Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care DOI Creative Commons

Udo Zifko,

Katja Guendling,

Raymond C.S. Seet

et al.

Frontiers in Pharmacology, Journal Year: 2024, Volume and Issue: 15

Published: April 22, 2024

Introduction: Although post-COVID-19 syndrome (PCS) with cognitive impairment is increasingly encountered in primary care, evidence-based recommendations for its appropriate management are lacking. Methods: A systematic literature search evaluating the diagnosis and treatment of associated PCS was conducted. Practical PCS-associated care summarized, based on an evaluation pharmacological plausibility clinical applications. Results: Currently, pathology remains unclear no high-quality data to support targeted interventions. Existing approaches directed towards symptom relief where counseling chronicity disease regular reassessments at 4- 8-week intervals considered reasonable. Patients should be informed encouraged adopt a healthy lifestyle that centers around balanced nutrition physical activities. They may also benefit from intake vitamins, micronutrients, probiotics. The administration Ginkgo biloba extract could offer safe potentially beneficial option. Other non-pharmacological measures include physiotherapy, digitally supported training, and, if indicated, ergotherapy or speech therapy. In most patients, symptoms improve within 8 weeks. If serious, ambiguous, when new occur, specialized diagnostic such as comprehensive neurocognitive testing neuroimaging initiated. Very few patients would require inpatient rehabilitation. Conclusion: debilitating condition affect daily functioning reduce work productivity. Management multidisciplinary approach, centering physical, cognitive, therapies.

Language: Английский

The immunology of long COVID DOI Open Access
Daniel M. Altmann, Emily M. Whettlock, Siyi Liu

et al.

Nature reviews. Immunology, Journal Year: 2023, Volume and Issue: 23(10), P. 618 - 634

Published: July 11, 2023

Language: Английский

Citations

265
Cognition and Memory after Covid-19 in a Large Community Sample DOI Open Access
Adam Hampshire, Adriana Azor, Christina Atchison

et al.

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

Citations

111
Post-COVID cognitive dysfunction: current status and research recommendations for high risk population DOI Creative Commons
Meina Quan,

Xuechu Wang,

Min Gong

et al.

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

Citations

67
Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study DOI Creative Commons
Sijia Zhao, Eva Maria Martin, Philipp Reuken

et al.

EClinicalMedicine, Journal Year: 2024, Volume and Issue: 68, P. 102434 - 102434

Published: Jan. 25, 2024

Summary

Background

COVID-19 survivors may experience a wide range of chronic cognitive symptoms for months or years as part post-COVID-19 conditions (PCC). To date, there is no definitive objective marker PCC. We hypothesised that key common deficit in people with PCC might be generalised slowing.

Methods

examine slowing, patients completed two short web-based tasks, Simple Reaction Time (SRT) and Number Vigilance Test (NVT). 270 diagnosed at different clinics UK Germany were compared to control groups: individuals who contracted before but did not after recovery (No-PCC group) uninfected (No-COVID group). All the study between May 18, 2021 July 4, 2023 Jena University Hospital, Jena, Long COVID clinic, Oxford, UK.

Findings

identified pronounced slowing PCC, which distinguished them from age-matched healthy previously had symptomatic manifest Cognitive was evident even on 30-s task measuring simple reaction time (SRT), responding stimuli ∼3 standard deviations slower than controls. 53.5% PCC's response speed 2 mean, indicating high prevalence This finding replicated across clinic samples Comorbidities such fatigue, depression, anxiety, sleep disturbance, post-traumatic stress disorder account extent Furthermore, SRT highly correlated poor performance NVT measure sustained attention.

Interpretation

Together, these results robustly demonstrate distinguishes an important factor contributing some impairments reported

Funding

Wellcome Trust (206330/Z/17/Z), NIHR Oxford Health Biomedical Research Centre, Thüringer Aufbaubank (2021 FGI 0060), German Forschungsgemeinschaft (DFG, FI 1424/2-1) Horizon 2020 Framework Programme European Union (ITN SmartAge, H2020-MSCA-ITN-2019-859890).

Language: Английский

Citations

45
Microstructural brain abnormalities, fatigue, and cognitive dysfunction after mild COVID-19 DOI Creative Commons

Lucas Scardua-Silva,

Beatriz Amorim Da Costa, Ítalo Karmann Aventurato

et al.

Scientific Reports, Journal Year: 2024, Volume and Issue: 14(1)

Published: Jan. 19, 2024

Abstract Although some studies have shown neuroimaging and neuropsychological alterations in post-COVID-19 patients, fewer combined neuropsychology evaluations of individuals who presented a mild acute infection. Here we investigated cognitive dysfunction brain changes group mildly infected individuals. We conducted cross-sectional study 97 consecutive subjects (median age 41 years) without current or history psychiatric symptoms (including anxiety depression) after infection, with median 79 days (and mean days) diagnosis COVID-19. performed semi-structured interviews, neurological examinations, 3T-MRI scans, assessments. For MRI analyses, included non-infected 77 controls. The white matter (WM) investigation diffusion tensor images (DTI) functional connectivity resting-state (RS-fMRI). patients reported memory loss (36%), fatigue (31%) headache (29%). quantitative analyses confirmed (83% participants), excessive somnolence (35%), impaired phonemic verbal fluency (21%), categorical (13%) logical immediate recall (16%). WM DTI revealed higher axial diffusivity values post-infected compared to Compared controls, there were no significant differences the posterior cingulum cortex. There correlations between scores features RS-fMRI). Our results suggest persistent impairment subtle abnormalities depression symptoms. longitudinal will clarify whether these are temporary permanent.

