Objective
To report the cognitive features of severe COVID-19 patients entering in the post-acute phase, to understand whether COVID-19 acute respiratory distress syndrome itself could result in long-term cognitive deficits and whether neuropsychological treatment after the acute stage might represent a specific rehabilitation need.
Design
Case series.
Setting
Rehabilitation hospital.
Participants
We assessed the general cognitive functioning, through tablet-supported video-call, in 9 of 12 consecutive patients admitted to the hospital at least 30 days earlier for acute respiratory distress syndrome due to COVID-19. None of these patients presented cognitive symptoms before the hospitalization.
Main Outcome Measures
General Cognitive functioning, measured using the Mini-Mental State Examination Test.
Results
A general cognitive decay was observed in three patients (33.3%), who had a pathological score at the Mini-Mental State Examination (MMSE), with a specific decline in attention, memory, language and praxis abilities. The cognitive (mal)functioning seems to be linearly associated with the length of stay (in days) in the intensive care unit (ICU): the higher the number of days spent in the ICU, the lower the MMSE score (indicating a lower global cognitive functioning).
Conclusions
Our results indicate that some COVID-19 patients might also benefit from a neuropsychological rehabilitation, given their possible global cognitive decay. The link between the neuropsychological functioning and the length of stay in the ICU suggests that neurocognitive rehabilitative treatments should be directed explicitly towards patients who are treated in the ICU care, rather than towards every patient who suffered from acute respiratory distress syndrome due to COVID-19. However, given the limitation of a case series study, those hypotheses should be tested with future studies with larger samples and a longer follow-up.
Background and aim:The reporting of clinical studies in rehabilitation has been criticized in several aspects, including the reporting of patient characteristics. This paper aims to contribute to the improvement of the reporting of patient characteristics in rehabilitation trials. Specifically, we want to determine the type of information that should be reported in rehabilitation trials that is specific to rehabilitation patients, and how this information is captured by current reporting standards.Methods: In the first step, we made a conceptual analysis of characteristics of rehabilitation patients by addressing the specifics of the field of medical rehabilitation, including the definition of rehabilitation and a description of its beneficiaries. In the second step we compared this reference framework to the current reporting standards, especially the CONSORT statement and its extensions, as well as standards for the reporting of clinical guidelines (AGREE, RIGHT).
Results: Patients included in rehabilitation interventions should be distinguished by specific information. From a clinical perspective, patients dealt with in rehabilitation comprise broader diagnostic groups compared to other clinical settings. Information on comorbidities should be added in the description of the patients. Also, a description of baseline characteristics of patients should always include functioning characteristics of the patients, including information on relevant context factors, i.e. environmental and personal factors. The CONSORT statement aims to provide patient characteristic to enable transferability of results to users. It is represented in terms of selection (inclusion/exclusion) criteria and the description of the resulting samples.Extensions of the CONSORT statement specified that information on socioeconomic variables should be added, and the selection of patient characteristics to be reported at baseline should be based on the selection of outcome variables. Also, all relevant prognostic variables should be
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.