Neurological and Mental Health Symptoms Associated with Post-COVID-19 Disability in a Sample of Patients Discharged from a COVID-19 Ward: A Secondary Analysis

Abstract

Recent studies suggest that COVID-19 survivors may experience long-term health consequences: in particular, neurological and mental health symptoms might be associated with long-term negative outcomes. This study is a secondary analysis of a larger cohort study and aims to determine the extent to which neurological and mental health sequelae are associated with survivors’ disability. Participants include COVID-19 survivors, with no pre-morbid brain conditions, who were discharged from the COVID-19 Unit of the ASST Spedali Civili Hospital between February and April 2020. At an average of 3.5 months after discharge, they were submitted to a neurological examination and completed the WHO Disability Assessment Schedule (WHODAS-12), the Hospital Anxiety and Depression Score, the Pittsburgh Sleep Quality Index and the Montreal Cognitive Assessment. Multivariable regression analysis was carried out to analyze variables that explain WHODAS-12 variation. In total, 83 patients (63 males, average age 66.9, 95% CI: 64.2–69.7) were enrolled; average WHODAS-12 was 13.2 (95% CI: 9.7–16.6). Cognitive dysfunction, anxiety, fatigue, and hyposmia/hypogeusia explained 28.8% of WHODAS-12 variation. These findings underline the importance and need for longitudinal follow-up assessments after recovery from COVID-19 and suggest the need for early rehabilitation of residual symptoms to enhance patients’ functioning.

The Impact of COVID-19 Lockdown Measures and COVID-19 Infection on Cognitive Functions: A Review in Healthy and Neurological Populations

“…Thus, it was expected that it would immediately impact the population as a whole with severe psychological and cognitive implications. Indeed, our findings are in line with previous literature on COVID-19 which report the presence of cognitive decline in the short [ 20 , 42 , 53 ], medium [ 49 , 52 , 61 ], and long-term periods [ 50 , 92 ].…”

“…As reported in Table 2 , the negative effects of COVID-19 infection on cognitive performance in healthy people were identified in 39 out of 46 studies (85%). Five out of seven studies performed in the short period (1–4 months) found a general worsening in cognitive performance [ 53 , 54 , 57 , 58 ], specifically, in verbal memory [ 54 , 57 ] and attention tasks [ 55 ]. On the contrary, Johnsen et al [ 56 ] and Priftis at al.…”

Behavioral and psychological factors in individuals with migraine without psychiatric comorbidities

“…There is a high proportion of patients that report feelings of anxiety, worry and sadness although not showing a clear psychiatric comorbidity or taking treatments for psychiatric illness. This proportion might be increasing in the post Covid-19 era, where subjects with no pre-morbid psychiatric conditions are more likely to experience mental health symptoms resulting in reduced well-being and enhanced psychosocial impairment [7]. Although this issue has not been systematically investigated, empirical evidence suggests that also migraine patients may be badly affected by post-covid psychopathological distress with all the ensuing consequences on migraine-related disability [8].…”

Acute and preventive treatment of COVID-19 related headache: A series of 100 patients

“…On the other hand, the effect of rehabilitation (34) and psychological treatment (35) has not been addressed in our study. The assessment and treatment of COVID-19 patients must be multidisciplinary (36), and may address the management of other possible comorbidities, which in the case of neurological manifestations are within the most prevalent (37)(38)(39).…”