Cognitive Deficits in the Acute Phase of COVID-19: A Review and Meta-Analysis

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.

Effects of COVID-19 on cognition and brain health

“…For example, a comprehensive examination of 49 largely non-hospitalised COVID-19 patients with an average age of 60 years showed lower scores on mini mental state examination (MMSE) compared to age-matched controls, and 53% were significantly impaired in at least one cognitive domain (attention and executive, memory, or visuospatial) using a more extensive neuropsychological battery 2–3 months after infection [ 28 ]. This accords with a meta-analysis of 24 studies, all using cognitive screening tests, which reported that 52% of patients overall demonstrated acute deficits, and those aged over 59 years fared worse [ 26 ]. However, most of the publications in this analysis focused on hospitalised patients, namely those with more severe manifestations.…”

“…Global, clinical cognitive screening tests were commonly used in the acute phase, namely within 3 months of infection [ 25. , 26. , 27.…”

Long COVID in Brain Health Research: A Call to Action

“…Impairments found using cognitive screening tests, especially in those over 59 years old and hospitalized patients [ 26 , 27 ];…”

Comparison of lifestyle, cognitive function, mental health, and quality of life between hospitalized older adults with COVID-19 and non-COVID-19 in South Korea: a cross-sectional study

“…Although there is much evidence regarding the correlation between COVID-19 and cognitive decline, evaluations and interventions related to cognitive impairment in patients with COVID-19 are currently lacking. Moreover, older adults aged > 55 years tend to be linked to more severe forms of COVID-19 and, therefore, potentially more severe cognitive impairment [ 17 ]. Previous studies have reported that COVID-19 negatively affects cognition, lifestyle, mental health, and quality of life [ 4 , 18 , 19 ].…”