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Zülke AE, Luppa M, Wirkner K, Reusche M, Sander C, Büchner R, Schomerus G, Then Bergh F, Lehmann J, Witte AV, Villringer A, Zeynalova S, Löffler M, Engel C, Riedel-Heller SG. Cognitive performance in adults with post-COVID syndrome: Results from a German case-control study. J Psychiatr Res 2024; 176:377-383. [PMID: 38944016 DOI: 10.1016/j.jpsychires.2024.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/18/2024] [Accepted: 06/24/2024] [Indexed: 07/01/2024]
Abstract
Numerous studies on post-COVID syndrome (PCS) describe persisting symptoms of cognitive impairment. Previous studies, however, often investigated small samples or did not assess covariates possibly linked to cognitive performance. We aimed to describe 1) global and domain-specific cognitive performance in adults with PCS, controls with previous SARS-CoV-2 infection and healthy controls, 2) associations of sociodemographics, depressive symptoms, anxiety, fatigue, somatic symptoms and stress with cognitive performance and subjective cognitive decline (SCD), using data of the LIFE-Long-COVID-Study from Leipzig, Germany. Group differences in cognitive performance and associations with sociodemographic and neuropsychiatric covariates were assessed using multivariable regression analyses. Our study included n = 561 adults (Mage: 48.8, SD: 12.7; % female: 70.6). Adults with PCS (n = 410) performed worse in tests on episodic memory (b = -1.07, 95 % CI: -1.66, -0.48) and visuospatial abilities (b = -3.92, 95 % CI: -6.01, -1.83) compared to healthy controls (n = 64). No impairments were detected for executive function, verbal fluency, and global cognitive performance. Odds of SCD were not higher in PCS. A previous SARS-CoV-2 infection without PCS (n = 87) was not linked to cognitive impairment. Higher age and higher levels of stress and fatigue were linked to worse performance in several cognitive domains. Routine administration of tests for episodic memory and visuospatial abilities might aid in the identification of individuals at risk for cognitive impairment when reporting symptoms of PCS. Low numbers of participants with severe COVID-19 infections possibly limit generalizability of our findings.
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Affiliation(s)
- Andrea E Zülke
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103, Leipzig, Germany.
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103, Leipzig, Germany.
| | - Kerstin Wirkner
- Leipzig Research Centre for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107, Leipzig, Germany.
| | - Matthias Reusche
- Leipzig Research Centre for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107, Leipzig, Germany.
| | - Christian Sander
- Leipzig Research Centre for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany; Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103, Leipzig, Germany.
| | - Ronja Büchner
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103, Leipzig, Germany.
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, 04103, Leipzig, Germany.
| | - Florian Then Bergh
- Department of Neurology, University of Leipzig Medical Center, 04103, Leipzig, Germany.
| | - Jörg Lehmann
- Department of Preclinical Development and Validation, Fraunhofer Institute for Cell Therapy and Immunology - IZI, 04103, Leipzig, Germany.
| | - A Veronica Witte
- Cognitive Neurology, University of Leipzig Medical Center, 04103, Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103, Leipzig, Germany.
| | - Arno Villringer
- Cognitive Neurology, University of Leipzig Medical Center, 04103, Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, 04103, Leipzig, Germany.
| | - Samira Zeynalova
- Leipzig Research Centre for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107, Leipzig, Germany.
| | - Markus Löffler
- Leipzig Research Centre for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107, Leipzig, Germany.
| | - Christoph Engel
- Leipzig Research Centre for Civilization Diseases, University of Leipzig, 04103, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107, Leipzig, Germany.
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103, Leipzig, Germany.
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Radtke T, Künzi L, Kopp J, Rasi M, Braun J, Zens KD, Winter B, Anagnostopoulos A, Puhan MA, Fehr JS. Effects of Pycnogenol® in people with post-COVID-19 condition (PYCNOVID): study protocol for a single-center, placebo controlled, quadruple-blind, randomized trial. Trials 2024; 25:385. [PMID: 38879571 PMCID: PMC11179231 DOI: 10.1186/s13063-024-08187-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/17/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND A significant proportion of the global population has been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at some point since the onset of the pandemic. Although most individuals who develop coronavirus disease 2019 (COVID-19) recover without complications, about 6% have persistent symptoms, referred to as post-COVID-19 condition (PCC). Intervention studies investigating treatments that potentially alleviate PCC-related symptoms and thus aim to mitigate the global public health burden and healthcare costs linked to PCC are desperately needed. The PYCNOVID trial investigates the effects of Pycnogenol®, a French maritime pine bark extract with anti-inflammatory and antioxidative properties, versus placebo on patient-reported health status in people with PCC. METHODS This is a single-center, placebo-controlled, quadruple blind, randomized trial. We aim to randomly assign 150 individuals with PCC (1:1 ratio) to receive either 200 mg Pycnogenol® or placebo daily for 12 weeks. Randomization is stratified for duration of PCC symptoms (≤ 6 months versus > 6 months) and presence of symptomatic chronic disease(s). The primary endpoint is perceived health status at 12 weeks (EuroQol-Visual Analogue Scale) adjusted for baseline values and stratification factors. Secondary endpoints include change in self-reported PCC symptoms, health-related quality of life, symptoms of depression and anxiety, cognitive function, functional exercise capacity, physical activity measured with accelerometry, and blood biomarkers for endothelial health, inflammation, coagulation, platelet function, and oxidative stress. Investigators, study participants, outcome assessors, and data analysts are blinded regarding the intervention assignment. Individuals with PCC were involved in the design of this study. DISCUSSION This is the first trial to investigate the effects of Pycnogenol® versus placebo on patient-reported health status in people with PCC. Should the trial proof clinical effectiveness, Pycnogenol® may serve as a therapeutic approach to mitigate symptoms associated with PCC. TRIAL REGISTRATION The study is registered at ClinicalTrials.gov. :NCT05890534, June 6, 2023.
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Affiliation(s)
- Thomas Radtke
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland.
| | - Lisa Künzi
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Julia Kopp
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Manuela Rasi
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Julia Braun
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Kyra D Zens
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Babette Winter
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Alexia Anagnostopoulos
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
| | - Jan S Fehr
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich (UZH), Zurich, Switzerland
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Paz-Rodríguez F, Lozano-Tovar S, Rodríguez-Agudelo Y, Cruz-Narciso B, Rodríguez-Rodríguez M, García-Santos A, López-González D, Soto-Moreno FJ, González-Navarro M, González-Alonso K, Castorena-Maldonado A, Carrillo-Mezo R, Marrufo-Meléndez O, Gutiérrez-Romero A, Del Río Quiñones M, Arauz-Góngora A, Ávila-Rios S, Chávez-Oliveros M. Assessment of visuospatial functions in post-Covid 19 patients: Beyond the traditional paradigm. Behav Brain Res 2024; 471:115095. [PMID: 38857705 DOI: 10.1016/j.bbr.2024.115095] [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: 12/27/2023] [Revised: 05/15/2024] [Accepted: 06/04/2024] [Indexed: 06/12/2024]
Abstract
Several studies indicate that some cognitive changes occur after COVID-19. Visuospatial alterations have been reported in 24-40 %. These alterations may be useful as early biomarkers of neurodegenerative disease. Thus, we can emphasize the importance of visuospatial processes in cognition through quantitative and qualitative analysis of performance on the Clock Test (CDT) and the Rey-Osterrieth Complex Figure (FCRO). Our objective was to describe the performance of post COVID 19 patients in visuospatial tests, with different degrees of respiratory impairment and to perform a qualitative analysis of the performance to check its relationship with alterations in attention and executive functions. This will allow highlighting the executive component of the performance of the CDT and ROCF and differentiate patients with possible cognitive impairment. 77 patients with SARS-CoV-2 infection were evaluated (3 months post-infection) with a complete neuropsychological battery and MRI. Overall, there is a significant difference between FCRO and CDT, with FCRO having only 9 % change and CDT having 51.9 % change. Regarding the correlations observed between groups (VM Inv, VM non I and non hospitalized) the highest correlations were observed between Boston with FCRO copy (r=0.497; p=0.001) and with FCRO memory (r=0.429; p=0.001). Comparing the performance between groups by severity, significant differences were observed only in the TMT A (13.706 p=0.001) and B (9.583 p=0.008) tests and in the phonological fluency letter A (13.445 p=0.001), we observed that the group of non-hospitalized patients had a better performance. Neuropsychological deficits often have a direct impact on daily life by affecting the ability to learn and adapt. Thus, a useful strategy for the neuropsychological characterization of post-COVID-19 patients is the qualitative analysis of visuospatial abilities in conjunction with executive functions that cannot be analyzed in isolation.
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Affiliation(s)
- Francisco Paz-Rodríguez
- Laboratory of Clinical Neuropsychology, National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez, Mexico City, Mexico
| | - Susana Lozano-Tovar
- Laboratory of Clinical Neuropsychology, National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez, Mexico City, Mexico
| | - Yaneth Rodríguez-Agudelo
- Laboratory of Clinical Neuropsychology, National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez, Mexico City, Mexico
| | - Beatriz Cruz-Narciso
- Laboratory of Clinical Neuropsychology, National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez, Mexico City, Mexico
| | - Mónica Rodríguez-Rodríguez
- Center for Research in Infectious Diseases-CIENI of the National Institute of Respiratory Diseases, Ismael Cosió Villegas, Mexico City, Mexico
| | - Anwar García-Santos
- Center for Research in Infectious Diseases-CIENI of the National Institute of Respiratory Diseases, Ismael Cosió Villegas, Mexico City, Mexico
| | - Diana López-González
- Center for Research in Infectious Diseases-CIENI of the National Institute of Respiratory Diseases, Ismael Cosió Villegas, Mexico City, Mexico
| | - Francisco-Javier Soto-Moreno
- Center for Research in Infectious Diseases-CIENI of the National Institute of Respiratory Diseases, Ismael Cosió Villegas, Mexico City, Mexico
| | - Mauricio González-Navarro
- Center for Research in Infectious Diseases-CIENI of the National Institute of Respiratory Diseases, Ismael Cosió Villegas, Mexico City, Mexico
| | - Karina González-Alonso
- Department of Imaging, National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez, Mexico City, Mexico
| | - Armando Castorena-Maldonado
- Service of Otorhinolaryngology and Head and Neck Surgery of the National Institute of Respiratory Diseases, Ismael Cosió Villegas, Mexico City, Mexico
| | - Roger Carrillo-Mezo
- Department of Imaging, National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez, Mexico City, Mexico
| | - Oscar Marrufo-Meléndez
- Department of Imaging, National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez, Mexico City, Mexico
| | - Alonso Gutiérrez-Romero
- Department of Medical Subdirection of the National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Manuel Del Río Quiñones
- Department of Medical Subdirection of the National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Antonio Arauz-Góngora
- General Direction of the National Institute of Neurology and Neurosurgery, Manuel Velasco Suárez, Mexico City, Mexico
| | - Santiago Ávila-Rios
- Center for Research in Infectious Diseases-CIENI of the National Institute of Respiratory Diseases, Ismael Cosió Villegas, Mexico City, Mexico
| | - Mireya Chávez-Oliveros
- Laboratory of Clinical Neuropsychology, National Institute of Neurology and Neurosurgery, Manuel Velasco Suarez, Mexico City, Mexico.
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4
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Zhao Y, Liang Q, Jiang Z, Mei H, Zeng N, Su S, Wu S, Ge Y, Li P, Lin X, Yuan K, Shi L, Yan W, Liu X, Sun J, Liu W, van Wingen G, Gao Y, Tan Y, Hong Y, Lu Y, Wu P, Zhang X, Wang Y, Shi J, Wang Y, Lu L, Li X, Bao Y. Brain abnormalities in survivors of COVID-19 after 2-year recovery: a functional MRI study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 47:101086. [PMID: 38774424 PMCID: PMC11107230 DOI: 10.1016/j.lanwpc.2024.101086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/03/2024] [Accepted: 04/22/2024] [Indexed: 05/24/2024]
Abstract
Background A variety of symptoms, particularly cognitive, psychiatric and neurological symptoms, may persist for a long time among individuals recovering from COVID-19. However, the underlying mechanism of these brain abnormalities remains unclear. This study aimed to investigate the long-term neuroimaging effects of COVID-19 infection on brain functional activities using resting-state functional magnetic resonance imaging (rs-fMRI). Methods Fifty-two survivors 27 months after infection (mild-moderate group: 25 participants, severe-critical: 27 participants), from our previous community participants, along with 35 healthy controls, were recruited to undergo fMRI scans and comprehensive cognitive function measurements. Participants were evaluated by subjective assessment of Cognitive Failures Questionnaire-14 (CFQ-14) and Fatigue Scale-14 (FS-14), and objective assessment of Montreal Cognitive Assessment (MoCA), N-back, and Simple Reaction Time (SRT). Each had rs-fMRI at 3T. Measures such as the amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) were calculated. Findings Compared with healthy controls, survivors of mild-moderate acute symptoms group and severe-critical group had a significantly higher score of cognitive complains involving cognitive failure and mental fatigue. However, there was no difference of cognitive complaints between two groups of COVID-19 survivors. The performance of three groups was similar on the score of MoCA, N-back and SRT. The rs-fMRI results showed that COVID-19 survivors exhibited significantly increased ALFF values in the left putamen (PUT.L), right inferior temporal gyrus (ITG.R) and right pallidum (PAL.R), while decreased ALFF values were observed in the right superior parietal gyrus (SPG.R) and left superior temporal gyrus (STG.L). Additionally, decreased ReHo values in the right precentral gyrus (PreCG.R), left postcentral gyrus (PoCG.L), left calcarine fissure and surrounding cortex (CAL.L) and left superior temporal gyrus (STG.L). Furthermore, significant negative correlations between the ReHo values in the STG.L, and CFQ-14 and mental fatigue were found. Interpretation This long-term study suggests that individuals recovering from COVID-19 continue to experience cognitive complaints, psychiatric and neurological symptoms, and brain functional alteration. The rs-fMRI results indicated that the changes in brain function in regions such as the putamen, temporal lobe, and superior parietal gyrus may contribute to cognitive complaints in individuals with long COVID even after 2-year infection. Funding The National Programs for Brain Science and Brain-like Intelligence Technology of China, the National Natural Science Foundation of China, Natural Science Foundation of Beijing Municipality of China, and the National Key Research and Development Program of China.
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Affiliation(s)
- Yimiao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
- School of Public Health, Peking University, Beijing 100191, China
| | - Qiongdan Liang
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China
| | - Zhendong Jiang
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, Hubei Province 430063, China
| | - Huan Mei
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
- School of Public Health, Peking University, Beijing 100191, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
- School of Public Health, Peking University, Beijing 100191, China
| | - Sizhen Su
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Shanshan Wu
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, Hubei Province 430063, China
| | - Yinghong Ge
- The Third Hospital of Wuhan City, Wuhan, Hubei Province 430000, China
| | - Peng Li
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Xiao Lin
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Kai Yuan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Le Shi
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Wei Yan
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Xiaoxing Liu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
| | - Jie Sun
- Peking University Third Hospital, Peking University, Beijing 100191, China
| | - Weijian Liu
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
- Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
- Department of Psychiatry, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Guido van Wingen
- Department of Psychiatry, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Yujun Gao
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, Hubei Province 430000, China
| | - Yiqing Tan
- The Third Hospital of Wuhan City, Wuhan, Hubei Province 430000, China
| | - Yi Hong
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, Hubei Province 430063, China
| | - Yu Lu
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, Hubei Province 430063, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Xiujun Zhang
- School of Psychology, College of Public Health, North China University of Science and Technology, 21 Bohai Road, Tang'shan, Hebei Province 063210, China
| | - Yongxiang Wang
- Shandong Institute of Brain Science and Brain-Inspired Research, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province 271016, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Yumei Wang
- Shandong Institute of Brain Science and Brain-Inspired Research, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province 271016, China
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province 250021, China
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
- Institute of Mental Health, National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health and Peking University Sixth Hospital, Peking University, Beijing 100191, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100191, China
- Chinese Academy of Medical Sciences Research Unit (No. 2018RU006), Peking University, Beijing 100191, China
- Shandong Institute of Brain Science and Brain-Inspired Research, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province 271016, China
| | - Xiangyou Li
- Wuhan Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, Hubei Province 430063, China
| | - Yanping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
- School of Public Health, Peking University, Beijing 100191, China
- Shandong Institute of Brain Science and Brain-Inspired Research, Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong Province 271016, China
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Carnes-Vendrell A, Piñol-Ripoll G, Ariza M, Cano N, Segura B, Junque C, Béjar J, Barrue C, Garolera M. Poor sleep quality may trigger cognitive deficits after recovery from COVID-19. Front Psychol 2024; 15:1382875. [PMID: 38860054 PMCID: PMC11164190 DOI: 10.3389/fpsyg.2024.1382875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/29/2024] [Indexed: 06/12/2024] Open
Abstract
Objective In the present study, we aimed to assess the cognition of post-COVID-19 condition (PCC) participants in relation to their subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI) and to analyse possible moderators of this effect, such as quality of life (European Quality of Life-5 Dimensions, EQ-5D), fatigue (Chadler Fatigue Questionnaire, CFQ), cognitive reserve (Cognitive Reserve Questionnaire, CRC), and subjective cognitive complaints (Memory Failures of Everyday Questionnaire, MFE-30). Methods We included 373 individuals with PCC and 126 healthy controls (HCs) from the NAUTILUS Project (NCT05307549 and NCT05307575) who were assessed with a comprehensive neuropsychological battery and various questionnaires. Results We found that PCC participants with poor sleep quality had a 4.3% greater risk of immediate verbal memory deficits than those with good sleep quality, as indicated by the greater odds ratio (OR) of 1.043 and confidence interval (CI) of 1.023-1.063. Additionally, their risk of immediate verbal memory disorders was multiplied by 2.4 when their EQ-5D score was low (OR 0.33; CI 0.145-0.748), and they had a lower risk of delayed visual memory deficits with a greater CRC (OR 0.963; CI 0.929-0.999). With respect to processing speed, PCC participants with poor sleep quality had a 6.7% greater risk of deficits as the MFE increased (OR 1.059; CI 1.024-1.096), and the risk of slowed processing speed tripled with a lower EQ-5D (OR 0.021; CI 0.003-0.141). Conclusion These results indicate that poor subjective sleep quality is a potential trigger for cognitive deficits. Therapeutic strategies to maximize sleep quality could include reducing sleep disturbances and perhaps cognitive impairment in PCC individuals.
