Post-COVID cognitive dysfunction: current status and research recommendations for high risk population

Quan, Meina; Wang, Xuechu; Gong, Min; Wang, Qi; Li, Yan; Jia, Jianping

doi:10.1016/j.lanwpc.2023.100836

Cited by 43 publications

(30 citation statements)

References 106 publications

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“…1,3,5 Current existing evidence updated by WHO suggest that post-COVID cognitive syndrome (PCCS) is defined 4 as a condition that "occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. 6 A comparatively small number of dynamic investigations limited to FDG-PET, have evaluated metabolic abnormalities while simultaneously assessing neuropsychological symptoms in COVID infection. 7,8 These studies suggested a significant correlation between frontoparietal hypometabolism and cognitive scores in post-COVID patients 8 a finding confirmed with by a few functional magnetic resonance imaging (fMRI) COVID studies 8,9 that revealed critical functional connectivity patterns in major functional networks (DMN and DAN) associated with impaired cognition.…”

Section: Introductionmentioning

confidence: 99%

“…Current existing evidence updated by WHO suggest that post‐COVID cognitive syndrome (PCCS) is defined 4 as a condition that “occurs in individuals with a history of probable or confirmed SARS‐CoV‐2 infection, usually 3 months from the onset of COVID‐19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis 6 . A comparatively small number of dynamic investigations limited to FDG‐PET, have evaluated metabolic abnormalities while simultaneously assessing neuropsychological symptoms in COVID infection 7,8 .…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, there is strong evidence suggesting the presence of certain neuropsychiatric symptoms such as depression and anxiety after COVID‐19 infection 2,13,14 . Here, it is noteworthy to remember that the presence of comorbid preexisting conditions, along with strict pandemic restrictions that have significant neuropsychiatric consequences, can mutually reinforce one another in a vicious cycle, ultimately impairing cognition and consequently elevating one's risk to degenerative dementia 6,15 . Finally, the current understanding of PCCS collectively emphasize the urgent necessity for additional comprehensive and prolonged cohort studies on individuals affected by COVID‐19 who experience cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

“…Finally, the current understanding of PCCS collectively emphasize the urgent necessity for additional comprehensive and prolonged cohort studies on individuals affected by COVID‐19 who experience cognitive impairment. More specifically, the prevailing consensus among experts indicates that the diagnosis of post‐COVID cognitive dysfunction (PCCD) should be taken into consideration when cognitive symptoms manifest subsequent to a COVID‐19 6 . To further enhance the precision of the diagnosis, and track and manage the fluctuating cognitive alterations timely, it is strongly recommended to supplement the comprehensive cognitive evaluation with suitable brain imaging and laboratory tests which will facilitate the development of an appropriate mental health intervention and treatment strategies 6 .…”

Section: Introductionmentioning

confidence: 99%

“…More specifically, the prevailing consensus among experts indicates that the diagnosis of post‐COVID cognitive dysfunction (PCCD) should be taken into consideration when cognitive symptoms manifest subsequent to a COVID‐19 6 . To further enhance the precision of the diagnosis, and track and manage the fluctuating cognitive alterations timely, it is strongly recommended to supplement the comprehensive cognitive evaluation with suitable brain imaging and laboratory tests which will facilitate the development of an appropriate mental health intervention and treatment strategies 6 . Here, it is noteworthy to mention that in addition to various nonpharmacological interventions such as cognitive training, lifestyle management, and noninvasive brain stimulation, there are several ongoing clinical trials investigating potential anti‐Alzheimer's disease (AD) treatment options, the results of which are eagerly awaited.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Infection with COVID‐19 is no longer a public emergency: But what about degenerative dementia?

Yulug,

Ayyıldız,

Ayyıldız

et al. 2023

Journal of Medical Virology

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Although no longer considered a public health threat, post‐COVID cognitive syndrome continues to impact on a considerable proportion of individuals who were infected with COVID‐19. Recent studies have also suggested that COVID may be represent a critical risk factor for the development of Alzheimer's disease (AD). We compared 17 COVID patients with 20 controls and evaluated the effects of COVID‐19 on general cognitive performance, hippocampal volume, and connections using structural and seed‐based connectivity analysis. We showed that COVID patients exhibited considerably worse cognitive functioning and increased hippocampal connectivity supported by the strong correlation between hippocampal connectivity and cognitive scores. Our findings of higher hippocampal connectivity with no observable hippocampal morphological changes even in mild COVID cases may be represent evidence of a prestructural compensatory mechanism for stimulating additional neuronal resources to combat cognitive dysfunction as recently shown for the prodromal stages of degenerative cognitive disorders. Our findings may be also important in light of recent data showing that other viral infections as well as COVID may constitute a critical risk factor for the development of AD. To our knowledge, this is the first study that investigated network differences in COVID patients, with a particular focus on compensatory hippocampal connectivity.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Infection with COVID‐19 is no longer a public emergency: But what about degenerative dementia?

