Cognitive Symptoms of Post–COVID-19 Condition and Daily Functioning

Jaywant, Abhishek; Gunning, Faith M.; Oberlin, Lauren E.; Santillana, Mauricio; Ognyanova, Katherine; Druckman, James N.; Baum, Matthew A.; Lazer, David; Perlis, Roy H.

doi:10.1001/jamanetworkopen.2023.56098

Cited by 11 publications

(1 citation statement)

References 46 publications

(95 reference statements)

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“…In our study, a negative impact on quality of life was also observed at the 6-month follow-up, quantified (EQ-5D-5L) in 22.5% of the 142 patients with mild COVID-19 tested at baseline and at the end of the study. Finally, a survey of 14,767 participants at least 2 months after an acute episode of COVID-19 suggests that cognitive symptoms are common, mostly referred to as mental confusion, associated with worse quality of life [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Preventive Intake of a Multiple Micronutrient Supplement during Mild, Acute SARS-CoV-2 Infection to Reduce the Post-Acute COVID-19 Condition: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

Tomasa-Irriguible,

Monfà,

Miranda-Jiménez

et al. 2024

Nutrients

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Patients hospitalized with COVID-19 have low levels of vitamins and trace elements. This could lead to a post-acute COVID-19 condition (PCC) that can worsen a patient’s quality of life. We aimed to study the baseline micronutrient status of patients and assess whether a multiple micronutrient supplement (MMS) taken for 2 weeks at the first sign of COVID-19 symptoms would be able to reduce the incidence of PCC. This double-blind, placebo-controlled, randomized clinical trial was conducted in adult outpatients with acute COVID-19, recruited between 2021 and 2023 in Spain. Of the 285 patients assessed for eligibility, 267 were randomized and 246 were included in the intent-to-treat population. The mean age was 46.8 years, and 68% were female. Overall, 54.6% had micronutrient deficiencies in the acute phase of COVID-19 at baseline, and 26.2% had PCC after 180 days of follow-up (D180). The most frequently recorded PCC symptoms were neurological (14.1%), with 24% patients scoring worse in the cognitive tests compared to their baseline status. The rate of PCC at D180 was similar between the placebo (25.0%) and intervention (27.7%) groups, without significant differences (p = 0.785). Age over 50 years was the most relevant risk factor for developing PCC, followed by female sex. The most important protective factor against PCC was SARS-CoV-2 vaccination. In this population of predominantly middle-aged, white women with acute COVID-19 not requiring hospital admission, MMS intake for 14 days at symptom onset did not prevent PCC nor improve their micronutrient status at D180.

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Section: Discussionmentioning

confidence: 99%

Preventive Intake of a Multiple Micronutrient Supplement during Mild, Acute SARS-CoV-2 Infection to Reduce the Post-Acute COVID-19 Condition: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

Tomasa-Irriguible,

Monfà,

Miranda-Jiménez

et al. 2024

Nutrients

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Neuroinflammation in Post COVID‐19 Sequelae: Neuroinvasion and Neuroimmune Crosstalk

Dos Reis,

Selvam,

Ayyavoo

2024

Reviews in Medical Virology

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The emergence of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in December 2019 triggered a swift global spread, leading to a devastating pandemic. Alarmingly, approximately one in four individuals diagnosed with coronavirus disease 2019 (COVID‐19) experience varying degrees of cognitive impairment, raising concerns about a potential increase in neurological sequelae cases. Neuroinflammation seems to be the key pathophysiological hallmark linking mild respiratory COVID‐19 to cognitive impairment, fatigue, and neurological sequelae in COVID‐19 patients, highlighting the interaction between the nervous and immune systems following SARS‐CoV‐2 infection. Several hypotheses have been proposed to explain how the virus disrupts physiological pathways to trigger inflammation within the CNS, potentially leading to neuronal damage. These include neuroinvasion, systemic inflammation, disruption of the lung and gut‐brain axes, and reactivation of latent viruses. This review explores the potential origins of neuroinflammation and the underlying neuroimmune cross‐talk, highlighting important unanswered questions in the field. Addressing these fundamental issues could enhance our understanding of the virus's impact on the CNS and inform strategies to mitigate its detrimental effects.

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The Impact of Long COVID on Employment and Well-Being: A Qualitative Study of Patient Perspectives

MacEwan,

Rahurkar,

Tarver

et al. 2024

J GEN INTERN MED

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Background Exploring the experiences of Long COVID patients who face challenges with employment may inform improvements in how healthcare systems can provide holistic care for this patient population. Objective Understand perspectives about the impact of Long COVID on employment and well-being among patients seeking healthcare for Long COVID. Design Qualitative study involving one-on-one interviews. Participants Eligible participants were 18 years of age or older, spoke English, self-reported as doing well in daily life before having COVID-19, and reported that COVID-19 was still having a significant impact on their life three or more months following an acute infection. Approach Participants were recruited from a post-COVID recovery clinic at an academic medical center. Interviews were conducted from August to September 2022. Key Results Among all participants (N = 21), most described that they were not able to work at a capacity equivalent to their norm pre-COVID-19. For those who continued working after their COVID-19 infection, the effort and energy required for work left little capacity to participate in other life activities and made it difficult to attend recommended healthcare appointments. Participants reported financial impacts of changes in employment including loss of income and changes in insurance, which were compounded by high healthcare costs. Changes in employment resulted in emotional repercussions including feelings of loss of self-identity and fear of judgement at work. Participants discussed issues surrounding access to strategies to address challenges posed by the impact of Long COVID on employment, including strategies learned from healthcare providers to cope with Long COVID symptoms at work and efforts to seek disability benefits or workplace accommodations. Conclusions Patients with Long COVID may face significant challenges due to changes in their ability to work. Healthcare providers can support these patients by connecting them to financial assistance resources, facilitating appropriate mental health treatment, and expediting workplace accommodation requests.

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Cognitive Symptoms of Post–COVID-19 Condition and Daily Functioning

Cited by 11 publications

References 46 publications

Preventive Intake of a Multiple Micronutrient Supplement during Mild, Acute SARS-CoV-2 Infection to Reduce the Post-Acute COVID-19 Condition: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

Preventive Intake of a Multiple Micronutrient Supplement during Mild, Acute SARS-CoV-2 Infection to Reduce the Post-Acute COVID-19 Condition: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial

Neuroinflammation in Post COVID‐19 Sequelae: Neuroinvasion and Neuroimmune Crosstalk

The Impact of Long COVID on Employment and Well-Being: A Qualitative Study of Patient Perspectives

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