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Affiliation(s)
- A. Carnes-Vendrell
- Cognitive Disorders Unit, Cognition and Behavior Study Group, Hospital Universitari Santa Maria, Lleida, Spain
| | - G. Piñol-Ripoll
- Cognitive Disorders Unit, Cognition and Behavior Study Group, Hospital Universitari Santa Maria, Lleida, Spain
| | - M. Ariza
- Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - N. Cano
- Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain
- Departament de Ciències Bàsiques, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - B. Segura
- Medical Psychology Unit, Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - C. Junque
- Medical Psychology Unit, Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - J. Béjar
- Faculty of Informatics of Barcelona (FIB), Polytechnic University of Catalonia, Barcelona, Spain
| | - C. Barrue
- Faculty of Informatics of Barcelona (FIB), Polytechnic University of Catalonia, Barcelona, Spain
| | - M. Garolera
- Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain
- Neuropsychology Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
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6
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Vavougios GD, Mavridis T, Doskas T, Papaggeli O, Foka P, Hadjigeorgiou G. SARS-CoV-2-Induced Type I Interferon Signaling Dysregulation in Olfactory Networks Implications for Alzheimer's Disease. Curr Issues Mol Biol 2024; 46:4565-4579. [PMID: 38785545 PMCID: PMC11119810 DOI: 10.3390/cimb46050277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/15/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024] Open
Abstract
Type I interferon signaling (IFN-I) perturbations are major drivers of COVID-19. Dysregulated IFN-I in the brain, however, has been linked to both reduced cognitive resilience and neurodegenerative diseases such as Alzheimer's. Previous works from our group have proposed a model where peripheral induction of IFN-I may be relayed to the CNS, even in the absence of fulminant infection. The aim of our study was to identify significantly enriched IFN-I signatures and genes along the transolfactory route, utilizing published datasets of the nasal mucosa and olfactory bulb amygdala transcriptomes of COVID-19 patients. We furthermore sought to identify these IFN-I signature gene networks associated with Alzheimer's disease pathology and risk. Gene expression data involving the nasal epithelium, olfactory bulb, and amygdala of COVID-19 patients and transcriptomic data from Alzheimer's disease patients were scrutinized for enriched Type I interferon pathways. Gene set enrichment analyses and gene-Venn approaches were used to determine genes in IFN-I enriched signatures. The Agora web resource was used to identify genes in IFN-I signatures associated with Alzheimer's disease risk based on its aggregated multi-omic data. For all analyses, false discovery rates (FDR) <0.05 were considered statistically significant. Pathways associated with type I interferon signaling were found in all samples tested. Each type I interferon signature was enriched by IFITM and OAS family genes. A 14-gene signature was associated with COVID-19 CNS and the response to Alzheimer's disease pathology, whereas nine genes were associated with increased risk for Alzheimer's disease based on Agora. Our study provides further support to a type I interferon signaling dysregulation along the extended olfactory network as reconstructed herein, ranging from the nasal epithelium and extending to the amygdala. We furthermore identify the 14 genes implicated in this dysregulated pathway with Alzheimer's disease pathology, among which HLA-C, HLA-B, HLA-A, PSMB8, IFITM3, HLA-E, IFITM1, OAS2, and MX1 as genes with associated conferring increased risk for the latter. Further research into its druggability by IFNb therapeutics may be warranted.
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Affiliation(s)
- George D. Vavougios
- Department of Neurology, Medical School, University of Cyprus, Nicosia 1678, Cyprus
| | - Theodoros Mavridis
- Department of Neurology, Tallaght University Hospital (TUH)/The Adelaide and Meath Hospital, Dublin, Incorporating the National Children’s Hospital (AMNCH), D24 NR0A Dublin, Ireland;
| | | | - Olga Papaggeli
- Molecular Virology Laboratory, Hellenic Pasteur Institute, 115 21 Athens, Greece; (O.P.); (P.F.)
| | - Pelagia Foka
- Molecular Virology Laboratory, Hellenic Pasteur Institute, 115 21 Athens, Greece; (O.P.); (P.F.)
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Boesl F, Goereci Y, Schweitzer F, Finke C, Schild AK, Bittner S, Steffen F, Schröder M, Quitschau A, Heine J, Warnke C, Franke C. Cognitive decline in post-COVID-19 syndrome does not correspond with persisting neuronal or astrocytic damage. Sci Rep 2024; 14:5326. [PMID: 38438479 PMCID: PMC10912552 DOI: 10.1038/s41598-024-55881-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/27/2024] [Indexed: 03/06/2024] Open
Abstract
Cognitive impairment is the most frequent symptom reported in post-COVID-19 syndrome (PCS). Aetiology of cognitive impairment in PCS is still to be determined. Neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) are increased in acute COVID-19. Their role as biomarkers in other neurological disorders is under debate. We analysed serum levels of NfL and GFAP as markers for neuronal and astrocytic damage in 53 patients presenting to a PCS Neurology outpatient clinic. Only individuals with self-reported cognitive complaints were included. In these individuals, cognitive complaints were further assessed by comprehensive neuropsychological assessment (NPA). Patients were categorized into subgroups of subjective cognitive decline, single domain impairment, or multi-domain impairment. Serum NfL was in normal range, however an increase of serum GFAP was detected in 4% of patients. Serum NfL and GFAP levels correlated with each other, even when adjusting for patient age (r = 0.347, p = 0.012). NPA showed deficits in 70%; 40% showing impairment in several tested domains. No significant differences were found between serum NfL- and GFAP-levels comparing patients with subjective cognitive decline, single domain impairment, or multi-domain impairment. Persistent neuronal or astrocytic damage did not correlate with cognitive impairment in PCS.
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Affiliation(s)
- Fabian Boesl
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Yasemin Goereci
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Finja Schweitzer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Carsten Finke
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Ann-Katrin Schild
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Stefan Bittner
- Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University Mainz, Rhine-Main Neuroscience Network (rmn2), Mainz, Germany
| | - Falk Steffen
- Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), University Medical Center of the Johannes Gutenberg University Mainz, Rhine-Main Neuroscience Network (rmn2), Mainz, Germany
| | - Maria Schröder
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Anneke Quitschau
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Josephine Heine
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Clemens Warnke
- Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christiana Franke
- Department of Neurology, Charité-University Medicine Berlin, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Hindenburgdamm 30, 12203, Berlin, Germany
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Rittmannsberger H, Barth M, Lamprecht B, Malik P, Yazdi-Zorn K. [Interaction of somatic findings and psychiatric symptoms in COVID-19. A scoping review]. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:1-23. [PMID: 38055146 DOI: 10.1007/s40211-023-00487-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/24/2023] [Indexed: 12/07/2023]
Abstract
An infection with SARS-CoV‑2 can affect the central nervous system, leading to neurological as well as psychiatric symptoms. In this respect, mechanisms of inflammation seem to be of much greater importance than the virus itself. This paper deals with the possible contributions of organic changes to psychiatric symptomatology and deals especially with delirium, cognitive symptoms, depression, anxiety, posttraumatic stress disorder and psychosis. Processes of neuroinflammation with infection of capillary endothelial cells and activation of microglia and astrocytes releasing high amounts of cytokines seem to be of key importance in all kinds of disturbances. They can lead to damage in grey and white matter, impairment of cerebral metabolism and loss of connectivity. Such neuroimmunological processes have been described as a organic basis for many psychiatric disorders, as affective disorders, psychoses and dementia. As the activation of the glia cells can persist for a long time after the offending agent has been cleared, this can contribute to long term sequalae of the infection.
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Affiliation(s)
- Hans Rittmannsberger
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich.
| | - Martin Barth
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich
| | - Bernd Lamprecht
- Med Campus III, Universitätsklinik für Innere Medizin mit Schwerpunkt Pneumologie, Kepler Universitätsklinikum GmbH, Linz, Österreich
- Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Österreich
| | - Peter Malik
- Abteilung Psychiatrie und psychotherapeutische Medizin, Pyhrn-Eisenwurzen Klinikum Steyr, Steyr, Österreich
| | - Kurosch Yazdi-Zorn
- Neuromed Campus, Klinik für Psychiatrie mit Schwerpunkt Suchtmedizin, Kepler Universitätsklinikum GmbH, Linz, Österreich
- Medizinische Fakultät, Johannes Kepler Universität Linz, Linz, Österreich
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Hayashi T, Iwata M. Spontaneous recovery from post-COVID-19 brain fog. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e169. [PMID: 38868481 PMCID: PMC11114291 DOI: 10.1002/pcn5.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/21/2023] [Accepted: 01/07/2024] [Indexed: 06/14/2024]
Abstract
Background One-third of individuals who contract novel coronavirus disease 2019 (COVID-19) reportedly experience persistent symptoms, including respiratory issues, headache, dizziness, taste disorders, fatigue, and various psychiatric and neurological symptoms, known as post-acute sequelae of SARS-CoV-2. In this case report, we present a patient who became aware of brain fog, which is cognitive impairment, approximately 2 months after their COVID-19 symptoms had resolved, accompanied by anxiety and depression. Case Presentation The patient, a 35-year-old Japanese man, was infected with COVID-19 and resumed work approximately 2 weeks later after symptoms improved. Approximately 1 month after returning to work, the patient's concentration became impaired and he started making noticeable errors at work. These symptoms did not improve, leading him to the outpatient clinic specializing in COVID-19 sequelae at our hospital. Here, he underwent blood tests, electroencephalography, and head magnetic resonance imaging, which did not reveal any abnormalities. Cognitive decline due to COVID-19 sequelae was therefore suspected, prompting his evaluation in our department approximately 5 months after his initial COVID-19 infection. Detailed cognitive function tests were performed. He was monitored without the use of medications, and his cognitive function gradually improved. Approximately 11 months after his initial COVID-19 infection, the same cognitive function tests were conducted again, because his subjective cognitive function symptoms had disappeared, and improvement was observed in many items. Conclusion Since brain fog is a relatively common sequela, we emphasize the importance of keeping this in mind from the initial consultations and comparing results over time.
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Affiliation(s)
- Teruaki Hayashi
- Department of Neuropsychiatry, Faculty of MedicineTottori UniversityYonagoJapan
| | - Masaaki Iwata
- Department of Neuropsychiatry, Faculty of MedicineTottori UniversityYonagoJapan
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Zhao S, Martin EM, Reuken PA, Scholcz A, Ganse-Dumrath A, Srowig A, Utech I, Kozik V, Radscheidt M, Brodoehl S, Stallmach A, Schwab M, Fraser E, Finke K, Husain M. Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study. EClinicalMedicine 2024; 68:102434. [PMID: 38318123 PMCID: PMC10839583 DOI: 10.1016/j.eclinm.2024.102434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 02/07/2024] Open
Abstract
Background COVID-19 survivors may experience a wide range of chronic cognitive symptoms for months or years as part of post-COVID-19 conditions (PCC). To date, there is no definitive objective cognitive marker for PCC. We hypothesised that a key common deficit in people with PCC might be generalised cognitive slowing. Methods To examine cognitive slowing, patients with PCC completed two short web-based cognitive tasks, Simple Reaction Time (SRT) and Number Vigilance Test (NVT). 270 patients diagnosed with PCC at two different clinics in UK and Germany were compared to two control groups: individuals who contracted COVID-19 before but did not experience PCC after recovery (No-PCC group) and uninfected individuals (No-COVID group). All patients with PCC completed the study between May 18, 2021 and July 4, 2023 in Jena University Hospital, Jena, Germany and Long COVID clinic, Oxford, UK. Findings We identified pronounced cognitive slowing in patients with PCC, which distinguished them from age-matched healthy individuals who previously had symptomatic COVID-19 but did not manifest PCC. Cognitive slowing was evident even on a 30-s task measuring simple reaction time (SRT), with patients with PCC responding to stimuli ∼3 standard deviations slower than healthy controls. 53.5% of patients with PCC's response speed was slower than 2 standard deviations from the control mean, indicating a high prevalence of cognitive slowing in PCC. This finding was replicated across two clinic samples in Germany and the UK. Comorbidities such as fatigue, depression, anxiety, sleep disturbance, and post-traumatic stress disorder did not account for the extent of cognitive slowing in patients with PCC. Furthermore, cognitive slowing on the SRT was highly correlated with the poor performance of patients with PCC on the NVT measure of sustained attention. Interpretation Together, these results robustly demonstrate pronounced cognitive slowing in people with PCC, which distinguishes them from age-matched healthy individuals who previously had symptomatic COVID-19 but did not manifest PCC. This might be an important factor contributing to some of the cognitive impairments reported in patients with PCC. Funding Wellcome Trust (206330/Z/17/Z), NIHR Oxford Health Biomedical Research Centre, the Thüringer Aufbaubank (2021 FGI 0060), German Forschungsgemeinschaft (DFG, FI 1424/2-1) and the Horizon 2020 Framework Programme of the European Union (ITN SmartAge, H2020-MSCA-ITN-2019-859890).
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Affiliation(s)
- Sijia Zhao
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
| | - Eva Maria Martin
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Philipp A. Reuken
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena, Germany
| | - Anna Scholcz
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| | - Akke Ganse-Dumrath
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| | - Annie Srowig
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Isabelle Utech
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Valeska Kozik
- Department of Neurology, Jena University Hospital, Jena, Germany
| | | | - Stefan Brodoehl
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Andreas Stallmach
- Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Matthias Schwab
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Emily Fraser
- Oxfordshire Post-COVID Assessment Clinic, Oxford University Hospitals Foundation NHS Trust, Oxford, UK
| | - Kathrin Finke
- Department of Neurology, Jena University Hospital, Jena, Germany
- Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
- Department of Psychology, LMU Munich, Munich, Germany
| | - Masud Husain
- Department of Experimental Psychology, University of Oxford, Oxford, OX2 6GG, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
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11
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Mehmood A, Almajwal AM, Addas A, Zeb F, Alam I, Sehar B. Exploring the relationship of cognitive function with and without COVID-19 recovered schizophrenic patients. Front Public Health 2024; 11:1306132. [PMID: 38235158 PMCID: PMC10791931 DOI: 10.3389/fpubh.2023.1306132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/09/2023] [Indexed: 01/19/2024] Open
Abstract
Background The Coronavirus disease 2019 (COVID-19) is linked to the deterioration of cognitive function among individuals suffering from schizophrenia. The purpose of this study was to compare the cognitive performance of schizophrenic patients before and after COVID-19. Methods A longitudinal cohort study involving a sample of 219 individuals diagnosed with schizophrenia was enrolled between June 2022 and May 2023. The participants were split into two groups infected with COVID-19 (n = 165) and not infected with COVID-19 (n = 54). The data were gathered via a questionnaire on demographic characteristics, the Brief Assessment of Cognition in Schizophrenia (BACS), the Positive and Negative Syndrome Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Activities of Daily Living (ADL) scale, and the Insomnia Severity Index (ISI). Results The repeated-measures ANOVA showed that Among patients diagnosed with COVID-19, there was a deterioration in global cognitive function (before COVID-19 = -2.45 vs. after COVID-19 = -3.02, p = 0.007), working memory (before COVID-19 = -2.76 vs. after COVID-19 = -3.34, p < 0.00 1), motor speed (before COVID-19 = -1.64 vs. after COVID-19 = -2.12, p < 0.001), attention and speed of information processing (before COVID-19 = -1.93 vs. after COVID-19 = -1.16, p = 0.008). multi-variable analysis showed that several factors as having a secondary grade of education (β = 0.434), experiencing insomnia (β = 0.411)and the interaction between COVID-19 diagnosis and cognition at baseline (β = 0.796) were significantly associated with cognitive deficits. At the same time, no significant associations were found between global cognition and clinical symptoms, autonomy, or depression (p > 0.05). Conclusion The COVID-19 pandemic has significantly impacted various cognitive functions, such as verbal memory, working memory, and global cognition. Insomnia has been identified as the predominant determinant of cognitive impairment, alongside the confirmation of a COVID-19 diagnosis. Additional research is imperative to elucidate the diversification of cognitive functionality observed in individuals diagnosed with schizophrenia who have acquired COVID-19.
