新型冠状病毒肺炎感染后的认知概况:导致神经心理损害的临床预测因素。

Cognitive profile following COVID-19 infection: Clinical predictors leading to neuropsychological impairment.

作者信息

Almeria M, Cejudo J C, Sotoca J, Deus J, Krupinski J

机构信息

Cognition and Behavior Unit, Department of Neurology, Hospital Universitari MútuaTerrassa, Terrassa, Barcelona, Spain.

Cognitive Impairment and Dementia Unit, Hospital Sagrat Cor, Hermanas Hospitalarias, Martorell, Barcelona, Spain.

出版信息

Brain Behav Immun Health. 2020 Dec;9:100163. doi: 10.1016/j.bbih.2020.100163. Epub 2020 Oct 22.

Abstract

BACKGROUND

Cognitive manifestations associated with the severity of a novel coronavirus (COVID-19) infection are unknown. An early detection of neuropsychological manifestations could modify the risk of subsequent irreversible impairment and further neurocognitive decline.

METHODS

In our single-center cohort study, we included all consecutive adult patients, aged between 20 and 60 years old with confirmed COVID-19 infection. Neuropsychological assessment was performed by the same trained neuropsychologist from April, 22nd through June 16th, 2020. Patients with previous known cognitive impairment, any central nervous system or psychiatric disease were excluded. Demographic, clinical, pharmacological and laboratory data were extracted from medical records.

RESULTS

Thirty-five patients met inclusion criteria and were included in the study. Patients presenting headache, anosmia, dysgeusia, diarrhea and those who required oxygen therapy had lower scores in memory, attention and executive function subtests as compared to asymptomatic patients. Patients with headache and clinical hypoxia scored lower in the global Cognitive Index (P ​= ​0.002, P ​= ​0.010). A T lower than 30 was observed in memory domains, attention and semantic fluency (2 [5.7%]) in working memory and mental flexibility (3 [8.6%]) and in phonetic fluency (4 [11.4%]). Higher scores in anxiety and depression (P ​= ​0.047, P ​= ​0.008) were found in patients with cognitive complaints.

CONCLUSIONS

In our cohort of COVID-19 patients neurologic manifestations were frequent, including cognitive impairment. Neurological symptoms during infection, diarrhea and oxygen therapy were risk factors for neurocognitive impairment. Cognitive complaints were associated with anxiety and depression.

摘要

背景

新型冠状病毒(COVID-19)感染严重程度相关的认知表现尚不清楚。早期发现神经心理学表现可能会改变后续不可逆损伤和进一步神经认知衰退的风险。

方法

在我们的单中心队列研究中,纳入了所有年龄在20至60岁之间确诊为COVID-19感染的连续成年患者。2020年4月22日至6月16日,由同一位经过培训的神经心理学家进行神经心理学评估。排除既往已知有认知障碍、任何中枢神经系统或精神疾病的患者。从医疗记录中提取人口统计学、临床、药理学和实验室数据。

结果

35名患者符合纳入标准并被纳入研究。与无症状患者相比,出现头痛、嗅觉丧失、味觉障碍、腹泻的患者以及需要吸氧治疗的患者在记忆、注意力和执行功能子测试中的得分较低。头痛和临床缺氧的患者在整体认知指数上得分较低(P = 0.002,P = 0.010)。在记忆领域、注意力和语义流畅性方面,工作记忆和心理灵活性方面以及语音流畅性方面观察到T低于30的情况分别有2例(5.7%)、3例(8.6%)和4例(11.4%)。有认知主诉的患者焦虑和抑郁得分较高(P = 0.047,P = 0.008)。

结论

在我们的COVID-19患者队列中,神经学表现很常见,包括认知障碍。感染期间的神经学症状、腹泻和吸氧治疗是神经认知障碍的危险因素。认知主诉与焦虑和抑郁有关。

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