Comparison of fatigue, cognitive dysfunction and psychological disorders in post-COVID patients and patients after sepsis: is there a specific constellation?

Abstract

Background Sequelae of COVID-19 can be severe and longlasting. We compared frequencies of fatigue, depression and cognitive dysfunction in survivors of SARS-CoV-2-infection and sepsis. Methods We performed a prospective cohort study of 355 symptomatic post-COVID patients who visited our out-patient clinic for post-COVID-19 care. We compared them with 272 symptomatic patients from the Mid-German Sepsis Cohort, which investigates the long-term courses of sepsis survivors. Possible predictors for frequent clinical findings (fatigue, signs of depression, cognitive dysfunction) in post-COVID were investigated with multivariable logistic regression. Results Median age of the post-COVID patients was 51 years (range 17–86), 60.0% were female, and 31.8% required hospitalization during acute COVID-19. In the post-COVID patients (median follow-up time: 163 days) and the post-sepsis patients (180 days), fatigue was found in 93.2% and 67.8%, signs of depression were found in 81.3% and 10.9%, and cognitive dysfunction was found in 23.5% and 21.3%, respectively. In post-COVID, we did not observe an association between fatigue or depression and the severity of acute COVID-19. In contrast, cognitive dysfunction was associated with hospitalization (out-patient versus in-patient) and more frequent in post-COVID patients treated on an ICU compared to the MSC patients. Conclusion In post-COVID patients, fatigue and signs of depression are more common than in sepsis survivors, independent from the acute SARS-CoV-2-infection. In contrast, cognitive dysfunction is associated with hospitalization. Despite the differences in frequencies, owing to the similarity of post-COVID and post-sepsis sequelae, this knowledge may help in implementing follow-up approaches after SARS-CoV-2 infection.

Subtle cognitive impairments in memory, attention, and executive functioning in patients with post-COVID syndrome and their relationships with clinical variables and subjective complaints

“…However, as we did not find an association between the severity of fatigue and depression and cognitive performance in this large patient cohort, the results might indicate that cognitive deficits after SARS-CoV-2 infection are a separate entity. This would be in line with previous findings, that only cognitive deficits but not fatigue and depression are associated with severity of the acute infection [6].…”

“…These finding is basically in line with findings of relationships between the severity of the acute illness and cognitive deficits in small samples of either subacute patients [20] or patients at heterogeneous stages of disease recovery [11,21]. Similarly, they are in principle also in accordance with a trend for higher incidences of pathological MOCA scores in previously hospitalized vs. non-hospitalized post-COVID patients of the Jena outpatient post-COVID clinic [6]. In the current study, the predictive power of initial disease severity was rather low.…”

“…As expected based on previous studies (e.g. [6,11]), patients also differed from sociodemographically matched controls in terms of fatigue and depression. However, as we did not find an association between the severity of fatigue and depression and cognitive performance in this large patient cohort, the results might indicate that cognitive deficits after SARS-CoV-2 infection are a separate entity.…”

Mobile Primary Healthcare for post-COVID Patients in Rural Areas: a Proof-of-Concept Study

“…The patients presenting to our mobile unit with symptoms that were similar to those reported by patients visiting our regular outpatient clinic 7 and are thus considered "typical" post-COVID patients. The examinations performed in the mobile unit were practical given the limited resource setting and permitted us to provide the patients with detailed advice regarding efforts to improve their condition and general health.…”

“…5,6 The most common symptoms include, but are not limited to fatigue, shortness of breath, depression, and cognitive dysfunction. 7 Given the large number and variety of symptoms and complaints, health care provided to these patients must follow an interdisciplinary and holistic approach. This approach is often unavailable to patients who reside in remote, rural areas.…”