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Affiliation(s)
- Anam Mehmood
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ali Madi Almajwal
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Addas
- Department of Civil Engineering, College of Engineering, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Landscape Architecture Department, Faculty of Architecture and Planning, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Falak Zeb
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Iftikhar Alam
- Department of Human Nutrition and Dietetics, Bacha Khan University Charsadda, KPK, Pakistan
| | - Bismillah Sehar
- Department of Health and Social Sciences, University of Bedfordshire, Luton, United Kingdom
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12
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Attwood M, Jarrold C. Investigating the impact of the COVID-19 pandemic on older adolescents' psychological wellbeing and self-identified cognitive difficulties. JCPP ADVANCES 2023; 3:e12164. [PMID: 38054057 PMCID: PMC10694530 DOI: 10.1002/jcv2.12164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/24/2023] [Indexed: 12/07/2023] Open
Abstract
Background The COVID-19 pandemic coincides with growing concern regarding the mental health of young people. Older adolescents have faced a particular set of pandemic-related challenges and demonstrate heightened vulnerability to affective disorders (particularly anxiety). Anxiety symptoms are associated with a range of cognitive difficulties. Older adolescents may therefore be susceptible to pandemic-related declines in wellbeing and associated cognitive difficulties. Methods At three timepoints, independent samples of young people aged 16-18 years (N = 607, 242, 618 respectively) completed an online survey. Data collection coincided with periods of lockdown (timepoints 1 and 3) and young people returning to school (timepoint 2). The survey assessed subjective impacts of the pandemic on overall wellbeing, anxiety and cognitive function. Results Findings demonstrated the detrimental impact of the COVID-19 pandemic on older adolescents' psychological wellbeing-a finding that was consistent across samples. The majority of young people at each timepoint experienced heightened anxiety. Crucially, pandemic-related anxiety was associated with self-identified cognitive difficulties, a pattern of association that was evident at all three timepoints. The nature and extent of these difficulties were predictive of specific pandemic-related concerns in this age group. Conclusions Older adolescents' experiences of the pandemic are characterised by subjective declines in wellbeing and stable patterns of association between anxiety and self-identified cognitive difficulties. Implications are discussed with reference to future research and intervention.
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Affiliation(s)
- Meg Attwood
- School of Psychological ScienceUniversity of BristolBristolUK
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13
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Espinar-Herranz K, Delgado-Lima AH, Villatoro BS, Garaboa EM, Gómez VS, Vides LG, Bouhaben J, Delgado-Losada ML. Memory, Emotion, and Quality of Life in Patients with Long COVID-19. Brain Sci 2023; 13:1670. [PMID: 38137118 PMCID: PMC10742100 DOI: 10.3390/brainsci13121670] [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: 10/31/2023] [Revised: 11/20/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Persistent COVID is characterized by the presence of fatigue, mental fog, and sleep problems, among others. We aimed to study cognitive abilities (attention, executive functions, memory, language) and psychological and emotional factors in a group of participants of the population with persistent COVID-19 and asymptomatic or non-COVID-19-infected patients; (2) Methods: A total of 86 participants aged 18 to 66 years (X = 46.76) took part in the study, with 57 individuals (66.27%) in the experimental group and 29 (33.73%) in the control group. A comprehensive assessment included neuropsychological evaluations, evaluations of anxious and depressive symptomatology, assessments of the impact of fatigue, sleep quality, memory failures in daily life, and the perceived general health status of the participants; (3) Results: significant differences between groups were found in incidental learning within the Key Numbers task (U = 462.5; p = 0.001; p = 0.022) and in the Direct Digit Span (U = 562; p = 0.022), but not in the Inverse Digit Span (U = 632.5; p = 0.105). Differences were also observed in the prospective memory task of the Rivermead Prospective Memory Tasks (from the Rivermead Behavioural Memory Test) in the recall of quotations (U = 610; p = 0.020) as well as in the recall of objects (U = 681.5; p = 0.032). Concerning the task of verbal fluency, significant differences were found for both phonological cues (p- and s-) (t = -2.190; p = 0.031) and semantic cues (animals) (t = -2.277; p = 0.025). In terms of the psychological impact assessment, significant differences were found in the emotional impact across all variables studied (fatigue, quality of sleep, memory lapses, and the perceived general health status), except for quality of life; (4) Conclusions: Our results suggest that the sequelae derived from persistent COVID may have an impact on people's lives, with higher levels of anxiety and depression, worse sleep quality, a greater number of subjective memory complaints, and a greater feeling of fatigue and impact on quality of life. Furthermore, poorer performance was observed in memory and verbal fluency.
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Affiliation(s)
- Katrina Espinar-Herranz
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain; (K.E.-H.); (A.H.D.-L.); (B.S.V.); (E.M.G.); (V.S.G.); (J.B.)
| | - Alice Helena Delgado-Lima
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain; (K.E.-H.); (A.H.D.-L.); (B.S.V.); (E.M.G.); (V.S.G.); (J.B.)
| | - Beatriz Sequeira Villatoro
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain; (K.E.-H.); (A.H.D.-L.); (B.S.V.); (E.M.G.); (V.S.G.); (J.B.)
| | - Esther Marín Garaboa
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain; (K.E.-H.); (A.H.D.-L.); (B.S.V.); (E.M.G.); (V.S.G.); (J.B.)
| | - Valeria Silva Gómez
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain; (K.E.-H.); (A.H.D.-L.); (B.S.V.); (E.M.G.); (V.S.G.); (J.B.)
| | - Leonela González Vides
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, C. de Arcos de Jalón, 118, 28037 Madrid, Spain;
| | - Jaime Bouhaben
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain; (K.E.-H.); (A.H.D.-L.); (B.S.V.); (E.M.G.); (V.S.G.); (J.B.)
| | - María Luisa Delgado-Losada
- Experimental Psychology, Cognitive Processes and Speech Therapy Department, Faculty of Psychology, Complutense University of Madrid, Campus de Somosaguas, 28223 Pozuelo de Alarcón, Spain; (K.E.-H.); (A.H.D.-L.); (B.S.V.); (E.M.G.); (V.S.G.); (J.B.)
- Group of Neurosciences, Psychoneuroendocrinology, Neuroimaging and Molecular Genetics in Neuropsychiatric Diseases, Instituto de Investigación Sanitaria San Carlos (IdISSC), Hospital Clínico de Madrid, 28040 Madrid, Spain
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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.
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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
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Amadoro G, Latina V, Stigliano E, Micera A. COVID-19 and Alzheimer's Disease Share Common Neurological and Ophthalmological Manifestations: A Bidirectional Risk in the Post-Pandemic Future. Cells 2023; 12:2601. [PMID: 37998336 PMCID: PMC10670749 DOI: 10.3390/cells12222601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
A growing body of evidence indicates that a neuropathological cross-talk takes place between the coronavirus disease 2019 (COVID-19) -the pandemic severe pneumonia that has had a tremendous impact on the global economy and health since three years after its outbreak in December 2019- and Alzheimer's Disease (AD), the leading cause of dementia among human beings, reaching 139 million by the year 2050. Even though COVID-19 is a primary respiratory disease, its causative agent, the so-called Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), is also endowed with high neuro-invasive potential (Neurocovid). The neurological complications of COVID-19, resulting from the direct viral entry into the Central Nervous System (CNS) and/or indirect systemic inflammation and dysregulated activation of immune response, encompass memory decline and anosmia which are typically associated with AD symptomatology. In addition, patients diagnosed with AD are more vulnerable to SARS-CoV-2 infection and are inclined to more severe clinical outcomes. In the present review, we better elucidate the intimate connection between COVID-19 and AD by summarizing the involved risk factors/targets and the underlying biological mechanisms shared by these two disorders with a particular focus on the Angiotensin-Converting Enzyme 2 (ACE2) receptor, APOlipoprotein E (APOE), aging, neuroinflammation and cellular pathways associated with the Amyloid Precursor Protein (APP)/Amyloid beta (Aβ) and tau neuropathologies. Finally, the involvement of ophthalmological manifestations, including vitreo-retinal abnormalities and visual deficits, in both COVID-19 and AD are also discussed. Understanding the common physiopathological aspects linking COVID-19 and AD will pave the way to novel management and diagnostic/therapeutic approaches to cope with them in the post-pandemic future.
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Affiliation(s)
- Giuseppina Amadoro
- Institute of Translational Pharmacology (IFT), National Research Council (CNR), Via Fosso del Cavaliere 100, 00133 Rome, Italy;
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Valentina Latina
- Institute of Translational Pharmacology (IFT), National Research Council (CNR), Via Fosso del Cavaliere 100, 00133 Rome, Italy;
- European Brain Research Institute (EBRI), Viale Regina Elena 295, 00161 Rome, Italy
| | - Egidio Stigliano
- Area of Pathology, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo Francesco Vito 1, 00168 Rome, Italy;
| | - Alessandra Micera
- Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences, IRCCS-Fondazione Bietti, Via Santo Stefano Rotondo, 6, 00184 Rome, Italy
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16
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Acharya V, Fan KH, Snitz BE, Ganguli M, DeKosky ST, Lopez OL, Feingold E, Kamboh MI. Meta-analysis of age-related cognitive decline reveals a novel locus for the attention domain and implicates a COVID-19-related gene for global cognitive function. Alzheimers Dement 2023; 19:5010-5022. [PMID: 37089073 PMCID: PMC10590825 DOI: 10.1002/alz.13064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Cognitive abilities have substantial heritability throughout life, as shown by twin- and population-based studies. However, there is limited understanding of the genetic factors related to cognitive decline in aging across neurocognitive domains. METHODS We conducted a meta-analysis on 3045 individuals aged ≥65, derived from three population-based cohorts, to identify genetic variants associated with the decline of five neurocognitive domains (attention, memory, executive function, language, visuospatial function) and global cognitive decline. We also conducted gene-based and functional bioinformatics analyses. RESULTS Apolipoprotein E (APOE)4 was significantly associated with decline of memory (p = 5.58E-09) and global cognitive function (p = 1.84E-08). We identified a novel association with attention decline on chromosome 9, rs6559700 (p = 2.69E-08), near RASEF. Gene-based analysis also identified a novel gene, TMPRSS11D, involved in the activation of SARS-CoV-2, to be associated with the decline in global cognitive function (p = 4.28E-07). DISCUSSION Domain-specific genetic studies can aid in the identification of novel genes and pathways associated with decline across neurocognitive domains. HIGHLIGHTS rs6559700 was associated with decline of attention. APOE4 was associated with decline of memory and global cognitive decline. TMPRSS11D, a gene involved in the activation of SARS-CoV-2, was implicated in global cognitive decline. Cognitive domain abilities had both unique and shared molecular pathways across the domains.
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Affiliation(s)
- Vibha Acharya
- Department of Human Genetics, University of Pittsburgh School of Public Health, Pittsburgh, PA 15261, USA
| | - Kang-Hsien Fan
- Department of Human Genetics, University of Pittsburgh School of Public Health, Pittsburgh, PA 15261, USA
| | - Beth E. Snitz
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Steven T. DeKosky
- McKnight Brain Institute and Department of Neurology, College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Oscar L. Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Eleanor Feingold
- Department of Human Genetics, University of Pittsburgh School of Public Health, Pittsburgh, PA 15261, USA
| | - M. Ilyas Kamboh
- Department of Human Genetics, University of Pittsburgh School of Public Health, Pittsburgh, PA 15261, USA
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
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17
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Pallanti S, Di Ponzio M, Gavazzi G, Gasic G, Besteher B, Heller C, Kikinis R, Makris N, Kikinis Z. From 'mental fog' to post-acute COVID-19 syndrome's executive function alteration: Implications for clinical approach. J Psychiatr Res 2023; 167:10-15. [PMID: 37804756 DOI: 10.1016/j.jpsychires.2023.09.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 09/15/2023] [Indexed: 10/09/2023]
Abstract
A common symptom of the neuropsychiatric Post-Acute COVID-19 syndrome (neuro-PACS) is the so called 'brain fog'. Patients describe the brain fog as problems with attention, memory and mental fatigue. Brain fog is experienced by 9-55% of people for months after having contracted SARS-CoV-2 virus. Several theories have been proposed to explain PACS's brain fog, including a neuroinflammatory hypothesis, but the hypothesis remains to be proven. Here, we examined inflammatory and immunological blood profile in a cohort of patients with PACS to investigate the association between executive functions and blood inflammatory markers. Executive function was assessed by the Trail Making Test (TMT) Part A and Part B, as well as the Barkley Deficits in Executive Functioning Scale (BDEFS), in 71 patients (36 men), average age of 40 years (range: 15-82, SD: 15.7). Impairment in executive functioning (BDEFS scores and TMT B scores) correlated with increased levels of Interleukin-6 (IL-6), fibrinogen and ferritin. Moreover, elevated levels of Il-6, fibrinogen, ferritin, tumor necrosis factor-alpha and C-reactive protein have been observed in PACS. These findings demonstrate that PACS is characterized by the presence of an immuno-inflammatory process, which is associated with diminished executive functioning. Here, we argue in favour of a shift from the non-descriptive definition of 'mental fog' to a characterization of a subtype of PACS, associated with alteration in executive functioning. Implication for clinical settings and prevention are discussed.
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Affiliation(s)
- Stefano Pallanti
- Department of Psychiatry and Behavioural Science, Albert Einstein College of Medicine, Bronx, USA; Istituto di Neuroscienze, Florence, Italy.
| | | | - Gioele Gavazzi
- Department of Neuroscience, Psychology, Drug Research, Child Health, University of Florence, Florence, Italy
| | | | - Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Carina Heller
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Clinical Psychology, Friedrich-Schiller-University Jena, Jena, Germany; Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ron Kikinis
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Nikos Makris
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Morphometric Analysis, Departments of Psychiatry, Neurology and A. A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, MA, USA; Department of Anatomy and Neurobiology, Boston University Medical School, Boston, USA
| | - Zora Kikinis
- Department of Psychiatry, Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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18
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Su S, Zhao Y, Zeng N, Liu X, Zheng Y, Sun J, Zhong Y, Wu S, Ni S, Gong Y, Zhang Z, Gao N, Yuan K, Yan W, Shi L, Ravindran AV, Kosten T, Shi J, Bao Y, Lu L. Epidemiology, clinical presentation, pathophysiology, and management of long COVID: an update. Mol Psychiatry 2023; 28:4056-4069. [PMID: 37491461 DOI: 10.1038/s41380-023-02171-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 06/20/2023] [Accepted: 06/27/2023] [Indexed: 07/27/2023]
Abstract
The increasing number of coronavirus disease 2019 (COVID-19) infections have highlighted the long-term consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection called long COVID. Although the concept and definition of long COVID are described differently across countries and institutions, there is general agreement that it affects multiple systems, including the immune, respiratory, cardiovascular, gastrointestinal, neuropsychological, musculoskeletal, and other systems. This review aims to provide a synthesis of published epidemiology, symptoms, and risk factors of long COVID. We also summarize potential pathophysiological mechanisms and biomarkers for precise prevention, early diagnosis, and accurate treatment of long COVID. Furthermore, we suggest evidence-based guidelines for the comprehensive evaluation and management of long COVID, involving treatment, health systems, health finance, public attitudes, and international cooperation, which is proposed to improve the treatment strategies, preventive measures, and public health policy making of long COVID.
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Affiliation(s)
- Sizhen Su
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yimiao Zhao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Scholl of Public Health, Peking University, Beijing, China
| | - Na Zeng
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Scholl of Public Health, Peking University, Beijing, China
| | - Xiaoxing Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yongbo Zheng
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Jie Sun
- Pain Medicine Center, Peking University Third Hospital, Beijing, China
| | - Yi Zhong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Shuilin Wu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Scholl of Public Health, Peking University, Beijing, China
| | - Shuyu Ni
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
- Scholl of Public Health, Peking University, Beijing, China
| | - Yimiao Gong
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Zhibo Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Nan Gao
- The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
| | - Kai Yuan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Wei Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Le Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Arun V Ravindran
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Thomas Kosten
- Department of Psychiatry, Baylor College of Medicine, Houston, TX, USA
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - Yanping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.
- Scholl of Public Health, Peking University, Beijing, China.
| | - Lin Lu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China.
- Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.
