Pistarini Caterina, Fiabane Elena, Houdayer Elise, Vassallo Claudio, Manera Marina Rita, Alemanno Federica
Department of Neurorehabilitation, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Pavia, Italy.
Department of Physical and Rehabilitation Medicine, Istituti Clinici Scientifici Maugeri, Genoa, Italy.
Front Neurol. 2021 May 17;12:643646. doi: 10.3389/fneur.2021.643646. eCollection 2021.
The coronavirus disease 19 (COVID-19) can cause neurological, psychiatric, psychological, and psychosocial impairments. Literature regarding cognitive impact of COVID-19 is still limited. The aim of this study was to evaluate cognitive deficits and emotional distress among COVID-19 and post-COVID-19 patients who required functional rehabilitation. Specifically, this study explored and compared cognitive and psychological status of patients in the subacute phase of the disease (COVID-19 group) and patients in the postillness period (post-COVID-19 group). Forty patients admitted to rehabilitation units were enrolled in the study and divided into two groups according to the phase of the disease: (a) COVID-19 group ( = 20) and (b) post-COVID-19 group ( = 20). All patients underwent a neuropsychological assessment including Mini-Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Impact of Event Scale-Revised (IES-R). A larger part of the COVID group showed neuropsychological deficits in the total MMSE (35%) compared to the post-COVID group (5%), whereas the majority of both groups (75-70%) reported cognitive impairments in the total MoCA. The post-COVID group reported significantly higher score in MMSE subtests of language ( = 0.02) and in MoCA subtests of executive functions ( = 0.05), language ( = 0.01), and abstraction ( = 0.02) compared to the COVID group. Regarding emotional disturbances, ~40% of patients presented with mild to moderate depression (57.9-60%). The post-COVID-19 group reported significantly higher levels of distress at the IES-R compared to the COVID group ( = 0.02). These findings highlight the gravity of neuropsychological and psychological symptoms that can be induced by COVID-19 infection and the need for tailored rehabilitation, including cognitive training and psychological support.
新型冠状病毒肺炎（COVID-19）可导致神经、精神、心理和社会心理方面的损害。关于COVID-19认知影响的文献仍然有限。本研究的目的是评估需要功能康复的COVID-19患者及康复后患者的认知缺陷和情绪困扰。具体而言，本研究探讨并比较了疾病亚急性期患者（COVID-19组）和病后时期患者（康复后COVID-19组）的认知和心理状态。40名入住康复科的患者被纳入研究，并根据疾病阶段分为两组：（a）COVID-19组（n = 20）和（b）康复后COVID-19组（n = 20）。所有患者均接受了神经心理学评估，包括简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）、汉密尔顿抑郁评定量表以及事件影响量表修订版（IES-R）。与康复后COVID-19组（5%）相比，COVID组中更大比例的患者在MMSE总分上表现出神经心理学缺陷（35%），而两组中的大多数患者（75%-70%）在MoCA总分上报告有认知障碍。与COVID组相比，康复后COVID-19组在MMSE语言子测试（p = 0.02）、MoCA执行功能子测试（p = 0.05）、语言子测试（p = 0.01）和抽象子测试（p = 0.02）中的得分显著更高。关于情绪障碍，约40%的患者表现为轻度至中度抑郁（57.9%-60%）。与COVID组相比，康复后COVID-19组在IES-R上报告的痛苦水平显著更高（p = 0.02）。这些发现凸显了COVID-19感染可能引发的神经心理学和心理症状的严重性，以及进行针对性康复的必要性，包括认知训练和心理支持。
