Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study

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

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COVID-19 severity is related to poor executive function in people with post-COVID conditions

Journal of Neurology, Journal Year: 2023, Volume and Issue: 270(5), P. 2392 - 2408

Published: March 20, 2023

Patients with post-coronavirus disease 2019 (COVID-19) conditions typically experience cognitive problems. Some studies have linked COVID-19 severity long-term damage, while others did not observe such associations. This discrepancy can be attributed to methodological and sample variations. We aimed clarify the relationship between outcomes determine whether initial symptomatology predict Cognitive evaluations were performed on 109 healthy controls 319 post-COVID individuals categorized into three groups according WHO clinical progression scale: severe-critical (n = 77), moderate-hospitalized 73), outpatients 169). Principal component analysis was used identify factors associated symptoms in acute-phase domains. Analyses of variance regression linear models study intergroup differences The group significantly worse than control general cognition (Montreal Assessment), executive function (Digit symbol, Trail Making Test B, phonetic fluency), social (Reading Mind Eyes test). Five components emerged from principal analysis: "Neurologic/Pain/Dermatologic" "Digestive/Headache", "Respiratory/Fever/Fatigue/Psychiatric" "Smell/ Taste" predictors Montreal Assessment scores; predicted attention working memory; verbal memory, "Respiratory/Fever/Fatigue/Psychiatric," "Neurologic/Pain/Dermatologic," "Digestive/Headache" function. severe exhibited persistent deficits Several sequelae, indicating role systemic inflammation neuroinflammation COVID-19." Study Registration: www.ClinicalTrials.gov , identifier NCT05307549 NCT05307575.

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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Effects of COVID-19 on cognition and brain health

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

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Cognitive dysfunction in post‐COVID‐19 condition: Mechanisms, management, and rehabilitation

Journal of Internal Medicine, Journal Year: 2023, Volume and Issue: 294(5), P. 563 - 581

Published: Sept. 27, 2023

Abstract The long‐term effects of COVID‐19 on cognitive function have become an area increasing concern. This paper provides overview characteristics, risk factors, possible mechanisms, and management strategies for dysfunction in post‐COVID‐19 condition (PCC). Prolonged is one the most common impairments PCC, affecting between 17% 28% individuals more than 12 weeks after infection persisting some cases several years. Cognitive dysfunctions can be manifested as a wide range symptoms including memory impairment, attention deficit, executive dysfunction, reduced processing speed. Risk factors developing with or without impairments, include advanced age, preexisting medical conditions, severity acute illness. underlying mechanisms remain unclear, but proposed contributors neuroinflammation, hypoxia, vascular damage, latent virus reactivation not excluding possibility direct viral invasion central nervous system, illustrating complex pathology. As individual variation large, neuropsychological examination person‐centered multidimensional approach are required. According to World Health Organization, limited evidence COVID‐19‐related necessitates implementing rehabilitation interventions from established practices similar conditions. Psychoeducation compensatory skills training recommended. Assistive products environmental modifications adapted needs might helpful. In specific attention‐ working dysfunctions, training—carefully monitored intensity—might effective people who do suffer post‐exertional malaise. Further research crucial evidence‐based impairments.

Language: Английский

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The kynurenine pathway relates to post‐acuteCOVID‐19 objective cognitive impairment andPASC

Annals of Clinical and Translational Neurology, Journal Year: 2023, Volume and Issue: 10(8), P. 1338 - 1352

Published: June 15, 2023

To determine the prevalence and natural history of post-acute COVID-19 objective cognitive impairment function, their relationship to demographic, clinical factors, sequelae (PASC), biomarkers.A total 128 patients (age = 46 ± 15; 42% women, acute disease severity: not hospitalized: 38.6% mild: 0-1 symptoms, 52% 2+ symptoms; 9.4% hospitalized) completed standard cognition, olfaction, mental health examinations 2-, 4-, 12-month post diagnosis. Over same time frame, WHO-defined PASC was determined. Blood cytokines, peripheral neurobiomarkers, kynurenine pathway (KP) metabolites were measured. Objective function demographically/practice corrected, determined using evidence-based Global Deficit Score method detect at least mild (GDS > 0.5). Linear mixed effect regression models with (month diagnosis) evaluated relationships cognition.Across study period, moderate ranged from 16% 26%, 46.5% impaired once. Impairment associated poorer work capacity (p < 0.05), 2-month objectively tested anosmia 0.05). 0.01) without disability 0.03) severity. KP measures showed prolonged activation (2 8 months) 0.0001) linked IFN-beta in those PASC. Of blood analytes, only (elevated quinolinic acid, 3-hydroxyanthranilic kynurenine, kynurenine/tryptophan ratio) 0.001) performance greater likelihood impairment. PASC, independent abnormal 0.03).The relates thereby enabling biomarker therapeutic possibilities.

