Cognition and Memory after Covid-19 in a Large Community Sample

New England Journal of Medicine, Journal Year: 2024, Volume and Issue: 390(9), P. 806 - 818

Published: Feb. 28, 2024

BackgroundCognitive symptoms after coronavirus disease 2019 (Covid-19), the caused by severe acute respiratory syndrome 2 (SARS-CoV-2), are well-recognized. Whether objectively measurable cognitive deficits exist and how long they persist unclear.MethodsWe invited 800,000 adults in a study England to complete an online assessment of function. We estimated global score across eight tasks. hypothesized that participants with persistent (lasting ≥12 weeks) infection onset would have impairments executive functioning memory be observed such participants, especially those who reported recent poor or difficulty thinking concentrating ("brain fog").ResultsOf 141,583 started assessment, 112,964 completed it. In multiple regression analysis, had recovered from Covid-19 whom resolved less than 4 weeks at least 12 similar small cognition as compared no–Covid-19 group, not been infected SARS-CoV-2 unconfirmed (−0.23 SD [95% confidence interval {CI}, −0.33 −0.13] −0.24 CI, −0.36 −0.12], respectively); larger group were seen unresolved (−0.42 SD; 95% −0.53 −0.31). Larger during periods which original virus B.1.1.7 variant was predominant later variants (e.g., −0.17 for vs. B.1.1.529 variant; −0.20 −0.13) hospitalized intensive care unit admission, −0.35 −0.49 −0.20). Results analyses propensity-score–matching analyses. comparison memory, reasoning, function tasks associated largest (−0.33 SD); these correlated weakly symptoms, including brain fog. No adverse events reported.ConclusionsParticipants measured shorter-duration although short-duration still recovery. Longer-term persistence any clinical implications remain uncertain. (Funded National Institute Health Care Research others.)

Language: Английский

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

The Lancet Regional Health - Western Pacific, Journal Year: 2023, Volume and Issue: 38, P. 100836 - 100836

Published: July 5, 2023

Summary

Post-COVID cognitive dysfunction (PCCD) is a condition in which patients with history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, usually three months from the onset, exhibit subsequent impairment various domains, and cannot be explained by an alternative diagnosis. While our knowledge risk factors management strategy PCCD still incomplete, it necessary to integrate current epidemiology, diagnosis treatment evidence, form consensus criteria better understand this disease improve management. Identifying vulnerable population providing reliable strategies for effective prevention urgently needed. In paper, we reviewed diagnostic markers, available treatments on disease, formed research recommendation framework population, under background post-COVID period.

Language: Английский

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Long COVID, the Brain, Nerves, and Cognitive Function

Neurology International, Journal Year: 2023, Volume and Issue: 15(3), P. 821 - 841

Published: July 6, 2023

SARS-CoV-2, a single-stranded RNA coronavirus, causes an illness known as coronavirus disease 2019 (COVID-19). Long-term complications are increasing issue in patients who have been infected with COVID-19 and may be result of viral-associated systemic central nervous system inflammation or arise from virus-induced hypercoagulable state. incite changes brain function wide range lingering symptoms. Patients often experience fatigue note fog, sensorimotor symptoms, sleep disturbances. Prolonged neurological neuropsychiatric symptoms prevalent can interfere substantially everyday life, leading to massive public health concern. The mechanistic pathways by which SARS-CoV-2 infection sequelae important subject ongoing research. Inflammation- induced blood-brain barrier permeability viral neuro-invasion direct nerve damage involved. Though the mechanisms uncertain, resulting documented numerous patient reports studies. This review examines constellation spectrum seen long COVID incorporates information on prevalence these contributing factors, typical course. Although treatment options generally lacking, potential therapeutic approaches for alleviating improving quality life explored.