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19
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van Houwelingen F, van Dellen E, Visser-Meily JMA, Valkenet K, Heijnen GH, Vernooij LM, Kerckhoffs MC, Slooter AJC. Mental, cognitive and physical outcomes after intensive care unit treatment during the COVID-19 pandemic: a comparison between COVID-19 and non-COVID-19 patients. Sci Rep 2023; 13:14414. [PMID: 37660228 PMCID: PMC10475104 DOI: 10.1038/s41598-023-41667-4] [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: 02/17/2023] [Accepted: 08/29/2023] [Indexed: 09/04/2023] Open
Abstract
To compare mental, cognitive and physical outcomes between COVID-19 and non-COVID-19 patients, 3-6 months after Intensive Care Unit (ICU) treatment during the COVID-19 pandemic and to compare mental outcomes between relatives of these patients. This retrospective cohort study included 209 ICU survivors (141 COVID-19 patients and 68 non-COVID-19 patients) and 168 of their relatives (maximum one per patient) during the COVID-19 pandemic. Primary outcomes were self-reported occurrence of mental, cognitive and/or physical symptoms 3-6 months after ICU discharge. The occurrence of mental symptoms did not differ between former COVID-19 patients (34.7% [43/124]) and non-COVID-19 patients (43.5% [27/62]) (p = 0.309), neither between relatives of COVID-19 patients (37.6% [38/101]) and relatives of non-COVID-19 patients (39.6% [21/53]) (p = 0.946). Depression scores on the Hospital Anxiety and Depression Scale were lower in former COVID-19 patients, compared to non-COVID-19 patients (p = 0.025). We found no differences between COVID-19 and non-COVID-19 patients in cognitive and physical outcomes. Mental, cognitive and physical outcomes in COVID-19 ICU survivors were similar to non-COVID-19 ICU survivors. Mental symptoms in relatives of COVID-19 ICU survivors did not differ from relatives of non-COVID-19 ICU survivors, within the same time frame.
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Affiliation(s)
- Fedor van Houwelingen
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Edwin van Dellen
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Department of Intensive Care Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 3584 CX, Utrecht, The Netherlands
| | - J M Anne Visser-Meily
- Department of Rehabilitation, Physiotherapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 3584 CX, Utrecht, The Netherlands
| | - Karin Valkenet
- Department of Rehabilitation, Physiotherapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 3584 CX, Utrecht, The Netherlands
| | - Germijn H Heijnen
- Department of Rehabilitation, Physiotherapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 3584 CX, Utrecht, The Netherlands
| | - Lisette M Vernooij
- Department of Intensive Care Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 3584 CX, Utrecht, The Netherlands
| | - Monika C Kerckhoffs
- Department of Intensive Care Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 3584 CX, Utrecht, The Netherlands
| | - Arjen J C Slooter
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
- Department of Intensive Care Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, 3584 CX, Utrecht, The Netherlands
- Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Brussels, Belgium
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20
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Sen S, Newman-Norlund R, Riccardi N, Rorden C, Newman-Norlund S, Sayers S, Fridriksson J, Logue M. Cerebral blood flow in patients recovered from mild COVID-19. J Neuroimaging 2023; 33:764-772. [PMID: 37265421 PMCID: PMC11205277 DOI: 10.1111/jon.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND AND PURPOSE Cerebral hypoperfusion has been described in both severe and mild forms of symptomatic Coronavirus Disease 2019 (COVID-19) infection. The purpose of this study was to investigate global and regional cerebral blood flow (CBF) in asymptomatic COVID-19 patients. METHODS Cases with mild COVID-19 infection and age-, sex-, and race-matched healthy controls were drawn from the Aging Brain Consortium at The University of South Carolina data repository. Demographics, risk factors, and data from the Montreal Cognitive Assessment were collected. Mean CBF values for gray matter (GM), white matter (WM), and the whole brain were calculated by averaging CBF values of standard space-normalized CBF image values falling within GM and WM masks. Whole brain region of interest-based analyses were used to create standardized CBF maps and explore differences between groups. RESULTS Twenty-eight cases with prior mild COVID-19 infection were compared with 28 controls. Whole-brain CBF (46.7 ± 5.6 vs. 49.3 ± 3.7, p = .05) and WM CBF (29.3 ± 2.6 vs. 31.0 ± 1.6, p = .03) were noted to be significantly lower in COVID-19 cases as compared to controls. Predictive models based on these data predicted COVID-19 group membership with a high degree of accuracy (85.2%, p < .001), suggesting CBF patterns are an imaging marker of mild COVID-19 infection. CONCLUSION In this study, lower WM CBF, as well as widespread regional CBF changes identified using quantitative MRI, was found in mild COVID-19 patients. Further studies are needed to determine the reliability of this newly identified COVID-19 brain imaging marker and determine what drives these CBF changes.
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Affiliation(s)
- Souvik Sen
- Department of Neurology, University of South Carolina, Columbia, South Carolina, USA
| | - Roger Newman-Norlund
- Department of Neurology, University of South Carolina, Columbia, South Carolina, USA
| | - Nicholas Riccardi
- Department of Neurology, University of South Carolina, Columbia, South Carolina, USA
| | - Christopher Rorden
- Department of Neurology, University of South Carolina, Columbia, South Carolina, USA
| | - Sarah Newman-Norlund
- Department of Neurology, University of South Carolina, Columbia, South Carolina, USA
| | - Sara Sayers
- Department of Neurology, University of South Carolina, Columbia, South Carolina, USA
| | - Julius Fridriksson
- Department of Neurology, University of South Carolina, Columbia, South Carolina, USA
| | - Makenzie Logue
- Department of Neurology, University of South Carolina, Columbia, South Carolina, USA
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21
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Dimitrova M, Marinova Y, Dilkov D. Investigation of Cognitive Impairment in the Course of Post-COVID Syndrome. Diagnostics (Basel) 2023; 13:2703. [PMID: 37627961 PMCID: PMC10453167 DOI: 10.3390/diagnostics13162703] [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: 04/24/2023] [Revised: 06/27/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
(1) Background: The study presents results from an investigation of cognitive impairment in patients hospitalized in the first psychiatric clinic in Bulgaria to treat patients with COVID-19 during the pandemic period between 2020 and 2022. One hundred and twenty patients who had recovered from acute COVID-19 infection (up to 12 weeks ago) and had no previous history of cognitive impairment participated in the study. In 23 of them (19.17%), disturbance of cognitive functioning was observed. (2) Methods: All 23 patients underwent neuropsychological (Luria's test, Platonov's Maze test, MMSE, Boston Naming test) and neuroimaging examinations. Only seven of them had evidence of cortical atrophy on CT/MRI images. The most significantly demonstrative image of one of those patients is presented. (3) Results: The neuropsychological testing results of both groups show a certain decrease in fixation and memory retention as well as in the range, concentration, distribution and switching of attention. Deviations from the norm on the MMSE, as well as on the Boston Naming Test, were found in the group of patients with cortical atrophy (mild to moderate aphasia). Neuroprotective agents such as Citicoline, Piracetam and Memantine were prescribed to the patients with evident cortical atrophy. After 3 months, positive results of the neuropsychological examination were reported in both groups. (4) Conclusions: Although there are limited data on the benefit of prescribing pro-cognitive agents in the post-COVID period, our clinical experience suggests that it might be useful in the recovery process from the infection's consequences on cognition for patients with brain pathology.
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Affiliation(s)
| | - Yoanna Marinova
- Psychiatry Clinic, Military Medical Academy, 1606 Sofia, Bulgaria
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22
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Graf K, Gustke A, Mösle M, Armann J, Schneider J, Schumm L, Roessner V, Beste C, Bluschke A. Preserved perception-action integration in adolescents after a COVID-19 infection. Sci Rep 2023; 13:13287. [PMID: 37587175 PMCID: PMC10432494 DOI: 10.1038/s41598-023-40534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 08/11/2023] [Indexed: 08/18/2023] Open
Abstract
Evidence is accumulating that the Coronavirus disease (COVID-19) can bring forth deficits in executive functioning via alterations in the dopaminergic system. Importantly, dopaminergic pathways have been shown to modulate how actions and perceptions are integrated within the brain. Such alterations in event file binding could thus underlie the cognitive deficits developing after a COVID-19 infection. We examined action-perception integration in a group of young people (11-19 years of age) that had been infected with COVID-19 before study participation (n = 34) and compared them to a group of uninfected healthy controls (n = 29) on the behavioral (i.e., task accuracy, reaction time) and neurophysiological (EEG) level using an established event file binding paradigm. Groups did not differ from each other regarding demographic variables or in reporting psychiatric symptoms. Overall, multiple lines of evidence (behavioral and neurophysiological) suggest that action-perception integration is preserved in adolescents who suffered from COVID-19 prior to study participation. Event file binding processes were intact in both groups on all levels. While cognitive impairments can occur following a COVID-19 infection, the study demonstrates that action-perception integration as one of the basic building blocks of cognition seems to be largely unaffected in adolescents with a rather mild course of the disease.
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Affiliation(s)
- Katharina Graf
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309, Dresden, Germany
- University Neuropsychology Center (UNC), Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Alena Gustke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309, Dresden, Germany
- University Neuropsychology Center (UNC), Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Mariella Mösle
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309, Dresden, Germany
- University Neuropsychology Center (UNC), Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Jakob Armann
- Department of Paediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Josephine Schneider
- Department of Paediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Leonie Schumm
- Department of Paediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309, Dresden, Germany.
- University Neuropsychology Center (UNC), Faculty of Medicine, TU Dresden, Dresden, Germany.
| | - Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Schubertstrasse 42, 01309, Dresden, Germany
- University Neuropsychology Center (UNC), Faculty of Medicine, TU Dresden, Dresden, Germany
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23
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Cysique LA, Jakabek D, Bracken SG, Allen‐Davidian Y, Heng B, Chow S, Dehhaghi M, Staats Pires A, Darley DR, Byrne A, Phetsouphanh C, Kelleher A, Dore GJ, Matthews GV, Guillemin GJ, Brew BJ. The kynurenine pathway relates to post-acute COVID-19 objective cognitive impairment and PASC. Ann Clin Transl Neurol 2023; 10:1338-1352. [PMID: 37318955 PMCID: PMC10424655 DOI: 10.1002/acn3.51825] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE To determine the prevalence and natural history of post-acute COVID-19 objective cognitive impairment and function, and their relationship to demographic, clinical factors, post-acute sequelae of COVID-19 (PASC), and biomarkers. METHODS A total of 128 post-acute COVID-19 patients (age = 46 ± 15; 42% women, acute disease severity: not hospitalized: 38.6% mild: 0-1 symptoms, 52% 2+ symptoms; 9.4% hospitalized) completed standard cognition, olfaction, and mental health examinations 2-, 4-, and 12-month post diagnosis. Over the same time frame, WHO-defined PASC was determined. Blood cytokines, peripheral neurobiomarkers, and kynurenine pathway (KP) metabolites were measured. Objective cognitive function was demographically/practice corrected, and impairment prevalence was determined using the evidence-based Global Deficit Score method to detect at least mild cognitive impairment (GDS > 0.5). Linear mixed effect regression models with time effect (month post diagnosis) evaluated the relationships to cognition. RESULTS Across the 12-month study period, mild to moderate cognitive impairment ranged from 16% to 26%, and 46.5% were impaired at least once. Impairment associated with poorer work capacity (p < 0.05), and 2-month objectively tested anosmia (p < 0.05). PASC with (p = 0.01) and without disability (p < 0.03) associated with acute COVID-19 severity. KP measures showed prolonged activation (2 to 8 months) (p < 0.0001) linked to IFN-beta in those with PASC. Of the blood analytes, only the KP metabolites (elevated quinolinic acid, 3-hydroxyanthranilic acid, kynurenine, the kynurenine/tryptophan ratio) associated (p < 0.001) with poorer cognitive performance and greater likelihood of impairment. PASC, independent of disability associated with abnormal kynurenine/tryptophan (p < 0.03). INTERPRETATION The kynurenine pathway relates to post-acute COVID-19 objective cognitive impairment and PASC, thereby enabling biomarker and therapeutic possibilities.
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Affiliation(s)
- Lucette A. Cysique
- Peter Duncan Neuroscience Research UnitSt. Vincent's Centre for Applied Medical ResearchDarlinghurstNew South WalesAustralia
- School of PsychologyUNSWSydneyNew South WalesAustralia
| | - David Jakabek
- Neurology DepartmentSt. Vincent's HospitalDarlinghurstNew South WalesAustralia
| | | | - Yasmin Allen‐Davidian
- Peter Duncan Neuroscience Research UnitSt. Vincent's Centre for Applied Medical ResearchDarlinghurstNew South WalesAustralia
- School of PsychologyMacquarie UniversitySydneyNew South WalesAustralia
| | - Benjamin Heng
- Macquarie Medical SchoolMacquarie UniversitySydneyNew South WalesAustralia
- PANDIS.orgSydneyNew South WalesAustralia
| | - Sharron Chow
- Macquarie Medical SchoolMacquarie UniversitySydneyNew South WalesAustralia
| | - Mona Dehhaghi
- Macquarie Medical SchoolMacquarie UniversitySydneyNew South WalesAustralia
- PANDIS.orgSydneyNew South WalesAustralia
| | | | - David R. Darley
- Faculty of MedicineUNSWSydneyNew South WalesAustralia
- Respiratory Medicine DepartmentSt. Vincent's HospitalDarlinghurstNew South WalesAustralia
| | - Anthony Byrne
- Faculty of MedicineUNSWSydneyNew South WalesAustralia
- Respiratory Medicine DepartmentSt. Vincent's HospitalDarlinghurstNew South WalesAustralia
| | | | - Anthony Kelleher
- Kirby InstituteUNSWSydneyNew South WalesAustralia
- Infectious Disease and Immunology DepartmentSt. Vincent's HospitalDarlinghurstNew South WalesAustralia
| | - Gregory J. Dore
- Kirby InstituteUNSWSydneyNew South WalesAustralia
- Infectious Disease and Immunology DepartmentSt. Vincent's HospitalDarlinghurstNew South WalesAustralia
| | - Gail V. Matthews
- Kirby InstituteUNSWSydneyNew South WalesAustralia
- Infectious Disease and Immunology DepartmentSt. Vincent's HospitalDarlinghurstNew South WalesAustralia
| | - Gilles J. Guillemin
- Macquarie Medical SchoolMacquarie UniversitySydneyNew South WalesAustralia
- PANDIS.orgSydneyNew South WalesAustralia
| | - Bruce J. Brew
- Peter Duncan Neuroscience Research UnitSt. Vincent's Centre for Applied Medical ResearchDarlinghurstNew South WalesAustralia
- Neurology DepartmentSt. Vincent's HospitalDarlinghurstNew South WalesAustralia
- Faculty of MedicineUNSWSydneyNew South WalesAustralia
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24
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Li Z, Zhang Z, Zhang Z, Wang Z, Li H. Cognitive impairment after long COVID-19: current evidence and perspectives. Front Neurol 2023; 14:1239182. [PMID: 37583958 PMCID: PMC10423939 DOI: 10.3389/fneur.2023.1239182] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 07/12/2023] [Indexed: 08/17/2023] Open
Abstract
COVID-19, caused by the SARS-CoV-2 virus, is a respiratory infectious disease. While most patients recover after treatment, there is growing evidence that COVID-19 may result in cognitive impairment. Recent studies reveal that some individuals experience cognitive deficits, such as diminished memory and attention, as well as sleep disturbances, suggesting that COVID-19 could have long-term effects on cognitive function. Research indicates that COVID-19 may contribute to cognitive decline by damaging crucial brain regions, including the hippocampus and anterior cingulate cortex. Additionally, studies have identified active neuroinflammation, mitochondrial dysfunction, and microglial activation in COVID-19 patients, implying that these factors may be potential mechanisms leading to cognitive impairment. Given these findings, the possibility of cognitive impairment following COVID-19 treatment warrants careful consideration. Large-scale follow-up studies are needed to investigate the impact of COVID-19 on cognitive function and offer evidence to support clinical treatment and rehabilitation practices. In-depth neuropathological and biological studies can elucidate precise mechanisms and provide a theoretical basis for prevention, treatment, and intervention research. Considering the risks of the long-term effects of COVID-19 and the possibility of reinfection, it is imperative to integrate basic and clinical research data to optimize the preservation of patients' cognitive function and quality of life. This integration will also offer valuable insights for responding to similar public health events in the future. This perspective article synthesizes clinical and basic evidence of cognitive impairment following COVID-19, discussing potential mechanisms and outlining future research directions.
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Affiliation(s)
- Zhitao Li
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
- The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhen Zhang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhuoya Zhang
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhiyong Wang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Hao Li
- Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
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25
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Rahman RS, Tovar MA, Peinado J, Palomino JS, Ramirez C, Llanos-Zavalaga F, Peralta E, Valderrama G, Ramos Cordova LB, Sanchez Cortez LI, Rodriguez G, LaHood AN, Franke MF, Mitnick CD, Lecca L, Velásquez GE. Respiratory, Cardiac, and Neuropsychiatric Manifestations of Postacute Sequelae of Coronavirus Disease 2019 in Lima, Peru. Open Forum Infect Dis 2023; 10:ofad320. [PMID: 37496609 PMCID: PMC10368202 DOI: 10.1093/ofid/ofad320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/16/2023] [Indexed: 07/28/2023] Open
Abstract
Background Few studies have examined the burden of postacute sequelae of coronavirus disease 2019 (COVID-19) (PASC) in low- and middle-income countries. We sought to characterize PASC with self-reported questionnaires and clinical examinations of end-organ function in Lima, Peru. Methods From January to July 2021, we recruited participants at least 8 weeks after COVID-19 diagnosis from a case registry in Lima, Peru. We evaluated participants for PASC with questionnaires, neuropsychiatric evaluations, chest X-ray, spirometry, electrocardiogram, and echocardiogram. We used multivariable models to identify risk factors for PASC. Results We assessed 989 participants for PASC at a median 4.7 months after diagnosis. Clinically significant respiratory symptoms were reported by 68.3% of participants, particularly those who had been severely ill during acute COVID-19, and were associated with cardiac findings of ventricular hypertrophy or dilation on echocardiogram. Neuropsychiatric questionnaires were consistent with depression in 20.7% and cognitive impairment in 8.0%. Female sex and older age were associated with increased risk of respiratory (adjusted odds ratio [aOR], 2.36 [95% confidence interval {CI}, 1.69-3.31] and aOR, 1.01 [95% CI, 1.00-1.03], respectively) and neuropsychiatric sequelae (aOR, 2.99 [95% CI, 2.16-4.18] and aOR, 1.02 [95% CI, 1.01-1.03], respectively). Conclusions COVID-19 survivors in Lima, Peru, experienced frequent postacute respiratory symptoms and depression, particularly among older and female participants. Clinical examinations highlighted the need for cardiopulmonary rehabilitation among persons with severe COVID-19; psychosocial support may be required among all COVID-19 survivors.
