Predictors of cognitive dysfunction one-year post COVID-19.

Abstract

Objectives: (a) To characterize the frequency of objective cognitive deficits and self-perceived cognitive difficulties and (b) to explore demographic and clinical predictors of cognitive dysfunction and cognitive complaints. Method: One hundred and ten adults diagnosed with COVID-19 between March and November 2020, aged ≤74 years underwent a brief neuropsychological evaluation 12 months after infection, which included: Brief Visuospatial Memory Test–Revised, California Verbal Learning Test, and Symbol Digit Modalities Test. T scores <38 were considered abnormal performance; cognitive dysfunction was defined as ≥2 abnormal tests. Participants also completed Broadbent’s Cognitive Failure Questionnaires (CFQ), Hospital Anxiety and Depression Scale, Modified Fatigue Impact Scale, and Short-Form Health Survey. CFQ ≥ 43 was considered indicative of cognitive complaints. Results: Twenty participants (18.2%) had cognitive dysfunction and 36 (33.3%) had cognitive complaints. Cognitive dysfunction was related to lower education, preinfection history of headache/migraine, and acute COVID-19 symptoms of headache and sleep disturbance. Cognitive complaints were more likely to occur in women, those with fewer years of education, and acute COVID-19 symptoms of headache and sleep disturbance. Cognitive complaints were also significantly related to symptoms of anxiety, depression, and fatigue. Sex and psychopathology were not significant predictors of cognitive dysfunction. Modest associations were found between CFQ total score and cognitive test performance. Discussion: A subset of individuals develops cognitive difficulties in the context of post-COVID syndrome. Results may support the protective effect of education, a known proxy of cognitive reserve. COVID-19 infection symptoms of headache and sleep disturbance appear to be risk factors for long-term cognitive difficulties.

Long COVID-19 and mnemonic effects: an integrative literature review

“…The results of the analysis indicated that the most impaired cognitive function was memory, affecting approximately 37% of patients. These findings may be related to later findings, which also observed neurological impairments in COVID-19-infected patients, however, in a period of at least 1 year after infection 17 . In this context, it is possible to identify similarities in the results obtained, and the main discrepancy is the average time interval for the onset of symptoms.…”

“… After 1 year, more than 50% of patients had abnormal performance on at least one cognitive test and more than one-third had significant cognitive complaints. Part of patients with long-term COVID have persistent cognitive changes 2023 Taruffi L. et al 17 Neurological Manifestations of Long COVID: A Single-Center One-Year Experience. Retrospective observational University of Bologna, Italy.…”

The Lasting Legacy of COVID-19: Exploring the Long-Term Effects of Infection, Disease Severity, and Vaccination on Health and Cognitive Function

“…Similarly, among other findings, processing speed, attention, working memory, and executive functions were found to be more compromised in patients in another study 9 ; however, other research did not find a significant difference between the patients and controls in attention and executive functions 10 . The role of age has also proved controversial, as one study reported a negative association between age and impairment in cognitive functioning 9 , while another study found a positive association in the patient group 14 . Findings regarding COVID severity have also been somewhat controversial, as one study found no significant relationship between disease severity and cognitive deficits 10 , while other studies reported significant associations 15 .…”

Course of fatigue among patients previously hospitalised due to COVID-19

“…It has been postulated for example that SARS-CoV-2 infection may act as a trigger activating a complex network of neuropsychiatric symptoms, including fatigue, anxiety, depression, sleep and cognitive disturbances [57]. Fatigue, apart from anxiety and depression, could, in turn, significantly affect cognitive abilities even months after the initial infection [58,59]. It has also been found that individuals with post-COVID symptoms assessed six months after hospital discharge expressed higher levels of interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), and monocyte chemoattractant protein-1 (MCP-1) compared to people without post-COVID sequelae [60,61].…”