Executive Test (BMET) in a cohort of N = 57 COVID-19 patients undergoing inpatient rehabilitation, calculating the frequency of impairment based on neuropsychologist diagnosis and by age-normed BMET subtests. In total, 43 patients (75%) were male, 35 (61%) were non-white, and mean age was 64.5 (SD = 13.9) years. In total, 48 (84%) were previously living at home independently. Two patients had documented preexisting cognitive dysfunction; none had known dementia. Patients were evaluated at a mean of 43.2 (SD = 19.2) days after initial admission. In total, 50 patients (88%) had documented hypoxemic respiratory failure and 44 (77%) required intubation. Forty-six patients (81%) had cognitive impairment, ranging from mild to severe. Deficits were common in working memory (26/47 [55%] of patients), set-shifting (21/44 [47%]), divided attention (18/39 [46%]), and processing speed (14/35 [40%]). Executive dysfunction was not significantly associated with intubation length or the time from extubation to assessment, psychiatric diagnosis, or preexisting cardiovascular/metabolic disease. Attention and executive functions are frequently impaired in COVID-19 patients who require acute rehabilitation prior to discharge. Though interpretation is limited by lack of a comparator group, these results provide an early benchmark for identifying and characterizing cognitive difficulties after COVID-19. Given the frequency and pattern of impairment, easy-to-disseminate interventions that target attention and executive dysfunctions may be beneficial to this population.
Collapse
Affiliation(s)
- Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, US
- Department of Rehabilitation Medicine, Weill Cornell Medicine, New York, NY, US
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, US
| | - W Michael Vanderlind
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, US
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, US
| | - George S Alexopoulos
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, US
- Institute of Geriatric Psychiatry, Weill Cornell Medicine, White Plains, NY, US
| | - Chaya B Fridman
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, US
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, US
| | - Roy H Perlis
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, US
| | - Faith M Gunning
- Department of Psychiatry, Weill Cornell Medicine, New York, NY, US.
- NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, US.
- Institute of Geriatric Psychiatry, Weill Cornell Medicine, White Plains, NY, US.
| |
Collapse
|
24
|
Ali Awan H, Najmuddin Diwan M, Aamir A, Ali M, Di Giannantonio M, Ullah I, Shoib S, De Berardis D. SARS-CoV-2 and the Brain: What Do We Know about the Causality of 'Cognitive COVID? J Clin Med 2021; 10:3441. [PMID: 34362224 PMCID: PMC8347421 DOI: 10.3390/jcm10153441] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 12/22/2022] Open
Abstract
The second year of the COVID-19 (coronavirus disease) pandemic has seen the need to identify and assess the long-term consequences of a SARS-CoV-2 infection on an individual's overall wellbeing, including adequate cognitive functioning. 'Cognitive COVID' is an informal term coined to interchangeably refer to acute changes in cognition during COVID-19 and/or cognitive sequelae with various deficits following the infection. These may manifest as altered levels of consciousness, encephalopathy-like symptoms, delirium, and loss of various memory domains. Dysexecutive syndrome is a peculiar manifestation of 'Cognitive COVID' as well. In the previous major outbreaks of viruses like SARS-CoV, MERS-CoV and Influenza. There have been attempts to understand the underlying mechanisms describing the causality of similar symptoms following SARS-CoV-2 infection. This review, therefore, is attempting to highlight the current understanding of the various direct and indirect mechanisms, focusing on the role of neurotropism of SARS-CoV-2, the general pro-inflammatory state, and the pandemic-associated psychosocial stressors in the causality of 'Cognitive COVID.' Neurotropism is associated with various mechanisms including retrograde neuronal transmission via olfactory pathway, a general hematogenous spread, and the virus using immune cells as vectors. The high amounts of inflammation caused by COVID-19, compounded with potential intubation, are associated with a deleterious effect on the cognition as well. Finally, the pandemic's unique psychosocial impact has raised alarm due to its possible effect on cognition. Furthermore, with surfacing reports of post-COVID-vaccination cognitive impairments after vaccines containing mRNA encoding for spike glycoprotein of SARS-CoV-2, we hypothesize their causality and ways to mitigate the risk. The potential impact on the quality of life of an individual and the fact that even a minor proportion of COVID-19 cases developing cognitive impairment could be a significant burden on already overwhelmed healthcare systems across the world make it vital to gather further evidence regarding the prevalence, presentation, correlations, and causality of these events and reevaluate our approach to accommodate early identification, management, and rehabilitation of patients exhibiting cognitive symptoms.
