COVID 19 and Cognitive dysfunction @יואל קסלר .com
Newly published data in The Lancet eClinical Medicine, that we are profiling at יואל קסלר .com suggests that severe COVID-19 may cause significant worsening of cognitive functioning that is long lasting. In this study, patients with severe COVID -19 had both slower and less accurate responses on cognitive testing as compared with others in their age demographic. Patients who required mechanical ventilation as part of treatment for COVID – 19 had significantly worse performance than both controls and patients who required less intensive care.
The abstract is below"
The full article in The Lancet eClinical Medicine can be found here.
Multivariate profile and acute-phase correlates of cognitive deficits in a COVID-19 hospitalised cohort
Open AccessPublished:April 28, 2022DOI:https://doi.org/10.1016/j.eclinm.2022.101417
Summary
Background
Methods
Preliminary evidence has highlighted a possible association between severe COVID-19 and persistent cognitive deficits. Further research is required to confirm this association, determine whether cognitive deficits relate to clinical features from the acute phase or to mental health status at the point of assessment, and quantify rate of recovery.
46 individuals who received critical care for COVID-19 at Addenbrooke's hospital between 10th March 2020 and 31st July 2020 (16 mechanically ventilated) underwent detailed computerised cognitive assessment alongside scales measuring anxiety, depression and post-traumatic stress disorder under supervised conditions at a mean follow up of 6.0 (± 2.1) months following acute illness. Patient and matched control (N = 460) performances were transformed into standard deviation from expected scores, accounting for age and demographic factors using N = 66,008 normative datasets. Global accuracy and response time composites were calculated (G_SScore & G_RT). Linear modelling predicted composite score deficits from acute severity, mental-health status at assessment, and time from hospital admission. The pattern of deficits across tasks was qualitatively compared with normal age-related decline, and early-stage dementia.
Findings
COVID-19 survivors were less accurate (G_SScore=-0.53SDs) and slower (G_RT=+0.89SDs) in their responses than expected compared to their matched controls. Acute illness, but not chronic mental health, significantly predicted cognitive deviation from expected scores (G_SScore (p=0.0037) and G_RT (p = 0.0366)). The most prominent task associations with COVID-19 were for higher cognition and processing speed, which was qualitatively distinct from the profiles of normal ageing and dementia and similar in magnitude to the effects of ageing between 50 and 70 years of age. A trend towards reduced deficits with time from illness (r∼=0.15) did not reach statistical significance.
Interpretation
Cognitive deficits after severe COVID-19 relate most strongly to acute illness severity, persist long into the chronic phase, and recover slowly if at all, with a characteristic profile highlighting higher cognitive functions and processing speed.
