Cognitive impairment in COVID-19 patients complicated by depression after the acute phase

Abstract

BACKGROUND: Damage of the central nervous system in COVID-19 patients includes cognitive impairment, depression, and fatigue. Clinical features of cognitive impairment after the acute phase of COVID-19 and the contribution of various factors to the development of memory deficit have not been fully studied. AIM: This study assesses the clinical features of cognitive impairment in COVID-19 patients complicated by depression after the acute phase and analyzes how health and demographic factors contribute to the development of cognitive impairment. MATERIALS AND METHODS: The observational cross-sectional study includes 33 patients aged 18–80 (mean age: 53.5; women: 60.6%) who meet the eligibility criteria. All subjects had a clinical semi-structured interview, a general clinical examination, MoCA, HDRS-17, and MFI-20 neuropsychological tests. RESULTS: The average MoCA-total score was 23.8±2.2. Cognitive impairments primarily affected memory (average MoCA memory score: 10.5±2.0), executive functions (average MoCA executive functioning score: 9.5±1.1), and attention (average MoCA attention score: 14.8±1.9). There is a strong negative correlation of HDRS-17 and MoCA-total values ( r=−0.72; p0.05), executive functioning index ( r=−0.82; p0.05), and memory index ( r=−0.85; p0.05). Age (β=−0.028; p=0.03), number of cardiovascular risk factors (β=−0.53; p=0.001), severity of COVID-19 in the acute phase (β=−0.97; p=0.001) and depression (β=−0.065; p=0.02) are the main contributors to cognitive impairment. CONCLUSION: Multi-domain cognitive impairment with predominant deterioration of executive functions, memory and attention was detected in patients who had COVID-19 complicated by depression after the acute phase. The key factors of, or main contributors to, cognitive impairment were identified, which can help select the best targeted therapy for this category of patients.