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Affiliation(s)
| | - Marco A Tovar
- Correspondence: Gustavo E. Velásquez, MD, MPH, Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, 1001 Potrero Ave, Bldg 80, Ward 84, San Francisco, CA 94110 (); Marco A. Tovar, MD, Socios En Salud Sucursal Peru, Jr Puno 279, Cercado de Lima, Lima, Peru ()
| | | | | | - Claudio Ramirez
- Dirección de Redes Integradas de Salud–Lima Norte, Lima, Peru
| | - Fernando Llanos-Zavalaga
- Dirección de Redes Integradas de Salud–Lima Norte, Lima, Peru
- Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia,Lima, Peru
| | - Ernesto Peralta
- Dirección de Redes Integradas de Salud–Lima Norte, Lima, Peru
| | | | | | | | | | - Allison N LaHood
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Molly F Franke
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Carole D Mitnick
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Partners In Health, Boston, Massachusetts, USA
| | | | - Gustavo E Velásquez
- Correspondence: Gustavo E. Velásquez, MD, MPH, Division of HIV, Infectious Diseases, and Global Medicine, University of California, San Francisco, 1001 Potrero Ave, Bldg 80, Ward 84, San Francisco, CA 94110 (); Marco A. Tovar, MD, Socios En Salud Sucursal Peru, Jr Puno 279, Cercado de Lima, Lima, Peru ()
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26
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Godoy-González M, Navarra-Ventura G, Gomà G, de Haro C, Espinal C, Fortià C, Ridao N, Miguel Rebanal N, Oliveras-Furriols L, Subirà C, Jodar M, Santos-Pulpón V, Sarlabous L, Fernández R, Ochagavía A, Blanch L, Roca O, López-Aguilar J, Fernández-Gonzalo S. Objective and subjective cognition in survivors of COVID-19 one year after ICU discharge: the role of demographic, clinical, and emotional factors. Crit Care 2023; 27:188. [PMID: 37189173 PMCID: PMC10184095 DOI: 10.1186/s13054-023-04478-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/04/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Intensive Care Unit (ICU) COVID-19 survivors may present long-term cognitive and emotional difficulties after hospital discharge. This study aims to characterize the neuropsychological dysfunction of COVID-19 survivors 12 months after ICU discharge, and to study whether the use of a measure of perceived cognitive deficit allows the detection of objective cognitive impairment. We also explore the relationship between demographic, clinical and emotional factors, and both objective and subjective cognitive deficits. METHODS Critically ill COVID-19 survivors from two medical ICUs underwent cognitive and emotional assessment one year after discharge. The perception of cognitive deficit and emotional state was screened through self-rated questionnaires (Perceived Deficits Questionnaire, Hospital Anxiety and Depression Scale and Davidson Trauma Scale), and a comprehensive neuropsychological evaluation was carried out. Demographic and clinical data from ICU admission were collected retrospectively. RESULTS Out of eighty participants included in the final analysis, 31.3% were women, 61.3% received mechanical ventilation and the median age of patients was 60.73 years. Objective cognitive impairment was observed in 30% of COVID-19 survivors. The worst performance was detected in executive functions, processing speed and recognition memory. Almost one in three patients manifested cognitive complaints, and 22.5%, 26.3% and 27.5% reported anxiety, depression and post-traumatic stress disorder (PTSD) symptoms, respectively. No significant differences were found in the perception of cognitive deficit between patients with and without objective cognitive impairment. Gender and PTSD symptomatology were significantly associated with perceived cognitive deficit, and cognitive reserve with objective cognitive impairment. CONCLUSIONS One-third of COVID-19 survivors suffered objective cognitive impairment with a frontal-subcortical dysfunction 12 months after ICU discharge. Emotional disturbances and perceived cognitive deficits were common. Female gender and PTSD symptoms emerged as predictive factors for perceiving worse cognitive performance. Cognitive reserve emerged as a protective factor for objective cognitive functioning. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04422444; June 9, 2021.
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Affiliation(s)
- Marta Godoy-González
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Guillem Navarra-Ventura
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain.
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain.
| | - Gemma Gomà
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Candelaria de Haro
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Espinal
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Cristina Fortià
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Natalia Ridao
- Physical and Rehabilitation Medicine Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Nuria Miguel Rebanal
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Clinical Psychology and Psychobiology Department, Universitat de Barcelona, Barcelona, Spain
| | - Laia Oliveras-Furriols
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Carles Subirà
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Critical Care Department, Althaia Xarxa Assistencial Universitària de Manresa, IRIS Research Institute, Manresa, Spain
| | - Mercè Jodar
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Neurology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Verónica Santos-Pulpón
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Leonardo Sarlabous
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Fernández
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Critical Care Department, Althaia Xarxa Assistencial Universitària de Manresa, IRIS Research Institute, Manresa, Spain
| | - Ana Ochagavía
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Lluís Blanch
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Oriol Roca
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Medicine Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Josefina López-Aguilar
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Sol Fernández-Gonzalo
- Critical Care Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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27
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Alves EV, Beber BC. Self-perception of cognitive sequels in post-COVID-19 individuals. Dement Neuropsychol 2023; 17:e20220080. [PMID: 37223832 PMCID: PMC10202328 DOI: 10.1590/1980-5764-dn-2022-0080] [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: 09/27/2022] [Revised: 11/28/2022] [Accepted: 12/15/2022] [Indexed: 05/25/2023] Open
Abstract
COVID-19 is an infection, primarily respiratory, caused by the SARS-CoV-2, which can also affect the central nervous system, causing neuropsychological damage. There are studies describing post-COVID-19 cognitive deficits, but it is important to know this outcome in populations with different social, biological, and cultural characteristics. Objective The aim of this study was to assess the self-perception of cognitive sequelae in post-COVID-19 individuals and identify whether there is a possible relationship between the outcome of the participants' self-perception and sociodemographic and clinical data. Methods This is a cross-sectional study, carried out through an online questionnaire on the Google Forms platform, in which sociodemographic data, general health data, clinical manifestations of COVID-19, and post-COVID-19 self-perception of the cognitive domains of memory, attention, language, and executive functions were collected. Results The final sample consisted of 137 participants, and it was possible to identify that memory and attention were the domains with the highest impression of worsening post-COVID-19, followed by executive functions and language. In addition, it was identified that being female may be related to a worse self-perception of all cognitive functions and that having depression or other psychiatric diseases and obesity can significantly affect at least half of the cognitive domains evaluated. Conclusions This study pointed to a post-COVID-19 cognitive worsening of the participants.
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Affiliation(s)
- Emily Viega Alves
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre RS, Brazil
| | - Bárbara Costa Beber
- Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre RS, Brazil
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28
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Liu TC, Yoo SM, Sim MS, Motwani Y, Viswanathan N, Wenger NS. Perceived Cognitive Deficits in Patients With Symptomatic SARS-CoV-2 and Their Association With Post-COVID-19 Condition. JAMA Netw Open 2023; 6:e2311974. [PMID: 37145596 DOI: 10.1001/jamanetworkopen.2023.11974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Importance Neuropsychiatric symptoms are common in acute SARS-CoV-2 infection and in post-COVID-19 condition (PCC; colloquially known as long COVID), but the association between early presenting neuropsychiatric symptoms and PCC is unknown. Objective To describe the characteristics of patients with perceived cognitive deficits within the first 4 weeks of SARS-CoV-2 infection and the association of those deficits with PCC symptoms. Design, Setting, and Participants This prospective cohort study was conducted from April 2020 to February 2021, with follow-up of 60 to 90 days. The cohort consisted of adults enrolled in the University of California, Los Angeles, SARS-CoV-2 Ambulatory Program who had a laboratory-confirmed symptomatic SARS-CoV-2 infection and were either hospitalized in a University of California, Los Angeles, hospital or one of 20 local health care facilities, or were outpatients referred by a primary care clinician. Data analysis was performed from March 2022 to February 2023. Exposure Laboratory-confirmed SARS-CoV-2 infection. Main Outcomes and Measures Patients responded to surveys that included questions about perceived cognitive deficits modified from the Perceived Deficits Questionnaire, Fifth Edition, (ie, trouble being organized, trouble concentrating, and forgetfulness) and symptoms of PCC at 30, 60, and 90 days after hospital discharge or initial laboratory-confirmed infection of SARS-CoV-2. Perceived cognitive deficits were scored on a scale from 0 to 4. Development of PCC was determined by patient self-report of persistent symptoms 60 or 90 days after initial SARS-CoV-2 infection or hospital discharge. Results Of 1296 patients enrolled in the program, 766 (59.1%) (mean [SD] age, 60.0 [16.7] years; 399 men [52.1%]; 317 Hispanic/Latinx patients [41.4%]) completed the perceived cognitive deficit items at 30 days after hospital discharge or outpatient diagnosis. Of the 766 patients, 276 (36.1%) perceived a cognitive deficit, with 164 (21.4%) having a mean score of greater than 0 to 1.5 and 112 patients (14.6 %) having a mean score greater than 1.5. Prior cognitive difficulties (odds ratio [OR], 1.46; 95% CI, 1.16-1.83) and diagnosis of depressive disorder (OR, 1.51; 95% CI, 1.23-1.86) were associated with report of a perceived cognitive deficit. Patients reporting perceived cognitive deficits in the first 4 weeks of SARS-CoV-2 infection were more likely to report symptoms of PCC than those without perceived cognitive deficits (118 of 276 patients [42.8%] vs 105 of 490 patients [21.4%]; χ21, 38.9; P < .001). Adjusting for demographic and clinical factors, perceived cognitive deficits in the first 4 weeks of SARS-CoV-2 were associated with PCC symptoms (patients with a cognitive deficit score of >0 to 1.5: OR, 2.42; 95% CI, 1.62-3.60; patients with cognitive deficit score >1.5: OR, 2.97; 95% CI, 1.86-4.75) compared to patients who reported no perceived cognitive deficits. Conclusions and Relevance These findings suggest that patient-reported perceived cognitive deficits in the first 4 weeks of SARS-CoV-2 infection are associated with PCC symptoms and that there may be an affective component to PCC in some patients. The underlying reasons for PCC merit additional exploration.
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Affiliation(s)
- Teresa C Liu
- Division of General Internal Medicine & Health Services Research, Department of Medicine, University of California, Los Angeles
| | - Sun M Yoo
- Division of General Internal Medicine & Health Services Research, Department of Medicine, University of California, Los Angeles
| | - Myung S Sim
- Department of Medicine Statistics Core, University of California, Los Angeles
| | - Yash Motwani
- Department of Medicine Statistics Core, University of California, Los Angeles
| | - Nisha Viswanathan
- Division of General Internal Medicine & Health Services Research, Department of Medicine, University of California, Los Angeles
| | - Neil S Wenger
- Division of General Internal Medicine & Health Services Research, Department of Medicine, University of California, Los Angeles
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29
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Gelpi E, Klotz S, Beyerle M, Wischnewski S, Harter V, Kirschner H, Stolz K, Reisinger C, Lindeck-Pozza E, Zoufaly A, Leoni M, Gorkiewicz G, Zacharias M, Haberler C, Hainfellner J, Woehrer A, Hametner S, Roetzer T, Voigtländer T, Ricken G, Endmayr V, Haider C, Ludwig J, Polt A, Wilk G, Schmid S, Erben I, Nguyen A, Lang S, Simonitsch-Klupp I, Kornauth C, Nackenhorst M, Kläger J, Kain R, Chott A, Wasicky R, Krause R, Weiss G, Löffler-Rag J, Berger T, Moser P, Soleiman A, Asslaber M, Sedivy R, Klupp N, Klimpfinger M, Risser D, Budka H, Schirmer L, Pröbstel AK, Höftberger R. Multifactorial White Matter Damage in the Acute Phase and Pre-Existing Conditions May Drive Cognitive Dysfunction after SARS-CoV-2 Infection: Neuropathology-Based Evidence. Viruses 2023; 15:908. [PMID: 37112888 PMCID: PMC10144140 DOI: 10.3390/v15040908] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND There is an urgent need to better understand the mechanisms underlying acute and long-term neurological symptoms after COVID-19. Neuropathological studies can contribute to a better understanding of some of these mechanisms. METHODS We conducted a detailed postmortem neuropathological analysis of 32 patients who died due to COVID-19 during 2020 and 2021 in Austria. RESULTS All cases showed diffuse white matter damage with a diffuse microglial activation of a variable severity, including one case of hemorrhagic leukoencephalopathy. Some cases revealed mild inflammatory changes, including olfactory neuritis (25%), nodular brainstem encephalitis (31%), and cranial nerve neuritis (6%), which were similar to those observed in non-COVID-19 severely ill patients. One previously immunosuppressed patient developed acute herpes simplex encephalitis. Acute vascular pathologies (acute infarcts 22%, vascular thrombosis 12%, diffuse hypoxic-ischemic brain damage 40%) and pre-existing small vessel diseases (34%) were frequent findings. Moreover, silent neurodegenerative pathologies in elderly persons were common (AD neuropathologic changes 32%, age-related neuronal and glial tau pathologies 22%, Lewy bodies 9%, argyrophilic grain disease 12.5%, TDP43 pathology 6%). CONCLUSIONS Our results support some previous neuropathological findings of apparently multifactorial and most likely indirect brain damage in the context of SARS-CoV-2 infection rather than virus-specific damage, and they are in line with the recent experimental data on SARS-CoV-2-related diffuse white matter damage, microglial activation, and cytokine release.
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Affiliation(s)
- Ellen Gelpi
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Sigrid Klotz
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Miriam Beyerle
- Departments of Neurology, Biomedicine and Clinical Research, University Hospital and University of Basel, 4031 Basel, Switzerland; (M.B.); (A.-K.P.)
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Department of Clinical Research, University Hospital and University of Basel, 4031 Basel, Switzerland;
| | - Sven Wischnewski
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany;
- Mannheim Center for Translational Neuroscience and Institute for Innate Immunoscience, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Verena Harter
- Department of Pathology, Klinik Favoriten, 1100 Vienna, Austria (H.K.); (R.S.); (M.K.)
| | - Harald Kirschner
- Department of Pathology, Klinik Favoriten, 1100 Vienna, Austria (H.K.); (R.S.); (M.K.)
| | - Katharina Stolz
- Department of Forensic Medicine, Medical University of Vienna, 1090 Vienna, Austria; (K.S.); (C.R.); (N.K.); (D.R.)
| | - Christoph Reisinger
- Department of Forensic Medicine, Medical University of Vienna, 1090 Vienna, Austria; (K.S.); (C.R.); (N.K.); (D.R.)
| | | | - Alexander Zoufaly
- Intensive Care Unit, Klinik Favoriten, 1100 Vienna, Austria;
- Faculty of Medicine, Sigmund Freud University, 1020 Vienna, Austria
| | - Marlene Leoni
- D&F Institute of Pathology, Neuropathology, Medical University Graz, 8036 Graz, Austria; (M.L.); (G.G.); (M.Z.); (M.A.)
| | - Gregor Gorkiewicz
- D&F Institute of Pathology, Neuropathology, Medical University Graz, 8036 Graz, Austria; (M.L.); (G.G.); (M.Z.); (M.A.)
| | - Martin Zacharias
- D&F Institute of Pathology, Neuropathology, Medical University Graz, 8036 Graz, Austria; (M.L.); (G.G.); (M.Z.); (M.A.)
| | - Christine Haberler
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Johannes Hainfellner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Adelheid Woehrer
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Simon Hametner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Thomas Roetzer
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Till Voigtländer
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Gerda Ricken
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Verena Endmayr
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Carmen Haider
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Judith Ludwig
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Andrea Polt
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Gloria Wilk
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Susanne Schmid
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Irene Erben
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Anita Nguyen
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Susanna Lang
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria; (S.L.); (I.S.-K.); (C.K.); (M.N.); (R.K.)
| | - Ingrid Simonitsch-Klupp
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria; (S.L.); (I.S.-K.); (C.K.); (M.N.); (R.K.)
| | - Christoph Kornauth
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria; (S.L.); (I.S.-K.); (C.K.); (M.N.); (R.K.)