Collapse
Affiliation(s)
- Hashir Ali Awan
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan; (H.A.A.); (M.N.D.); (A.A.); (M.A.)
| | - Mufaddal Najmuddin Diwan
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan; (H.A.A.); (M.N.D.); (A.A.); (M.A.)
| | - Alifiya Aamir
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan; (H.A.A.); (M.N.D.); (A.A.); (M.A.)
| | - Muneeza Ali
- Department of Internal Medicine, Dow Medical College, Karachi 74200, Pakistan; (H.A.A.); (M.N.D.); (A.A.); (M.A.)
| | - Massimo Di Giannantonio
- Department of Neurosciences and Imaging, Chair of Psychiatry, University “G. D’Annunzio”, 66100 Chieti, Italy;
| | - Irfan Ullah
- Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar 25000, Pakistan;
| | - Sheikh Shoib
- Department of Internal Medicine, Jawahar Lal Nehru Memorial Hospital, Srinagar 190003, India;
| | - Domenico De Berardis
- Department of Neurosciences and Imaging, Chair of Psychiatry, University “G. D’Annunzio”, 66100 Chieti, Italy;
- Department of Internal Medicine, Jawahar Lal Nehru Memorial Hospital, Srinagar 190003, India;
- NHS, National Health Service, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital “G. Mazzini,” ASL 4, 64100 Teramo, Italy
| |
Collapse
|
25
|
Scarpina F, Godi M, Corna S, Seitanidis I, Capodaglio P, Mauro A. Psychological functioning in survivors of COVID-19: Evidence from recognition of fearful facial expressions. PLoS One 2021; 16:e0254438. [PMID: 34292994 PMCID: PMC8297857 DOI: 10.1371/journal.pone.0254438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/27/2021] [Indexed: 11/22/2022] Open
Abstract
Evidence about the psychological functioning in individuals who survived the COVID-19 infectious is still rare in the literature. In this paper, we investigated fearful facial expressions recognition, as a behavioural means to assess psychological functioning. From May 15th, 2020 to January 30th, 2021, we enrolled sixty Italian individuals admitted in multiple Italian COVID-19 post-intensive care units. The detection and recognition of fearful facial expressions were assessed through an experimental task grounded on an attentional mechanism (i.e., the redundant target effect). According to the results, our participants showed an altered behaviour in detecting and recognizing fearful expressions. Specifically, their performance was in disagreement with the expected behavioural effect. Our study suggested altered processing of fearful expressions in individuals who survived the COVID-19 infectious. Such a difficulty might represent a crucial sign of psychological distress and it should be addressed in tailored psychological interventions in rehabilitative settings and after discharge.
Collapse
Affiliation(s)
- Federica Scarpina
- Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Ospedale S. Giuseppe, Piancavallo, Italy
- “Rita Levi Montalcini” Department of Neurosciences, University of Turin, Turin, Italy
- * E-mail: ,
| | - Marco Godi
- Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Gattico-Veruno, Italy
| | - Stefano Corna
- Institute of Veruno, Istituti Clinici Scientifici Maugeri IRCCS, Gattico-Veruno, Italy
| | - Ionathan Seitanidis
- Istituto Auxologico Italiano, IRCCS, U.O. di U.O. Riabilitazione Osteoarticolare, Ospedale S. Giuseppe, Piancavallo, Italy
| | - Paolo Capodaglio
- Istituto Auxologico Italiano, IRCCS, U.O. di U.O. Riabilitazione Osteoarticolare, Ospedale S. Giuseppe, Piancavallo, Italy
- Department of Surgical Sciences, Physical and Rehabilitation Medicine, University of Turin, Turin, Italy
| | - Alessandro Mauro
- Istituto Auxologico Italiano, IRCCS, U.O. di Neurologia e Neuroriabilitazione, Ospedale S. Giuseppe, Piancavallo, Italy
- “Rita Levi Montalcini” Department of Neurosciences, University of Turin, Turin, Italy
| |
Collapse
|
26
|
Health-related quality of life issues, including symptoms, in patients with active COVID-19 or post COVID-19; a systematic literature review. Qual Life Res 2021; 30:3367-3381. [PMID: 34146226 PMCID: PMC8214069 DOI: 10.1007/s11136-021-02908-z] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 12/13/2022]
Abstract
Purpose This systematic review was performed to identify all relevant health-related quality of life (HRQoL) issues associated with COVID-19. Methods A systematic literature search was undertaken in April 2020. In four teams of three reviewers each, all abstracts were independently reviewed for inclusion by two reviewers. Using a pre-defined checklist of 93 criteria for each publication, data extraction was performed independently by two reviewers and subsequently compared and discussed. If necessary, a third reviewer resolved any discrepancies. The search was updated in February 2021 to retrieve new publications on HRQoL issues including issues related to the long-term consequences of COVID-19. Results The search in April 2020 identified 3342 potentially relevant publications, and 339 publications were selected for full-text review and data extraction. We identified 75 distinct symptoms and other HRQoL issues categorized into 12 thematic areas; from general symptoms such as fever, myalgia, and fatigue, to neurological and psychological issues. The updated search revealed three extra issues experienced during active disease and long-term problems with fatigue, psychological issues and impaired cognitive function. Conclusion This first comprehensive systematic review provides a detailed overview of the wide range of HRQoL issues experienced by patients with COVID-19 throughout the course of the disease. It demonstrates the devastating impact of the disease and provides critically important information for clinicians, to enable them to better recognize the disease and to provide knowledge important for treatment and follow-up. The results provided the foundation for the international development of a COVID-19 specific patient-reported HRQoL questionnaire. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02908-z.