Yulug,

Ayyıldız,

Ayyıldız

et al. 2023

Journal of Medical Virology

View full text Add to dashboard Cite

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Cognitive reserve, depressive symptoms, obesity, and change in employment status predict mental processing speed and executive function after COVID-19

Ariza,

Béjar,

Barrué

et al. 2024

Eur Arch Psychiatry Clin Neurosci

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The risk factors for post-COVID-19 cognitive impairment have been poorly described. This study aimed to identify the sociodemographic, clinical, and lifestyle characteristics that characterize a group of post-COVID-19 condition (PCC) participants with neuropsychological impairment. The study sample included 426 participants with PCC who underwent a neurobehavioral evaluation. We selected seven mental speed processing and executive function variables to obtain a data-driven partition. Clustering algorithms were applied, including K-means, bisecting K-means, and Gaussian mixture models. Different machine learning algorithms were then used to obtain a classifier able to separate the two clusters according to the demographic, clinical, emotional, and lifestyle variables, including logistic regression with least absolute shrinkage and selection operator (LASSO) (L1) and Ridge (L2) regularization, support vector machines (linear/quadratic/radial basis function kernels), and decision tree ensembles (random forest/gradient boosting trees). All clustering quality measures were in agreement in detecting only two clusters in the data based solely on cognitive performance. A model with four variables (cognitive reserve, depressive symptoms, obesity, and change in work situation) obtained with logistic regression with LASSO regularization was able to classify between good and poor cognitive performers with an accuracy and a weighted averaged precision of 72%, a recall of 73%, and an area under the curve of 0.72. PCC individuals with a lower cognitive reserve, more depressive symptoms, obesity, and a change in employment status were at greater risk for poor performance on tasks requiring mental processing speed and executive function. Study registration:www.ClinicalTrials.gov, identifier NCT05307575.

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Multi-target drugs for the treatment of cognitive impairment and fatigue in post-COVID syndrome: focus on Ginkgo biloba and Rhodiola rosea

Mueller,

Müller

2024

J Neural Transm

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Cognitive impairment, depression and (mental) fatigue represent the most frequent neuropsychiatric symptoms of the post-COVID syndrome. Neuroinflammation, oxidative stress and mitochondrial dysfunction have been identified as common pathophysiological mechanisms underlying these symptoms. Attempts to treat post-COVID-associated cognitive impairment and fatigue with different drugs available for other diseases have not yet been successful. One probable explanation could be that these drugs work by one specific mechanism of action only and not in a broad multi-target way. Therefore, they will not address the broad pathophysiological spectrum possibly responsible for cognitive impairment, depression and fatigue in post-COVID syndrome. Notably, nearly all drugs currently under investigation for fatigue in post-COVID syndrome are rather addressing one single target instead of the several pathomechanisms underlying this condition. Contrary to this approach, herbal drugs often consist of many different ingredients with different pharmacological properties and pharmacological targets. Therefore, these drugs might be a promising approach for the treatment of the broad symptomatic presentation and the pathophysiological mechanisms of cognitive impairment and fatigue following a SARS-CoV-2 infection. Of these herbal drugs, extracts of Ginkgo biloba and Rhodiola rosea probably are the best investigated candidates. Their broad pharmacological spectrum in vitro and in vivo includes anti-oxidative, anti-inflammatory, antidepressant as well as properties reducing cognitive impairment and fatigue. In several studies, both drugs showed positive effects on physical and mental fatigue and impaired cognition. Moreover, depressive symptoms were also reduced in some studies. However, even if these results are promising, the data are still preliminary and require additional proof by further studies.

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Post-COVID cognitive dysfunction: current status and research recommendations for high risk population

Cited by 43 publications

References 106 publications

Infection with COVID‐19 is no longer a public emergency: But what about degenerative dementia?

Infection with COVID‐19 is no longer a public emergency: But what about degenerative dementia?

Cognitive reserve, depressive symptoms, obesity, and change in employment status predict mental processing speed and executive function after COVID-19

Multi-target drugs for the treatment of cognitive impairment and fatigue in post-COVID syndrome: focus on Ginkgo biloba and Rhodiola rosea

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