Language: Английский

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Cognitive impairment after long COVID-19: current evidence and perspectives

Frontiers in Neurology, Journal Year: 2023, Volume and Issue: 14

Published: July 31, 2023

COVID-19, caused by the SARS-CoV-2 virus, is a respiratory infectious disease. While most patients recover after treatment, there growing evidence that COVID-19 may result in cognitive impairment. Recent studies reveal some individuals experience deficits, such as diminished memory and attention, well sleep disturbances, suggesting could have long-term effects on function. Research indicates contribute to decline damaging crucial brain regions, including hippocampus anterior cingulate cortex. Additionally, identified active neuroinflammation, mitochondrial dysfunction, microglial activation patients, implying these factors be potential mechanisms leading Given findings, possibility of impairment following treatment warrants careful consideration. Large-scale follow-up are needed investigate impact function offer support clinical rehabilitation practices. In-depth neuropathological biological can elucidate precise provide theoretical basis for prevention, intervention research. Considering risks reinfection, it imperative integrate basic research data optimize preservation patients' quality life. This integration will also valuable insights responding similar public health events future. perspective article synthesizes discussing outlining future directions.

Language: Английский

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Sex differences in post-acute neurological sequelae of SARS-CoV-2 and symptom resolution in adults after coronavirus disease 2019 hospitalization: an international multi-centre prospective observational study

Brain Communications, Journal Year: 2024, Volume and Issue: 6(2)

Published: Jan. 1, 2024

Abstract Although it is known that coronavirus disease 2019 can present with a range of neurological manifestations and in-hospital complications, sparse data exist on whether these initial symptoms are closely associated post-acute sequelae SARS-CoV-2 (severe acute respiratory syndrome 2; PANSC) female versus male sex impacts symptom resolution. In this international, multi-centre, prospective, observational study across 407 sites from 15 countries (30 January 2020 to 30 April 2022), we report the prevalence risk factors PANSC among hospitalized adults investigate differences between males females resolution over time. included altered consciousness/confusion, fatigue/malaise, anosmia, dysgeusia muscle ache/joint pain, which information was collected at index hospitalization during follow-up assessments. The analysis considered time individual all symptoms. resulting times were modelled by Weibull regression, assuming mixed-case interval censoring, age as covariates. model results summarized cumulative probability functions age-adjusted sex-adjusted median We 6862 2019, who had participants 57 years (39.2% females). Males similar baseline characteristics, except more (versus females) admitted intensive care unit (30.5 20.3%) received mechanical ventilation (17.2 11.8%). Approximately 70% patients multiple first (median = 102 days). Fatigue (49.9%) myalgia/arthralgia (45.2%) most prevalent follow-up. reported in generally higher males) for At 12 months, anosmia resolved patients, although fatigue, consciousness myalgia remained unresolved >10% cohort. Females longer (5.2 3.4 months) those than one symptom. multivariable analysis, shorter (hazard ratio 1.53; 95% confidence 1.39–1.69). Intensive admission 0.68; 0.60–0.77). Post-discharge stroke uncommon (0.3% 0.5% males). Despite methodological challenges involved collection survey data, international multi-centre prospective cohort demonstrated following high. Symptom took resolve males. This supported fact while sicker illness, disproportionately affected PANSC.

Language: Английский

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Neurocognitive Impairment in Long COVID: A Systematic Review

Archives of Clinical Neuropsychology, Journal Year: 2024, Volume and Issue: unknown

Published: June 8, 2024

Abstract Objective Although Coronavirus disease 2019 (COVID-19) is primarily a respiratory infectious disease, it has also been associated with wide range of other clinical manifestations. It widely accepted in the scientific community that many patients after recovery continue to experience COVID-19-related symptoms, including cognitive impairment. The aim this systematic review was investigate profile long-COVID syndrome. Methods A search empirical studies conducted through PubMed/Medline and Scopus electronic databases. Cross-sectional longitudinal published between 2020 2023 were included. Results Of 516 assessed for eligibility, 36 met inclusion criteria. All included support presence persistent changes COVID-19 disease. Executive function, memory, attention, processing speed appear be domains are predominantly syndrome, whereas language an area not sufficiently investigated. Conclusions In review, high frequency impairment evident. If we consider functioning affects our ability live independently key determinant quality life, imperative precisely define those factors may induce survivors, ultimate goal early diagnosis and, consequently, development targeted rehabilitation interventions address them.