- Münchner Leukämielabor, 81377 Munich, Germany
| | - Maja Nackenhorst
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria; (S.L.); (I.S.-K.); (C.K.); (M.N.); (R.K.)
| | - Johannes Kläger
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria; (S.L.); (I.S.-K.); (C.K.); (M.N.); (R.K.)
| | - Renate Kain
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria; (S.L.); (I.S.-K.); (C.K.); (M.N.); (R.K.)
| | - Andreas Chott
- Institute of Pathology, Klinik Ottakring, 1160 Vienna, Austria; (A.C.); (R.W.)
| | - Richard Wasicky
- Institute of Pathology, Klinik Ottakring, 1160 Vienna, Austria; (A.C.); (R.W.)
| | - Robert Krause
- Division of Infectious Diseases, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria;
| | - Günter Weiss
- Department of Internal Medicine and Pulmonology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (G.W.); (J.L.-R.)
| | - Judith Löffler-Rag
- Department of Internal Medicine and Pulmonology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (G.W.); (J.L.-R.)
| | - Thomas Berger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Patrizia Moser
- Department of Neuropathology, Tirol Kliniken GmbH, 6020 Innsbruck, Austria; (P.M.); (A.S.)
| | - Afshin Soleiman
- Department of Neuropathology, Tirol Kliniken GmbH, 6020 Innsbruck, Austria; (P.M.); (A.S.)
| | - Martin Asslaber
- D&F Institute of Pathology, Neuropathology, Medical University Graz, 8036 Graz, Austria; (M.L.); (G.G.); (M.Z.); (M.A.)
| | - Roland Sedivy
- Department of Pathology, Klinik Favoriten, 1100 Vienna, Austria (H.K.); (R.S.); (M.K.)
| | - Nikolaus Klupp
- Department of Forensic Medicine, Medical University of Vienna, 1090 Vienna, Austria; (K.S.); (C.R.); (N.K.); (D.R.)
| | - Martin Klimpfinger
- Department of Pathology, Klinik Favoriten, 1100 Vienna, Austria (H.K.); (R.S.); (M.K.)
- Department of Pathology, Medical University of Vienna, 1090 Vienna, Austria; (S.L.); (I.S.-K.); (C.K.); (M.N.); (R.K.)
| | - Daniele Risser
- Department of Forensic Medicine, Medical University of Vienna, 1090 Vienna, Austria; (K.S.); (C.R.); (N.K.); (D.R.)
| | - Herbert Budka
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Lucas Schirmer
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Department of Clinical Research, University Hospital and University of Basel, 4031 Basel, Switzerland;
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany;
- Interdisciplinary Center for Neurosciences, Heidelberg University, 69120 Heidelberg, Germany
| | - Anne-Katrin Pröbstel
- Departments of Neurology, Biomedicine and Clinical Research, University Hospital and University of Basel, 4031 Basel, Switzerland; (M.B.); (A.-K.P.)
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), Department of Clinical Research, University Hospital and University of Basel, 4031 Basel, Switzerland;
| | - Romana Höftberger
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria; (S.K.); (C.H.); (J.H.); (A.W.); (S.H.); (T.R.); (T.V.); (V.E.); (C.H.); (J.L.); (A.P.); (G.W.); (S.S.); (I.E.); (A.N.); (T.B.); (H.B.)
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, 1090 Vienna, Austria
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Haddad C, Chamoun A, Sacre H, Hallit S, Salameh P, Calvet B. Cognitive function in recovered COVID-19 Lebanese patients with schizophrenia. Ann Gen Psychiatry 2023; 22:7. [PMID: 36906570 PMCID: PMC10008071 DOI: 10.1186/s12991-023-00435-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/03/2023] [Indexed: 03/13/2023] Open
Abstract
INTRODUCTION It remains unclear whether COVID-19 which is an infectious disease caused by the SARS-CoV-2 virus is associated with the deterioration of cognitive function among patients with schizophrenia. This study aimed to evaluate changes in cognitive function before and after COVID-19 and associated factors among patients with schizophrenia at the Psychiatric Hospital of the Cross (HPC). METHODS A prospective cohort study was conducted among 95 patients with schizophrenia followed from mid-2019 until June 2021 at the Psychiatric Hospital of the Cross (HPC). This cohort was divided into a group diagnosed with COVID-19 (n = 71) and another not diagnosed with COVID-19 (n = 24). The questionnaire included the Brief Assessment of Cognition in Schizophrenia (BACS), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), and Activities of Daily Living (ADL). RESULTS The repeated-measures ANOVA showed no significant effect of time and the interaction between time and being diagnosed or not with COVID-19 on cognition. However, being diagnosed or not with COVID-19 had a significant effect on global cognitive function (p = 0.046), verbal memory (p = 0.046), and working memory (p = 0.047). The interaction between being diagnosed with COVID-19 and cognitive impairment at baseline was significantly associated with a higher cognitive deficit (Beta = 0.81; p = 0.005). Clinical symptoms, autonomy, and depression were not associated with the cognition (p > 0.05 for all). CONCLUSION COVID-19 disease affected global cognition and memory: patients diagnosed with COVID-19 had more deficits in these domains than those without COVID-19. Further studies are necessary to clarify the variation of cognitive function among schizophrenic patients with COVID-19.
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Affiliation(s)
- Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon. .,Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France. .,Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon. .,School of Health Sciences, Modern University for Business and Science, Beirut, Lebanon. .,School of Medicine, Lebanese American University, Byblos, Lebanon.
| | - Angela Chamoun
- Faculty of Sciences, Lebanese University, Fanar, Lebanon
| | - Hala Sacre
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon
| | - Souheil Hallit
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jal Eddib, Lebanon.,School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.,Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Pascale Salameh
- Institut National de Santé Publique, d'Épidémiologie Clinique et de Toxicologie-Liban (INSPECT-LB), Beirut, Lebanon.,School of Medicine, Lebanese American University, Byblos, Lebanon.,Department of Primary Care and Population Health, University of Nicosia Medical School, 2417, Nicosia, Cyprus.,Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Benjamin Calvet
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France.,Centre Hospitalier Esquirol, Pôle Universitaire de Psychiatrie de l'Adulte et de la Personne Âgée, d'Addictologie, Centre Mémoire de Ressources et de Recherche, 87000, Limoges, France.,Centre Hospitalier Esquirol, Unité de Recherche et d'Innovation, 87000, Limoges, France
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Velichkovsky BB, Razvaliaeva AY, Khlebnikova AA, Manukyan PA, Kasatkin VN. Attention and memory after COVID-19 as measured by neuropsychological tests: Systematic review and meta-analysis. Acta Psychol (Amst) 2023; 233:103838. [PMID: 36657196 PMCID: PMC9834202 DOI: 10.1016/j.actpsy.2023.103838] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/29/2022] [Accepted: 01/11/2023] [Indexed: 01/13/2023] Open
Abstract
COVID-19 is associated with a range of sequelae, including cognitive dysfunctions as long-standing symptoms. Considering that the number of people infected worldwide keeps growing, it is important to understand specific domains of impairments to further organize appropriate rehabilitation procedures. In this study we conducted a meta-analysis to investigate specific cognitive functions impacted by COVID-19. A literature search was conducted in Web of Science, Scopus, PubMed, Academic Search Premier, Health Source: Nursing/Academic Edition, and preprint databases (OSF and PsyArXiv via OSF Preprints, medRxiv, bioRxiv, Research Square). We included the studies that compared cognitive functioning in COVID-19 reconvalescents and healthy controls, and used at least one validated neuropsychological test. Our findings show that short-term memory in the verbal domain, and possibly, visual short-term memory and attention, are at risk in COVID-19 reconvalescents. The impact of COVID-19 on cognitive functioning has yet to be studied in detail. In the future more controlled studies with validated computerized tests might help deepen our understanding of the issue. PSYCINFO CLASSIFICATION: 3360 Health Psychology & Medicine.
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Affiliation(s)
- Boris B. Velichkovsky
- Research Institute for Brain Development and Peak Performance, RUDN University (Peoples' Friendship University of Russia), 117198, 11A Miklukho-Maklaya str., Moscow, Russia,Lomonosov Moscow State University, 125009, 11 Mokhovaya str., Moscow, Russia
| | - Anna Yu. Razvaliaeva
- Institute of Psychology, Russian Academy of Sciences, 129366, 13 Yaroslavskaya str., Moscow, Russia,Corresponding author at: 129366, Laboratory of Cognitive and Mathematical Psychology, Institute of Psychology, Russian Academy of Sciences, 13 Yaroslavskaya str., Moscow, Russia
| | | | - Piruza A. Manukyan
- Research Institute for Brain Development and Peak Performance, RUDN University (Peoples' Friendship University of Russia), 117198, 11A Miklukho-Maklaya str., Moscow, Russia,Lomonosov Moscow State University, 125009, 11 Mokhovaya str., Moscow, Russia
| | - Vladimir N. Kasatkin
- Research Institute for Brain Development and Peak Performance, RUDN University (Peoples' Friendship University of Russia), 117198, 11A Miklukho-Maklaya str., Moscow, Russia
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Damico V, Murano L, Margosio V, Tognoni N, Dal Molin A, Bassi E, Busca E, Crimella F. Long-term effects of Coronavirus 2 infection after intensive care: a prospective study. Minerva Anestesiol 2023; 89:175-187. [PMID: 35833859 DOI: 10.23736/s0375-9393.22.16728-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND While the multi-organ manifestations of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection are now well-documented, the potential long-term implications of these manifestations remain to be uncovered. The aim of the study was to study the level and predictors of post-traumatic stress, anxiety and depression symptoms, quality of life and functional disability in COVID-19 survivors during the first year post Intensive Care Unit (ICU) discharge. METHODS A prospective longitudinal study, reported following the STROBE guidance, was conducted in adult patients with SARS-CoV-2 infection admitted to an Italian ICU from March 2020 to March 2021 who were followed until March 2022. RESULTS A total of 207 patients were included in the study, of which 145 (70.1%) were male. One hundred and six (51.2%) patients between six and 12 months after ICU discharge reported at least one physical or cognitive impairment. The concurrent prevalence of anxiety, depression and PTSD is present in 25/106 patients (23.6% of cases) at six months and increases in 29/106 patients (27.3% of cases) at 12 months. However, the prevalence of anxiety, depression and PTSD was observed in 86 patients (41.5%) at six months and it gets smaller in 78 patients (37.7%) at 12 months (P=0.049). The EqVAS score (58.8 vs. 72.3, P=0.017) and the Barthel Index (61.5 vs. 74.8, P<0.001) increased significantly between six and 12 months after ICU. CONCLUSIONS Our results show that functional and cognitive recovery improves between six and 12 months after ICU discharge with a high perception of the patients' quality of life. These results will help to inform health system planning and the development of multidisciplinary strategies to reduce chronic health loss among individuals with COVID-19.
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Affiliation(s)
- Vincenzo Damico
- Azienda Socio Sanitaria Territoriale of Lecco, Lecco, Italy -
| | | | - Viola Margosio
- Azienda Socio Sanitaria Territoriale of Lecco, Lecco, Italy
| | | | - Alberto Dal Molin
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Erika Bassi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Erica Busca
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
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Basagni B, Abbruzzese L, Damora A, Conforti J, Saviola D, De Tanti A, Podgorska A, Biagioni C, Bacci M, Gambarelli C, Strologo F, Maietti A, Mancuso M. Cognition in COVID-19 infected patients undergoing invasive ventilation: results from a multicenter retrospective study. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-10. [PMID: 36827188 DOI: 10.1080/23279095.2023.2181083] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
A growing number of scientific contributions suggest that COVID-19 infection can lead to impairment of cognition, mainly in executive functions and memory domains, even in the absence of frank neurological pathologies.The primary objective of this retrospective study is to evaluate the frequency and type of inefficiencies in a selection of cognitive tests administered to a sample of subjects who, following infection, required invasive assisted ventilation and were admitted to rehabilitation wards for the treatment of functional impairment.Fifty-seven subjects were enrolled. The recruited patients undergone an assessment of verbal and visuospatial memory and executive functions, upon entry into the rehabilitation department, after discharge from intensive care. The following tests were administered: Rey Auditory Verbal Learning Test (AVLT) (immediate and delayed recall), Rey-Osterrieth Complex Figure Test (ROCFT) (copy and delayed recall), Stroop Color-Word Test, and Trail Making Test (TMT, A and B).Deficient scores, in beyond 25% of subjects, were found in the copy of the ROCFT (32.1% of subjects), and in the delayed recall of ROCFT (27.2%). Between 10 and 20% of patients presented an abnormal result in delayed recall of AVLT (16.07%), and Stroop Test (time, 15.6%, error, 11.5%). Less than 10% of the sample had abnormal performances on TMT (A, 3.5%, and B, 9.4%), and in AVLT immediate recall (8.9%). Correlations of the performances with age, sex, and education were also found.This paper highlights the high incidence of abnormal cognitive performances in this specific subpopulation of patients with COVID-19 infection.
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Affiliation(s)
| | | | - Alessio Damora
- CRT Clinica Riabilitazione Toscana, Montevarchi (AR), Italy
| | | | | | | | - Aleksandra Podgorska
- UOC Recupero e Rieducazione Funzionale-Area Grossetana, USL Toscana Sud-Est, Grosseto (GR), Italy
| | - Clarissa Biagioni
- UOC Recupero e Rieducazione Funzionale-Area Grossetana, USL Toscana Sud-Est, Grosseto (GR), Italy
| | - Marco Bacci
- UOC Recupero e Rieducazione Funzionale-Area Grossetana, USL Toscana Sud-Est, Grosseto (GR), Italy
| | - Carmen Gambarelli
- Ospedale Civile di Baggiovara- Struttura Complessa di Medicina Riabilitativa, Baggiovara (MO), Italy
| | - Francesca Strologo
- Ospedale Civile di Baggiovara- Struttura Complessa di Medicina Riabilitativa, Baggiovara (MO), Italy
| | - Alessandra Maietti
- Fondazione Poliambulanza - UO Riabilitazione Specialistica, Brescia (BS), Italy
| | - Mauro Mancuso
- CRT Clinica Riabilitazione Toscana, Montevarchi (AR), Italy
- UOC Recupero e Rieducazione Funzionale-Area Grossetana, USL Toscana Sud-Est, Grosseto (GR), Italy
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Almeria M, Cejudo JC, Sanz-Santos J, Deus J, Krupinski J. Impact of COVID-19 infection on cognition and its association with neurological symptoms. Brain Behav 2023; 13:e2902. [PMID: 36811291 PMCID: PMC10097052 DOI: 10.1002/brb3.2902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/03/2023] [Accepted: 01/18/2023] [Indexed: 02/24/2023] Open
Abstract
OBJECTIVE To characterize the cognitive profile following COVID-19 infection and its possible association to clinical symptoms, emotional disturbance, biomarkers, and disease severity. METHODS This was a single-center cross-sectional cohort study. Subjects between 20- and 60-year old with confirmed COVID-19 infection were included. Evaluation was performed between April 2020 and July 2021. Patients with previous cognitive impairment and other neurological or severe psychiatric disorders were excluded. Demographic and laboratory data were extracted from the medical records. RESULTS Altogether 200 patients were included, 85 subjects were female (42.3%), and mean age was 49.12 years (SD: 7.84). Patients were classified into four groups: nonhospitalized (NH, n = 21), hospitalized without intensive care unit (ICU) nor oxygen therapy (HOSP, n = 42), hospitalized without ICU but with oxygen therapy (OXY, n = 107), and ICU (ICU, n = 31) patients. NH group was younger (p = .026). No significant differences were found in any test performed attending severity of illness (p > .05). A total of 55 patients reported subjective cognitive complaints (SCC). Subjects with neurological symptoms (NS) performed worse in trail making test B (p = .013), digits backwards (p = .006), letter&numbers (p = .002), symbol digit modalities test (p = .016), and Stroop color (p = .010) tests. CONCLUSIONS OXY patients and females referred more SCC associated with symptoms of anxiety and depression. Objective cognitive performance was unrelated to SCC. No cognitive impairment was found regarding the severity of COVID-19 infection. Results suggest that NS such as headache, anosmia, and dysgeusia during infection were a risk factor for later cognitive deficits. Tests assessing attention, processing speed, and executive function were the most sensitive in detecting cognitive changes in these patients.
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Affiliation(s)
- Marta Almeria
- Medicine Department, Autonomous University of Barcelona, Barcelona, Spain.,Department of Neurology, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Juan Carlos Cejudo
- Cognitive Impairment and Dementia Unit, Hospital Sagrat Cor, Hermanas Hospitalarias, Martorell, Barcelona, Spain
| | - Jose Sanz-Santos
- Department of Pneumology, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain
| | - Joan Deus
- Clinical and Health Department, Psychology Faculty, Autonomous University of Barcelona, Barcelona, Spain.,MRI Research Unit, Hospital del Mar, Barcelona, Spain
| | - Jerzy Krupinski
- Medicine Department, Autonomous University of Barcelona, Barcelona, Spain.,Healthcare sciences Manchester Metropolitan University, CBS, Manchester, UK
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Systematic Review and Meta-Analysis of Clinically Relevant Executive Functions Tests Performance after COVID-19. Behav Neurol 2023; 2023:1094267. [PMID: 36815864 PMCID: PMC9935808 DOI: 10.1155/2023/1094267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/12/2023] [Accepted: 01/27/2023] [Indexed: 02/11/2023] Open
Abstract
It is widely known that COVID-19 has a number of prolonged effects on general health, wellbeing, and cognitive functioning. However, studies using differentiated performance measures of cognitive functions are still not widely spread making it hard to assess the exact functions that get impaired. Taking into account the similarities between post-COVID 'brain fog' and chemofog, we hypothesized that executive functions (EF) would be impaired. Literature search yielded six studies with 14 effect sizes of interest; pooled effect size was small to medium (d = -0.35). Combined with a narrative synthesis of six studies without a comparison group, these results show that EF get impaired after COVID-19; although, in most cases the impairment is transient and does not seem to be severe. These results specify the picture of 'brain fog' and may help to discover its mechanisms and ways of helping people with long COVID.