Collapse
|
27
|
A Well-Structured Follow-Up Program is Required after Recovery from Coronavirus Disease 2019 (COVID-19); Release from Quarantine is Not the End of Treatment. J Clin Med 2021; 10:jcm10112329. [PMID: 34073504 PMCID: PMC8198537 DOI: 10.3390/jcm10112329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 12/23/2022] Open
Abstract
During the Coronavirus Infection Disease-19 (COVID-19) pandemic, the number of patients released from quarantine is exceeding the number of newly diagnosed cases. This study is a retrospective cohort study in which consultation data were collected from a COVID-19 follow-up health consultation program. The studied population was selected from patients who recovered after quarantine and treatment for COVID-19 in Daegu City and in Gyeongsangbukdo province, Korea, from March to June 2020. The healthcare providers comprised 20 family-medicine specialists who consulted and educated the patients through phone calls in accordance with structured guidelines. Physical and mental status before and after recovery were compared among patients who received a single consultation and those who received two or more consultations. A total of 1604 subjects were selected for the final analysis. Of these, 1145 (71.4%) had one consultation and 459 (28.6%) had two or more. The group that had two or more consultations reported significantly more physical symptoms, more psychological symptoms (including depression), and more psychological stress. Multivariate forward selection logistic regression analysis showed that re-confirmed cases of COVID-19, physical symptoms after quarantine, feelings of depression, and psychological stress had a significant effect on the number of consultations received. In conclusion, COVID-19 has various physical and mental sequelae after discharge from quarantine. Therefore, a well-structured follow-up program is needed after recovery.
Collapse
|
28
|
Whiteside DM, Oleynick V, Holker E, Waldron EJ, Porter J, Kasprzak M. Neurocognitive deficits in severe COVID-19 infection: Case series and proposed model. Clin Neuropsychol 2021; 35:799-818. [PMID: 33487098 DOI: 10.1080/13854046.2021.1874056] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: To date, very few studies investigating neurocognitive deficits in COVID-19 have been published. This case series addresses cognition in post-COVID-19 patient by describing three patients in acute rehabilitation to inform a model of cognitive sequelae of COVID-19. Methods: Three English-speaking inpatients with severe symptoms and long-term intensive care unit (ICU) treatment are described. All patients had a premorbid history of hypertension and hyperlipidemia and experienced delirium and hypoxemia when hospitalized. Patient 1 is a 62-year-old male with 15 years of education with additional history of obstructive sleep apnea and type 2 diabetes. Patient 2 is a 73-year-old female with 12 years of education with a premorbid medical history of alcohol use disorder and Guillain-Barre syndrome. Patient 3 is a 75-year-old male with 14 years of education. No patients had premorbid psychiatric histories. Results: The three patients demonstrated deficits on formal neuropsychological testing, particularly with encoding and verbal fluency. Memory measures improved with a more structured story memory task compared to a less-structured verbal list-learning task, suggesting executive dysfunction impacted learning. None of the patients demonstrated rapid forgetting of information. Two patients endorsed new depressive and/or anxiety symptoms. Conclusions: The results suggest evidence for neurocognitive deficits after severe COVID-19 infection, particularly in encoding and verbal fluency. These results were interpreted with caution given the limited number of patients and the telephone-based battery. The specific mechanism that caused these cognitive deficits in these individuals remains unclear. A proposed three-stage model of cognitive dysfunction is described to help guide future research.