Language: Английский

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Psychometric properties of the COVID-19 Yorkshire Rehabilitation Scale: Post-Covid-19 syndrome in Iranian elderly population

BMC Infectious Diseases, Journal Year: 2024, Volume and Issue: 24(1)

Published: Jan. 11, 2024

Abstract Background This study aimed to assess the construct validity and reliability of Iranian version COVID-19 Yorkshire Rehabilitation Scale (C19-YRS) among elderly population. Method A cohort 230 individuals who tested positive for Covid-19 via PCR were administered a health demographic information questionnaire along with C19-YRS. Both exploratory confirmatory factor analyses conducted, Cronbach’s alpha was calculated. Results Findings from C19-YRS revealed alterations compared original version, resulting in an adapted three factors achieved by redistributing questions. These accounted 57.46% total variance. Despite relatively lower loading 6th question, it retained due its significance elderly. The subscales ranged 0.730 0.890, indicating acceptable reliability. Conclusion validation results indicated well-adjusted structure internal consistency, affirming utility this tool Consequently, Iran can serve as valuable resource healthcare settings, aiding assessment chronic complications arising It be utilized initial screening or triage test evaluate effectiveness interventions.

Language: Английский

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Scientific Rationale for the Treatment of Cognitive Deficits from Long COVID

Neurology International, Journal Year: 2023, Volume and Issue: 15(2), P. 725 - 742

Published: May 31, 2023

Sustained cognitive deficits are a common and debilitating feature of “long COVID”, but currently there no FDA-approved treatments. The functions the dorsolateral prefrontal cortex (dlPFC) most consistently afflicted by long COVID, including in working memory, motivation, executive functioning. COVID-19 infection greatly increases kynurenic acid (KYNA) glutamate carboxypeptidase II (GCPII) brain, both which can be particularly deleterious to PFC function. KYNA blocks NMDA nicotinic-alpha-7 receptors, two receptors required for dlPFC neurotransmission, GCPII reduces mGluR3 regulation cAMP-calcium-potassium channel signaling, weakens network connectivity neuronal firing. Two agents approved other indications may helpful restoring physiology: antioxidant N-acetyl cysteine inhibits production KYNA, α2A-adrenoceptor agonist guanfacine regulates signaling is also anti-inflammatory. Thus, these treating symptoms COVID.

Language: Английский

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COVID-19 and cognitive function: Evidence for increased processing speed variability in COVID-19 survivors and multifaceted impairment with long-COVID symptoms

European Psychiatry, Journal Year: 2023, Volume and Issue: 66(1)

Published: Jan. 1, 2023

There is increasing evidence for cognitive function to be negatively impacted by COVID-19. is, however, limited research evaluating pre- and post-COVID-19 using objective measures.We examined processing speed, attention, working memory, executive memory in adults (≤69 years) with a history of COVID-19 (n = 129, none acutely unwell), compared those no known 93). We also changes sub-group COVID 30) non-COVID 33) participants, their pre-COVID-19 pandemic level.Cross-sectionally, the group showed significantly larger intra-individual variability group. The pre-COVID level; significant change occurred participants over same time scale. Other indices were not cross-sectional or within-subjects investigations, but 20) who had needed hospitalisation due poor attention relative required 109). Poor health long-COVID symptoms correlated across domains group.The findings indicate impact only speed being an adult UK sample. However, severity and/or experience display multifaceted impairment may benefit from repeated assessments remediation efforts.

Language: Английский

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Long-term follow-up of brain regional changes and the association with cognitive impairment in quarantined COVID-19 survivors

European Archives of Psychiatry and Clinical Neuroscience, Journal Year: 2024, Volume and Issue: 274(8), P. 1911 - 1922

Published: Feb. 6, 2024

Language: Английский

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