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Pihlaja RE, Kauhanen LLS, Ollila HS, Tuulio-Henriksson AS, Koskinen SK, Tiainen M, Salmela VR, Hästbacka J, Hokkanen LS. Associations of subjective and objective cognitive functioning after COVID-19: A six-month follow-up of ICU, ward, and home-isolated patients. Brain Behav Immun Health 2023; 27:100587. [PMID: 36624888 PMCID: PMC9812472 DOI: 10.1016/j.bbih.2023.100587] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/05/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Background Subjective and objective cognitive dysfunction are reported after COVID-19 but with limited data on their congruence and associations with the severity of the acute disease. The aim of this cohort study is to describe the prevalence of subjective and objective cognitive dysfunction at three and six months after COVID-19 and the associations of subjective cognitive symptoms and psychological and disease-related factors. Methods We assessed a cohort of 184 patients at three and six months after COVID-19: 82 patients admitted to the Intensive Care Unit (ICU), 53 admitted to regular hospital wards, and 49 isolated at home. A non-COVID control group of 53 individuals was included. Demographic and clinical data were collected. Subjective cognitive symptoms, objective cognitive impairment, and depressive and post-traumatic stress disorder (PTSD) symptoms were assessed. Results At six months, subjective cognitive impairment was reported by 32.3% of ICU-treated, 37.3% of ward-treated, and 33.3% of home-isolated patients and objective cognitive impairment was observed in 36.1% of ICU-treated, 34.7% of ward-treated, and 8.9% of home-isolated patients. Subjective cognitive symptoms were associated with depressive and PTSD symptoms and female sex, but not with objective cognitive assessment or hospital metrics. Conclusions One-third of COVID-19 patients, regardless of the acute disease severity, reported high levels of subjective cognitive dysfunction which was not associated with results from objective cognitive screening but with psychological and demographic factors. Our study stresses the importance of thorough assessment of patients reporting long-term subjective symptoms, screening for underlying mental health related factors such as PTSD or depression.
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Affiliation(s)
- Riikka E. Pihlaja
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland,Division of Neuropsychology, HUS Neurocenter, Helsinki University Hospital and University of Helsinki, Helsinki, Finland,Corresponding author. Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Lina-Lotta S. Kauhanen
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Henriikka S. Ollila
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | - Sanna K. Koskinen
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marjaana Tiainen
- Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Viljami R. Salmela
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Johanna Hästbacka
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Laura S. Hokkanen
- Department of Psychology and Logopaedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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Bek LM, Hellemons ME, Berentschot JC, Visser MM, Huijts SM, van Bommel J, van Genderen ME, Aerts JGJV, Ribbers GM, van den Berg-Emons RJG, Heijenbrok-Kal MH. Cognitive and Psychological Recovery Patterns Across Different Care Pathways 12 months after hospitalization for COVID-19: A Multicenter Cohort Study (CO-FLOW). Ann Phys Rehabil Med 2023; 66:101737. [PMID: 37043952 PMCID: PMC9915122 DOI: 10.1016/j.rehab.2023.101737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/02/2022] [Accepted: 12/11/2022] [Indexed: 02/12/2023]
Abstract
BACKGROUND The comparison of recovery patterns for different care pathways following COVID-19 is necessary for optimizing rehabilitation strategies. OBJECTIVES To evaluate cognitive and psychological outcomes across different care pathways up to 12 months after hospitalization for COVID-19. METHODS CO-FLOW is an ongoing multicenter prospective cohort study with assessments at 3, 6, and 12 months after hospitalization for COVID-19. The main outcomes are cognitive deficits (Montreal Cognitive Assessment, score <26), cognitive failure (Cognitive Failure Questionnaire, score >43), posttraumatic stress disorder (PTSD; Impact of Event Scale-Revised, score ≥33), and anxiety and depression (Hospital Anxiety and Depression Scale, subscale score ≥11). RESULTS In total, data from 617 participants were analyzed. Mean age was 59.7 (SD 11.4) years and 188 (31%) were female. Significant recovery occurred within the first 6 months post-discharge (p ≤ 0.001). Cognitive deficits persisted in 21% (101/474), and psychological problems in 15% (74/482) of people at 12 months. Significantly improved cognition scores were reported for people who did not receive rehabilitation ('No-rehab'; 124/617, 20%; mean difference, MD 2.32, 95% CI 1.47 to 3.17; p<0.001), those who received community-based rehabilitation ('Com-rehab'; 327/617, 53%; MD 1.27, 95% CI 0.77 to 1.78; p<0.001), and those who received medical rehabilitation ('Med-rehab'; 86/617, 14%; MD 1.63, 95% CI 0.17 to 3.10; p = 0.029). Med-rehab participants experienced more cognitive failure from 3 to 6 months (MD 4.24, 95% 1.63 to 6.84; p = 0.001). Com-rehab showed recovery for PTSD (MD -2.43, 95% -3.50 to -1.37; p<0.001), anxiety (MD -0.67, 95% -1.02 to -0.32; p<0.001), and depression (MD -0.60, 95% -0.96 to -0.25; p<0.001), but symptoms persisted at 12 months. CONCLUSIONS Survivors of COVID-19 showed cognitive and psychological recovery, especially within the first 6 months after hospitalization. Most persistent problems were related to cognitive functioning at 12 months. Recovery differed rehabilitation settings. Additional cognitive or psychological support might be warranted in people who medical or community-based rehabilitation.
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Cognitive Deficits in the Acute Phase of COVID-19: A Review and Meta-Analysis. J Clin Med 2023; 12:jcm12030762. [PMID: 36769410 PMCID: PMC9917639 DOI: 10.3390/jcm12030762] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
This meta-analysis was conducted to quantify the risk of patients exhibiting cognitive deficits in the acute phase of COVID-19 at the time of the first variants (i.e., before the vaccine) and quantify the potential vulnerability of older patients and those who experienced more severe respiratory symptoms. To this end, we searched the LitCovid and EMBASE platforms for articles, including preprints, and included all studies (n = 48) that featured a measurement of cognition, which encompassed 2233 cases of COVID-19. Of these, 28 studies reported scores on global cognitive efficiency scales administered in the acute phase of COVID-19 (up to 3 months after infection). We were able to perform a meta-analysis of proportions on 24 articles (Npatients = 943), and a logistic regression on 18 articles (Npatients = 518). The meta-analysis for proportion indicated that 52.31% of patients with COVID-19 exhibited cognitive deficits in the acute phase. This high percentage, however, has to be interpreted taking in consideration the fact that the majority of patients were hospitalized, and some presented neurological complications, such as encephalopathy. A bootstrap procedure with random resampling revealed that an age of 59 was the threshold at which one would be more prone to present cognitive deficits. However, the severity of respiratory symptoms did not influence the scores on a global cognitive efficiency scale. Overall, our results indicated that neuropsychological deficits were a major consequence of the acute phase of the first forms of COVID-19.
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Diana L, Regazzoni R, Sozzi M, Piconi S, Borghesi L, Lazzaroni E, Basilico P, Aliprandi A, Bolognini N, Bonardi DR, Colombo D, Salmaggi A. Monitoring cognitive and psychological alterations in COVID-19 patients: A longitudinal neuropsychological study. J Neurol Sci 2023; 444:120511. [PMID: 36473347 PMCID: PMC9707027 DOI: 10.1016/j.jns.2022.120511] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/19/2022] [Accepted: 11/23/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND SARS-COV-2 infection has been associated to long-lasting neuropsychiatric sequelae, including cognitive deficits, that persist after one year. However, longitudinal monitoring has been scarcely performed. Here, in a sample of COVID-19 patients, we monitor cognitive, psychological and quality of life-related profiles up to 22 months from resolution of respiratory disease. METHODS Out of 657 COVID-19 patients screened at Manzoni Hospital (Lecco, Italy), 22 underwent neuropsychological testing because of subjective cognitive disturbances at 6 months, 16 months, and 22 months. Tests of memory, attention, and executive functions were administered, along with questionnaires for depressive and Post-traumatic stress disorder (PTSD) symptoms, psychological well-being and quality of life. Cross-sectional descriptives, correlational, as well as longitudinal analyses considering COVID19-severity were carried out. A preliminary comparison with a sample of obstructive sleep apneas patients was also performed. RESULTS Around 50% of COVID-19 patients presented with cognitive deficits at t0. The most affected domain was verbal memory. Pathological scores diminished over time, but a high rate of borderline scores was still observable. Longitudinal analyses highlighted improvements in verbal and non-verbal long term memory, as well as attention, and executive functioning. Depression and PTSD-related symptoms were present in 30% of patients. The latter decreased over time and were associated to attentional-executive performance. CONCLUSIONS Cognitive dysfunctions in COVID-19 patients may extend over 1 year, yet showing a significant recovery in several cases. Cognitive alterations are accompanied by a significant psychological distress. Many patients displaying borderline scores, especially those at higher risk of dementia, deserve clinical monitoring.
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Affiliation(s)
- Lorenzo Diana
- Neurology Unit, Ospedale "A. Manzoni", Lecco, Italy; Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | | | - Matteo Sozzi
- Neurology Unit, Ospedale "A. Manzoni", Lecco, Italy
| | - Stefania Piconi
- Infectious Diseases Unit, Ospedale "A. Manzoni", Lecco, Italy
| | - Luca Borghesi
- Infectious Diseases Unit, Ospedale "A. Manzoni", Lecco, Italy
| | - Elisa Lazzaroni
- Department of Mental Health, Ospedale "A. Manzoni", Lecco, Italy
| | | | | | - Nadia Bolognini
- Neuropsychology Laboratory, IRCCS Istituto Auxologico Italiano, Milan, Italy; Department of Psychology and NeuroMI, University of Milano-Bicocca, Milan, Italy
| | - Daniela R Bonardi
- Respiratory Unit, IRCCS INRCA (Italian National Research Centre On Aging), Casatenovo, Italy
| | - Daniele Colombo
- Respiratory Unit, IRCCS INRCA (Italian National Research Centre On Aging), Casatenovo, Italy
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Akıncı B, Oğul ÖE, Hanoğlu L, Kulaç B, Ören D, Ulu O, Basançelebi B. Evaluation of cognitive functions in adult individuals with COVID-19. Neurol Sci 2023; 44:793-802. [PMID: 36574178 PMCID: PMC9793347 DOI: 10.1007/s10072-022-06562-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 12/12/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Cognitive deficits that are associated with coronavirus disease 2019 (COVID-19) and occur in the acute period are gaining importance. While most studies have focused on the elderly severely affected during acute infection, it remains unclear whether mild to moderate COVID-19 results in cognitive deficits in young patients. This study aims to evaluate the post-infection cognitive functions of young adults with mild to moderate symptoms of COVID-19. METHODS A total of 100 adults with similar age and educational background were included in the study. Half of those had been infected with COVID-19 in the last 60 days (N = 50), and the other half had not (N = 50). Global cognitive skills of the participants were evaluated through Montreal Cognitive Assessment Scale (MoCA) and Clock-Drawing Test; memory functions with Öktem Verbal Memory Processes Test (Ö-VMPT); attention span with Digit Span Test; executive functions with Fluency Tests, Stroop Test, and Trail Making Test; visual perceptual skills with Rey Osterrieth Complex Figure Test (ROCF); and neuropsychiatric status with Neuropsychiatric Inventory (NPI). Evaluations were performed in the experimental group for 21 to 60 days from the onset of the disease, and throughout the study, in the control group. RESULTS It was found that global cognitive skills, verbal memory, visual memory, executive function, and neuropsychiatric status were affected during COVID-19 (p < 0.05). CONCLUSION When the cases were analyzed according to disease severity, no relationship was found between cognitive deficits and disease severity.
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Affiliation(s)
- Büşra Akıncı
- Department of Physical Therapy and Rehabilitation, Medipol Mega University Hospital, Bagcilar, 34214, Istanbul, Turkey.
| | - Özden Erkan Oğul
- Department of Occupational Therapy, Faculty of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
| | - Lütfü Hanoğlu
- Department of Neurology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Betül Kulaç
- Department of Physical Therapy and Rehabilitation, Medipol Mega University Hospital, Bagcilar, 34214 Istanbul, Turkey
| | - Damla Ören
- Department of Physical Therapy and Rehabilitation, Pendik Medipol University Hospital, Istanbul, Turkey
| | - Oğulcan Ulu
- Faculty of Science and Letters, Psychology, Beykent University, Istanbul, Turkey
| | - Berkan Basançelebi
- Department of Electroneurophysiology, Health Vocational School Istanbul Medipol University, Istanbul, Turkey
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Asensio D, Duñabeitia JA. The necessary, albeit belated, transition to computerized cognitive assessment. Front Psychol 2023; 14:1160554. [PMID: 37168430 PMCID: PMC10165007 DOI: 10.3389/fpsyg.2023.1160554] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/06/2023] [Indexed: 05/13/2023] Open
Abstract
Cognitive assessment is a common and daily process in educational, clinical, or research settings, among others. Currently, most professionals use classic pencil-and-paper screenings, tests, and assessment batteries. However, as the SARS-CoV-2 health crisis has shown, the pencil-and-paper format is becoming increasingly outdated and it is necessary to transition to new technologies, using computerized cognitive assessments (CCA). This article discusses the advantages, disadvantages, and implications of this necessary transition that professionals should face in the immediate future, and encourages careful adoption of this change to ensure a smooth transition.
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Affiliation(s)
- David Asensio
- Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
| | - Jon Andoni Duñabeitia
- Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
- AcqVA Aurora Center, UiT The Arctic University of Norway, Tromsø, Norway
- *Correspondence: Jon Andoni Duñabeitia,
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Caroli A, Capelli S, Napolitano A, Cabrini G, Arrigoni A, Pezzetti G, Previtali M, Longhi LG, Zangari R, Lorini FL, Sessa M, Remuzzi A, Gerevini S. Brain diffusion alterations in patients with COVID-19 pathology and neurological manifestations. Neuroimage Clin 2023; 37:103338. [PMID: 36731251 PMCID: PMC9883079 DOI: 10.1016/j.nicl.2023.103338] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND OBJECTIVE COVID-19 neurological manifestations have been progressively recognized. Among available MRI techniques, diffusion weighted imaging (DWI) shows promise to study microstructure, inflammation, and edema. Previous DWI studies reported alterations in brain diffusivity in COVID-19 patients, as assessed by morphologic evaluation of brain DWI scans only. The aim of this study was to assess and quantify brain diffusion alterations in COVID-19 patients with neurological manifestations. METHODS 215 COVID-19 patients with neurological manifestations (olfactory and/or other neurological disorders) and 36 normal controls were compared and studied with DWI and T1-weighted MRI scans. MRI scans were processed by a semi-automatic processing procedure specifically developed for the purpose of this study, and the Apparent Diffusion Coefficient (ADC) was quantified in different brain tissues and individual white matter (WM) and gray matter (GM) regions. Differences in ADC values were assessed between COVID-19 patients and normal controls, as well as in the COVID-19 patient population grouped by hospitalization and neurological symptoms. RESULTS Among COVID-19 patients (median [IQR] = 52 [42 - 60] years of age, 58 % females), 91 were hospitalized and 26 needed intensive care. 84 patients had hyposmia/ageusia only, while 131 ones showed other neurological disorders. COVID-19 patients showed significantly increased ADC values in the WM and in several GM regions (p < 0.001). ADC values were significantly correlated with MRI time from disease onset (p < 0.05). Hospitalized patients showed significantly higher ADC alteration than non-hospitalized patients in all brain tissues; similarly, COVID-19 patients with neurological disorders showed significantly higher ADC values than those with olfactory loss only. ADC alteration was highest in patients with cognitive or memory disorder and in those with encephalitis or meningitis. ADC values were neither associated with the duration of hospitalization nor with the need for intensive care. CONCLUSION Current findings suggest DWI potential as a non-invasive marker of neuroinflammation in COVID-19, and the transient nature of the same. Future longitudinal studies are needed to confirm our findings.
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Affiliation(s)
- Anna Caroli
- Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 24020 Ranica, BG, Italy
| | - Serena Capelli
- Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 24020 Ranica, BG, Italy
| | - Angela Napolitano
- Department of Neuroradiology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Giulia Cabrini
- Department of Management, Information and Production Engineering, University of Bergamo, 24044 Dalmine, BG, Italy
| | - Alberto Arrigoni
- Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 24020 Ranica, BG, Italy
| | - Giulio Pezzetti
- Department of Neuroradiology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Mattia Previtali
- Bioengineering Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, 24020 Ranica, BG, Italy
| | - Luca Giovanni Longhi
- Neurosurgical Intensive Care Unit, Department of Anesthesia and Critical Care Medicine, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Rosalia Zangari
- FROM Research Foundation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Ferdinando Luca Lorini
- Department of Emergency and Critical Care Area, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Maria Sessa
- Department of Neurology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy
| | - Andrea Remuzzi
- Department of Management, Information and Production Engineering, University of Bergamo, 24044 Dalmine, BG, Italy
| | - Simonetta Gerevini
- Department of Neuroradiology, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy.