Language: Английский

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Psychological factors associated with Long COVID: a systematic review and meta-analysis

EClinicalMedicine, Journal Year: 2024, Volume and Issue: 74, P. 102756 - 102756

Published: July 27, 2024

Language: Английский

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Neuropsychological outcome of indoor rehabilitation in post-COVID-19 condition—results of the PoCoRe study

Frontiers in Neurology, Journal Year: 2025, Volume and Issue: 15

Published: Jan. 6, 2025

Post COVID-19 condition (PCC) is increasingly recognized as a debilitating characterized by persistent symptoms following SARS-CoV-2 infection. Neuropsychological deficits, including cognitive impairments and fatigue, are prevalent in individuals with PCC. The PoCoRe study aimed to evaluate the burden of neuropsychological deficits PCC patients undergoing multidisciplinary indoor rehabilitation describe possible changes this symptomatology. study, prospective, non-randomized, controlled longitudinal recruited from six German centers. Eligible participants underwent comprehensive assessments at admission discharge. Various measures were employed, fatigue scale for motor functioning cognition (FSMC), Test Battery Attention (TAP) Montreal Cognitive Assessment (MoCA). Out 1,086 participants, total N = 701 included main data analysis. prevalence on was high (84.6%) decreased significantly discharge (77.4%), mild effect size. Reaction times alertness subtest abnormal 70% 50% Sustained attention 55% admission, decreasing 43% These differences significant sizes. Furthermore, 27% pathological MoCA scores 63% improved normative levels during rehabilitation, indicating treatment (p ≤ 0.001). However, demonstrated limited sensitivity detecting deficits. highlights patients, notable improvements observed rehabilitation. Challenges remain accurately identifying addressing these underscoring importance assessment tailored interventions. Further research warranted optimize screening tools enhance care both outpatient settings.

Language: Английский

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Hippocampal subfield abnormalities and biomarkers of pathologic brain changes: from SARS-CoV-2 acute infection to post-COVID syndrome

EBioMedicine, Journal Year: 2023, Volume and Issue: 94, P. 104711 - 104711

Published: July 13, 2023

Cognitive deficits are among the main disabling symptoms in COVID-19 patients and post-COVID syndrome (PCS). Within brain regions, hippocampus, a key region for cognition, has shown vulnerability to SARS-CoV-2 infection. Therefore, vivo detailed evaluation of hippocampal changes PCS patients, validated on post-mortem samples at acute phase, would shed light into relationship between cognition.Hippocampal subfields volume, microstructure, perfusion were evaluated 84 compared 33 controls. Associations with blood biomarkers, including glial fibrillary acidic protein (GFAP), myelin oligodendrocyte glycoprotein (MOG), eotaxin-1 (CCL11) neurofilament chain (NfL) evaluated. Besides, biomarker immunodetection seven necropsies phase contrasted against eight controls.In analyses revealed that grey matter atrophy is accompanied by altered microstructural integrity, hypoperfusion, functional connectivity patients. Hippocampal structural alterations related cognitive dysfunction, particularly attention memory. GFAP, MOG, CCL11 NfL biomarkers PCS, showed associations volume changes, selective subfields. Moreover, post mortem histology presence increased GFAP reduced MOG concentrations hippocampus phase.The current results evidenced sequalae present cascade pathological indicating axonal damage, astrocyte alterations, neuronal injury, already from phase.Nominative Grant FIBHCSC 2020 COVID-19. Department Health, Community Madrid. Instituto de Salud Carlos III through project INT20/00079, co-funded European Regional Development Fund "A way make Europe" (JAMG). (ISCIII) Sara Borrell postdoctoral fellowship No. CD22/00043) Union (MDC). predoctoral contract (FI20/000145) (co-funded Europe") (MVS). Fundación para el Conocimiento Madri+d G63-HEALTHSTARPLUS-HSP4 (JAMG, SOM).

Language: Английский

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Mast cells in the autonomic nervous system and potential role in disorders with dysautonomia and neuroinflammation

Annals of Allergy Asthma & Immunology, Journal Year: 2023, Volume and Issue: 132(4), P. 440 - 454

Published: Nov. 10, 2023

Mast cells (MC) are ubiquitous in the body, and they critical for not only allergic diseases but also immunity inflammation, including having potential involvement pathophysiology of dysautonomias neuroinflammatory disorders. MC located perivascularly close to nerve endings sites such as carotid bodies, heart, hypothalamus, pineal gland, adrenal gland that would allow them regulate be affected by autonomic nervous system (ANS). stimulated allergens many other triggers some from ANS can affect release neurosensitizing, proinflammatory, vasoactive mediators. Hence, may able homeostatic functions seem dysfunctional conditions, postural orthostatic tachycardia syndrome, autism spectrum disorder, myalgic encephalomyelitis/chronic fatigue Long-COVID syndrome. The evidence indicates there is a possible association between these conditions associated with activation. There no effective treatment any form than minimizing symptoms. Given ways could activated numerous mediators released, it important develop inhibit stimulation ANS-relevant

Language: Английский

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