Language: Английский

Citations

19
Development of criteria for cognitive dysfunction in post-COVID syndrome: the IC-CoDi-COVID approach DOI
Jordi A. Matías‐Guiu, Elena Herrera, María González‐Nosti

et al.

Psychiatry Research, Journal Year: 2022, Volume and Issue: 319, P. 115006 - 115006

Published: Dec. 10, 2022

Language: Английский

Citations

48
Effects of COVID-19 on cognition and brain health DOI Creative Commons
Sijia Zhao, Sofia Toniolo, Adam Hampshire

et al.

Trends in Cognitive Sciences, Journal Year: 2023, Volume and Issue: 27(11), P. 1053 - 1067

Published: Aug. 30, 2023

COVID-19 is associated with a range of neurological, cognitive, and mental health symptoms both acutely chronically that can persist for many months after infection in people long-COVID syndrome. Investigations cognitive function neuroimaging have begun to elucidate the nature some these symptoms. They reveal that, although deficits may be related brain imaging abnormalities people, also occur absence objective or changes. Furthermore, impairment detected even asymptomatic individuals. We consider evidence regarding symptoms, deficits, neuroimaging, as well their possible underlying mechanisms.

Language: Английский

Citations

40
Cognitive Symptoms of Post–COVID-19 Condition and Daily Functioning DOI Creative Commons
Abhishek Jaywant, Faith M. Gunning, Lauren E. Oberlin

et al.

JAMA Network Open, Journal Year: 2024, Volume and Issue: 7(2), P. e2356098 - e2356098

Published: Feb. 14, 2024

Importance The frequent occurrence of cognitive symptoms in post–COVID-19 condition has been described, but the nature these and their demographic functional factors are not well characterized generalizable populations. Objective To investigate prevalence self-reported condition, comparison with individuals prior acute SARS-CoV-2 infection who did develop association other individual features, including depressive status. Design, Setting, Participants Two waves a 50-state nonprobability population-based internet survey conducted between December 22, 2022, May 5, 2023. included respondents aged 18 years older. Exposure Post–COVID-19 defined as self-report attributed to COVID-19 beyond 2 months after initial month illness. Main Outcomes Measures Seven items from Neuro-QoL cognition battery assessing frequency past week patient Health Questionnaire-9. Results 14 767 reporting test-confirmed illness at least before had mean (SD) age 44.6 (16.3) years; 568 (3.8%) were Asian, 1484 (10.0%) Black, 1408 (9.5%) Hispanic, 10 811 (73.2%) White. A total 037 (68.0%) women 4730 (32.0%) men. Of 1683 955 (56.7%) reported 1 symptom experienced daily, compared 3552 13 084 (27.1%) those report condition. More daily associated greater likelihood moderate interference functioning (unadjusted odds ratio [OR], 1.31 [95% CI, 1.25-1.36]; adjusted [AOR], 1.30 1.25-1.36]), lesser full-time employment OR, 0.95 0.91-0.99]; AOR, 0.92 0.88-0.96]) severity coefficient, 1.40 1.29-1.51]; coefficient 1.27 1.17-1.38). After regression models, associations also found everyday (AOR, 1.21-1.33]) lower 0.88-0.97]). Conclusions Relevance findings this study US adults suggest that common among impairment, employment, severity. Screening for addressing is an important component public health response

Language: Английский

Citations

16
Post-COVID-19 conditions: a systematic review on advanced magnetic resonance neuroimaging findings DOI
Sana Mohammadi, Sadegh Ghaderi

Neurological Sciences, Journal Year: 2024, Volume and Issue: 45(5), P. 1815 - 1833

Published: Feb. 29, 2024

Language: Английский

Citations

14
Cerebral microstructural alterations in Post-COVID-condition are related to cognitive impairment, olfactory dysfunction and fatigue DOI Creative Commons
Jonas A. Hosp, Marco Reisert, Andrea Dreßing

et al.

Nature Communications, Journal Year: 2024, Volume and Issue: 15(1)

Published: May 18, 2024

Abstract After contracting COVID-19, a substantial number of individuals develop Post-COVID-Condition, marked by neurologic symptoms such as cognitive deficits, olfactory dysfunction, and fatigue. Despite this, biomarkers pathophysiological understandings this condition remain limited. Employing magnetic resonance imaging, we conduct comparative analysis cerebral microstructure among patients with healthy controls, that contracted COVID-19 without long-term symptoms. We reveal widespread alterations in microstructure, attributed to shift volume from neuronal compartments free fluid, associated the severity initial infection. Correlating these cognition, olfaction, fatigue unveils distinct affected networks, which are close anatomical-functional relationship respective

Language: Английский

Citations

13