Collapse
Affiliation(s)
- Douglas M Whiteside
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Victoria Oleynick
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Erin Holker
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Eric J Waldron
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - James Porter
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Michael Kasprzak
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
29
|
Devita M, Di Rosa E, Iannizzi P, Bianconi S, Contin SA, Tiriolo S, Bernardinello N, Cocconcelli E, Balestro E, Cattelan A, Leoni D, Mapelli D, Volpe B. Cognitive and Psychological Sequelae of COVID-19: Age Differences in Facing the Pandemic. Front Psychiatry 2021; 12:711461. [PMID: 34603102 PMCID: PMC8481580 DOI: 10.3389/fpsyt.2021.711461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/16/2021] [Indexed: 11/24/2022] Open
Abstract
Literature about the novel Coronavirus (COVID-19) is currently focusing on the potential cognitive and neuropsychiatric sequelae observed in individuals receiving intensive care unit (ICU) treatments. The aim of the present study is to evaluate the differences in cognitive and psychological sequelae of COVID-19 between younger and older adults, regardless of being admitted to the ICU or not. The study involved 299 recovered individuals (from 18 to 90 years old), who underwent a comprehensive cognitive and psychological assessment. Linear regression models were conducted separately for Montreal Cognitive Assessment (MoCA) test and Post-traumatic Stress Disorder Checklist (PCL) scores to investigate the effect of socio-demographic and clinical characteristics on them. Separate linear regression models were then applied sorting participants by age: younger adults (<65 years) and older adults (≥65 years). In the whole sample, PCL scores were predicted by the intensity of care received, by being intubated, and by the persistence of cough after 1 month after hospitalization. Only age had instead an effect on cognition. In younger adults, PCL scores were predicted by the presence of neurological symptoms, by the intensity of care received, and by being intubated; MoCA scores were only predicted by the intensity of care received. No significant associations were found in older adults. Psychological negative effects of the COVID-19 pandemic particularly affect individuals under 65 years old, who also subjectively report cognitive sequelae associated with the infection. Individuals over 65 years old, instead, seem to be free from psychological and cognitive difficulties due to COVID-19.
Collapse
Affiliation(s)
- Maria Devita
- Department of General Psychology (DPG), University of Padua, Padua, Italy
| | - Elisa Di Rosa
- Department of General Psychology (DPG), University of Padua, Padua, Italy
| | | | - Sara Bianconi
- U.O.C. Clinical Psychology, Hospital of Padua, Padua, Italy
| | - Sara A Contin
- U.O.C. Clinical Psychology, Hospital of Padua, Padua, Italy
| | - Simona Tiriolo
- U.O.C. Clinical Psychology, Hospital of Padua, Padua, Italy
| | - Nicol Bernardinello
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Elisabetta Cocconcelli
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | - Elisabetta Balestro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padua, Italy
| | | | - Davide Leoni
- Infectious Disease Unit, Hospital of Padua, Padua, Italy
| | - Daniela Mapelli
- Department of General Psychology (DPG), University of Padua, Padua, Italy
| | | |
Collapse
|
30
|
Riordan P, Stika M, Goldberg J, Drzewiecki M. COVID-19 and clinical neuropsychology: A review of neuropsychological literature on acute and chronic pulmonary disease. Clin Neuropsychol 2020; 34:1480-1497. [PMID: 32883155 DOI: 10.1080/13854046.2020.1810325] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective: The illness resulting from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), better known as COVID-19, has quickly escalated to a worldwide pandemic. Although understanding of the short and long-term manifestations of COVID-19 remains incomplete, there is a preponderance of respiratory pathology in COVID-19 and potential for chronic loss of pulmonary function in recovered patients, raising concerns for associated cognitive impacts.Method: We conducted a narrative review of the existing literature on neuropsychological variables in acute/severe respiratory disease and various forms of chronic pulmonary disease to inform expectations about potential cognitive manifestations of COVID-19.Results: Cognitive dysfunction is common but not inevitable in acute and chronic pulmonary disease, although unique predictors and symptom trajectories appear to be associated with each.Conclusions: Although the full scope of neuropathophysiology associated with COVID-19 remains to be established, pulmonary insults associated with the disease are likely to produce cognitive dysfunction in a substantial percentage of patients.
Collapse
Affiliation(s)
- Patrick Riordan
- Mental Health Service, Hines VA Medical Center, Hines, IL, USA.,Department of Neurology, Loyola University Medical Center, Maywood, IL, USA
| | - Monica Stika
- Department of Neurology, Loyola University Medical Center, Maywood, IL, USA
| | - Joshua Goldberg
- Department of Neurology, Loyola University Medical Center, Maywood, IL, USA
| | | |
Collapse
|