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Cognitive Deficits among Individuals Admitted to a Post-Acute Pneumological Rehabilitation Unit in Southern Italy after COVID-19 Infection. Brain Sci 2023; 13:brainsci13010084. [PMID: 36672066 PMCID: PMC9857316 DOI: 10.3390/brainsci13010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023] Open
Abstract
(1) Background: We investigated the differences in the neuropsychological profile as well as the pneumological and motor functions in two groups of patients admitted to rehabilitation who received different respiratory support during their COVID-19 infection. (2) Methods: Group-1 (n = 18; 15 male, median age 67.5) consisted of patients who received non-invasive mechanical ventilation; Group-2 (n = 19; 16 male, median age 63) consisted of patients who received invasive mechanical ventilation. All patients underwent a neuropsychological assessment including Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and the Repeatable Battery for the Assessment of Neuropsychological Status (R-BANS) to evaluate the patients' cognition. Depression and anxiety were also measured at admission and discharge to rehabilitation. (3) Results: At admission, patients impaired at MMSE were 44% in Group-1 and 5% in Group-2, while patients impaired at FAB were 88% in Group-1 and 26% in Group-2. Wilcoxon's effect size revealed meaningful differences between groups for FAB, R-BANS global score, immediate and delayed memory, and attention-coding task, with Group-2 performing better than Group-1 across all measures. At discharge, 52% of the 25 patients re-assessed still had mild to moderate cognitive deficits, while 19% had depression and 35% had anxiety. (4) Conclusions: Patients who received oxygen therapy experienced higher levels of acute and chronic stress compared to those who benefitted from invasive mechanical ventilation. Despite patients showing a meaningful improvement at discharge, cognitive impairment persisted in a great number of patients; therefore, long-term neuropsychological follow-up and treatment for COVID-19 patients are recommended.
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Tarnanas I, Tsolaki M. Making Pre-screening for Alzheimer's Disease (AD) and Postoperative Delirium Among Post-Acute COVID-19 Syndrome (PACS) a National Priority: The Deep Neuro Study. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1424:41-47. [PMID: 37486477 DOI: 10.1007/978-3-031-31982-2_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
SARS-CoV-2 effects on cognition are a vibrant area of active research. Many researchers suggest that COVID-19 patients with severe symptoms leading to hospitalization sustain significant neurodegenerative injury, such as encephalopathy and poor discharge disposition. However, despite some post-acute COVID-19 syndrome (PACS) case series that have described elevated neurodegenerative biomarkers, no studies have been identified that directly compared levels to those in mild cognitive impairment, non-PACS postoperative delirium patients after major non-emergent surgery, or preclinical Alzheimer's disease (AD) patients that have clinical evidence of Alzheimer's without symptoms. According to recent estimates, there may be 416 million people globally on the AD continuum, which include approximately 315 million people with preclinical AD. In light of all the above, a more effective application of digital biomarker and explainable artificial intelligence methodologies that explored amyloid beta, neuronal, axonal, and glial markers in relation to neurological complications in-hospital or later outcomes could significantly assist progress in the field. Easy and scalable subjects' risk stratification is of utmost importance, yet current international collaboration initiatives are still challenging due to the limited explainability and accuracy to identify individuals at risk or in the earliest stages that might be candidates for future clinical trials. In this open letter, we propose the administration of selected digital biomarkers previously discovered and validated in other EU-funded studies to become a routine assessment for non-PACS preoperative cognitive impairment, PACS neurological complications in-hospital, or later PACS and non-PACS improvement in cognition after surgery. The open letter also includes an economic analysis of the implications for such national-level initiatives. Similar collaboration initiatives could have existing pre-diagnostic detection and progression prediction solutions pre-screen the stage before and around diagnosis, enabling new disease manifestation mapping and pushing the field into unchartered territory.
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Affiliation(s)
- Ioannis Tarnanas
- Altoida Inc, Washington, DC, USA.
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA.
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Santiago, Chile.
| | - Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh) Balkan Center, Buildings A & B, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Serena S, Deborah P, Anja F, Gwendolyn G, Puhan MA, Albanese E. Association between serologically confirmed COVID-19 infection and cognitive functioning in community dwelling older adults. Front Neurol 2023; 14:1093852. [PMID: 37025205 PMCID: PMC10070998 DOI: 10.3389/fneur.2023.1093852] [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: 11/09/2022] [Accepted: 03/03/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction COVID-19 infection can impact the central nervous system, and is often associated with cognitive decline. However, there are no studies linking serologically confirmed COVID-19 infection with objectively assessed cognitive functioning. We explored whether presence of SARS-CoV-2 antibodies account for variability in participants' scores on a neuropsychological assessment. Methods In this cross-sectional study participants were 657 (mean age = 72.97; SD = 6.07 years; women = 47.7%) individuals randomly selected from the general population of the canton of Zurich and included in the Corona Immunitas study. We conducted serological tests between October 2020 and May 2021 to detect and quantify SARS-CoV-2 antibodies in peripheral venous blood samples. We assessed cognitive function, vaccination status (vaccinated; not vaccinated), number of health conditions, and demographic variables between January and August 2021. We studied the association between seropositivity and global cognitive function and five cognitive domains (language expression, language comprehension, temporal orientation, spatial orientation, and memory) with linear regression models. Based on SARS-CoV-2 antibodies and vaccination status, we stratified participants into three groups: No SARS-CoV-2 antibodies (N = 402); SARS-CoV-2 antibodies due to vaccination (N = 218); history of SARS-CoV-2 infection and no vaccination (N = 37). Results In the regression model adjusted for age, sex, educational level, and number of health conditions, compared to those without SARS-CoV-2 antibodies, those with SARS-CoV-2 antibodies due to vaccination had better global cognitive functioning (Standardized beta = 0.10; 95% CI = 0.02; 0.17), and those with SARS-CoV-2 antibodies due to infection had poorer cognitive functioning (Standardized beta = -0.10; 95% CI = -0.18; -0.03). Regarding cognitive domains, compared to those without SARS-CoV-2 antibodies, those with SARS-CoV-2 antibodies due to infection scored more poorly on language comprehension and temporal orientation, and those with SARS-CoV-2 antibodies due to vaccination scored better on memory. Discussion By linking serologically confirmed presence of SARS-CoV-2 antibodies to poorer global cognitive functioning in community dwelling older adults we strengthen existing evidence in support of cognitive decline related to COVID-19. Given the large number of infected older adults, and the endurance of the pandemic, our results highlight the need to address COVID-19 related cognitive decline in the clinical and public health areas of prevention, diagnosis, and treatment.
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Affiliation(s)
- Sabatini Serena
- School of Medicine, University of Nottingham, Nottingham, United Kingdom
- *Correspondence: Serena Sabatini,
| | - Pacifico Deborah
- Faculty of Biomedical Sciences, Institute of Public Health (IPH), Università della Svizzera italiana, Lugano, Switzerland
| | - Frei Anja
- Epidemiology Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Graf Gwendolyn
- Epidemiology Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo A. Puhan
- Epidemiology Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Emiliano Albanese
- Faculty of Biomedical Sciences, Institute of Public Health (IPH), Università della Svizzera italiana, Lugano, Switzerland
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Multidomain cognitive impairment in non-hospitalized patients with the post-COVID-19 syndrome: results from a prospective monocentric cohort. J Neurol 2023; 270:1215-1223. [PMID: 36422669 PMCID: PMC9686246 DOI: 10.1007/s00415-022-11444-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND A fraction of patients with asymptomatic to mild/moderate acute COVID-19 disease report cognitive deficits as part of the post-COVID-19 syndrome. This study aimed to assess the neuropsychological profile of these patients. METHODS Assessment at baseline (three months or more following acute COVID-19) of a monocentric prospective cohort of patients with post-COVID-19 syndrome. Multidomain neuropsychological tests were performed, and questionnaires on depression, anxiety, fatigue, sleep, and general health status were administered. RESULTS Of the 58 patients screened, six were excluded due to possible alternative causes of cognitive impairment (major depression, neurodegenerative disease). Of the remaining 52 individuals, only one had a below-threshold screening result on Mini-Mental State Examination, and 13 scored below the cut-off on Montreal Cognitive Assessment. Extended neuropsychological testing revealed a neurocognitive disorder (NCD) in 31 (59.6%) participants with minor NCD in the majority of cases (n = 26). In patients with NCD, the cognitive domains learning/memory and executive functions were impaired in 60.7%, complex attention in 51.6%, language in 35.5%, and perceptual-motor function in 29.0%. Cognitive profiles were associated with daytime sleepiness but not with depression, anxiety, sleep quality, total general health status, or fatigue. CONCLUSION Neurocognitive impairment can be confirmed in around 60% of individuals with self-reported deficits as part of post-COVID-19 syndrome following a mild acute COVID-19 disease course. Notably, screening tests cannot reliably detect this dysfunction. Standard psychiatric assessments showed no association with cognitive profiles. Longitudinal studies are needed to further evaluate the course of neurocognitive deficits and clarify pathophysiology.
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Dubey S, Das S, Ghosh R, Dubey MJ, Chakraborty AP, Roy D, Das G, Dutta A, Santra A, Sengupta S, Benito-León J. The Effects of SARS-CoV-2 Infection on the Cognitive Functioning of Patients with Pre-Existing Dementia. J Alzheimers Dis Rep 2023; 7:119-128. [PMID: 36891252 PMCID: PMC9986710 DOI: 10.3233/adr-220090] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 01/03/2023] [Indexed: 02/05/2023] Open
Abstract
Background Cognitive postscripts of COVID-19, codenamed as 'cognitive COVID' or 'brain fog,' characterized by multidomain cognitive impairments, are now being reckoned as the most devastating sequelae of COVID-19. However, the impact on the already demented brain has not been studied. Objective We aimed to assess the cognitive functioning and neuroimaging following SARS-CoV-2 infection in patients with pre-existing dementia. Methods Fourteen COVID-19 survivors with pre-existing dementia (four with Alzheimer's disease, five with vascular dementia, three with Parkinson's disease dementia, and two with the behavioral variant of frontotemporal dementia) were recruited. All these patients had detailed cognitive and neuroimaging evaluations within three months before suffering from COVID-19 and one year later. Results Of the 14 patients, ten required hospitalization. All developed or increased white matter hyperintensities that mimicked multiple sclerosis and small vessel disease. There was a significant increase in fatigue (p = 0.001) and depression (p = 0.016) scores following COVID-19. The mean Frontal Assessment Battery (p < 0.001) and Addenbrooke's Cognitive Examination (p = 0.001) scores also significantly worsened. Conclusion The rapid progression of dementia, the addition of further impairments/deterioration of cognitive abilities, and the increase or new appearance of white matter lesion burden suggest that previously compromised brains have little defense to withstand a new insult (i.e., 'second hit' like infection/dysregulated immune response, and inflammation). 'Brain fog' is an ambiguous terminology without specific attribution to the spectrum of post-COVID-19 cognitive sequelae. We propose a new codename, i.e. 'FADE-IN MEMORY' (i.e., Fatigue, decreased Fluency, Attention deficit, Depression, Executive dysfunction, slowed INformation processing speed, and subcortical MEMORY impairment).
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Affiliation(s)
- Souvik Dubey
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Shambaditya Das
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Ritwik Ghosh
- Department of General Medicine, Burdwan Medical College, and Hospital, Burdwan, West Bengal, India
| | - Mahua Jana Dubey
- Department of Psychiatry, Berhampur Mental Hospital, Berhampur, West Bengal, India
| | - Arka Prava Chakraborty
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Dipayan Roy
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Patna, Bihar, India.,Indian Institute of Technology (IIT), Madras, Tamil Nadu, India.,School of Sciences, Indira Gandhi National Open University, New Delhi, India
| | - Gautam Das
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Ajitava Dutta
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Arindam Santra
- Department of Neuromedicine, Bangur Institute of Neurosciences (BIN), Kolkata, West Bengal, India
| | - Samya Sengupta
- Department of General Medicine, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Centro de Investigación Biomódica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Department of Medicine, Complutense University, Madrid, Spain
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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:jpm12122070. [PMID: 36556290 PMCID: PMC9781311 DOI: 10.3390/jpm12122070] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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.
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Tobita M, Fanchiang SP, Saldivar A, Taylor S, Jordan B. Complex Hallucinations in Hospitalized Rehabilitation Patients With COVID-19. Arch Rehabil Res Clin Transl 2022; 4:100234. [PMID: 36277732 PMCID: PMC9574548 DOI: 10.1016/j.arrct.2022.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives To explore the characteristics of hallucinations in hospitalized rehabilitation patients with COVID-19. Design Retrospective review using medical records of patients with COVID-19 and admitted to the acute inpatient rehabilitation unit (ARU). Setting A public hospital in southern California, specializing in rehabilitation medicine. Participants: Patients with COVID-19 and hallucinations who were consecutively admitted from January 1st to April 30th, 2021. Interventions Not applicable. Main Outcome Measures Types and themes of hallucinations. Results Eight of the 37 patients (21.6%) admitted to the ARU with COVID-19 exhibited hallucinations. All were Hispanic and 7 of them were men; their average age was 56.5 (range: 38-71). Seven patients had COVID-19 pneumonia and 1 developed respiratory distress secondary to Guillain-Barre Syndrome. One patient had posterior reversible encephalopathy syndrome. The average length of stay in the intensive care unit (ICU) was 31.3 days (range: 8-48). Most of the hallucinations occurred during their ICU stay and 2 continued to their ARU stay. All recalled details of hallucinations with 7 exhibiting visual hallucinations, consistent with peduncular hallucinosis with or without auditory and/or tactile components. One patient experienced tactile hallucinations. The themes of hallucinations identified to reflect the contents of the hallucinations were patients' comfort-seeking, fearfulness, and seeing deceased family members. All patients had impaired cognition at the ARU admission but improved at discharge. Four patients had depressed mood/anxiety and 1 had depressed mood alone but without a history of psychiatric illness. ICU delirium was documented in 5 patients. The negative experience of hallucinations seemed to affect their participation of the ARU stay. Conclusions More than 20% of patients with COVID-19 who were transferred to attend inpatient rehabilitation exhibited hallucinations. It remains uncertain if these hallucinations were related to the SARS-CoV-2 infection. Multidisciplinary rehabilitation team should be aware to support patients with COVID-19 who experience hallucinations.
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Affiliation(s)
- Mari Tobita
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA,Rancho Research Institute, Downey, CA,Corresponding author Mari Tobita, MD, 7601 E Imperial Highway, Downey, CA 90242
| | - Shan-Pin Fanchiang
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA,Rancho Research Institute, Downey, CA,Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA
| | - Aida Saldivar
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA
| | - Sarah Taylor
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA
| | - Barry Jordan
- Rancho Los Amigos National Rehabilitation Center, Department of Health Services, County of Los Angeles, Downey, CA,Rancho Research Institute, Downey, CA,Department of Neurology, Keck Medicine of University of Southern California, Los Angeles, CA
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Umesh M, Singaravelu V, Daulatabad V, Kamble P, Singhal A, John NA, John J. An overview of prognostic value of neurologic and cardiac biomarkers in patients with COVID-19 sequelae. Horm Mol Biol Clin Investig 2022; 43:475-484. [PMID: 35728088 DOI: 10.1515/hmbci-2022-0015] [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: 01/27/2022] [Accepted: 04/08/2022] [Indexed: 01/08/2023]
Abstract
Many studies conducted after the pandemic period revealed that, while COVID-19 primarily injured the lungs, it also affects other organs in the form of cardiovascular complications, metabolic derangements, renal damage, and so on. Although we know that inflammatory cascades, complement activation, and pro-inflammatory cytokines are all involved in vasculitic processes that cause organ damage, we do not know the exact mechanism of complications such as acute respiratory distress syndrome (ARDS), cardiovascular ischemia, deep vein thrombosis, pulmonary thromboembolism, and brain injuries (embolism) that are frequently observed in COVID 19. The currently available biomarkers do not predict the severity of the aforementioned complications. As a result, more specific biomarkers such as serum calcium binding protein (S100B), glial fibrillary acid protein (GFAP), myelin basic protein (MBP), neuron-specific enolase (NSE), hs-TNI, (highly sensitive cardiac troponin) - HBDH, (Hydroxybutyrate Dehydrogenase), CK-MB (creatine kinase myocardial band), ST2 (suppression of tumorigenicity 2) are in need for early detection & improved clinical outcome.
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Affiliation(s)
- Madhusudhan Umesh
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Vidya Singaravelu
- Department of Pediatrics, Malla Reddy Institute of Medical Sciences, Hyderabad, Telangana, India
| | | | - Prafull Kamble
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Anish Singhal
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Nitin Ashok John
- Department of Physiology, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India
| | - Jyoti John
- Department of Biochemistry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
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