Fleni, Department of Cognitive Neurology, Buenos Aires, Argentina.
Universidad de la Costa, Barranquilla, Colombia.
Arq Neuropsiquiatr. 2022 Mar;80(3):240-247. doi: 10.1590/0004-282X-ANP-2021-0320.
Neurological and psychiatric manifestations associated with SARS-CoV-2 infection have been reported throughout the scientific literature. However, studies on post-COVID cognitive impairment in people with no previous cognitive complaint are scarce.
We aim to investigate the impact of COVID-19 on cognitive functions in adults without cognitive complaints before infection and to study cognitive dysfunction according to disease severity and cognitive risk factors.
Forty-five post-COVID-19 patients and forty-five controls underwent extensive neuropsychological evaluation, which assessed cognitive domains such as memory, language, attention, executive functions, and visuospatial skills, including psychiatric symptomatology scales. Data were collected on the severity of infection, premorbid medical conditions, and functionality for activities of daily living before and after COVID-19.
Significant differences between groups were found in cognitive composites of memory (p=0.016, Cohen's d= 0.73), attention (p<0.001, Cohen's d=1.2), executive functions (p<0.001, Cohen's d=1.4), and language (p=0.002, Cohen's d=0.87). The change from premorbid to post-infection functioning was significantly different between severity groups (WHODAS, p=0.037). Self-reported anxiety was associated with the presence of cognitive dysfunction in COVID-19 subjects (p=0.043).
Our results suggest that the presence of cognitive symptoms in post-COVID-19 patients may persist for months after disease remission and argue for the inclusion of cognitive assessment as a protocolized stage of the post-COVID examination. Screening measures may not be sufficient to detect cognitive dysfunction in post-COVID-19 patients.
与 SARS-CoV-2 感染相关的神经和精神表现已在整个科学文献中得到报道。然而，关于无先前认知主诉的 COVID-19 后认知障碍的研究却很少。
我们旨在研究 COVID-19 对无认知主诉成人认知功能的影响，并根据疾病严重程度和认知危险因素研究认知功能障碍。
45 名 COVID-19 后患者和 45 名对照者接受了广泛的神经心理学评估，评估了记忆、语言、注意力、执行功能和视空间技能等认知领域，包括精神病症状量表。在 COVID-19 前后收集了感染严重程度、发病前的医疗状况和日常生活活动的功能数据。
组间在记忆（p=0.016，Cohen's d=0.73）、注意力（p<0.001，Cohen's d=1.2）、执行功能（p<0.001，Cohen's d=1.4）和语言（p=0.002，Cohen's d=0.87）认知综合表现上存在显著差异。严重程度组之间从发病前到感染后的功能变化差异具有统计学意义（WHODAS，p=0.037）。自我报告的焦虑与 COVID-19 患者认知功能障碍的存在相关（p=0.043）。
我们的结果表明，COVID-19 患者存在认知症状可能会在疾病缓解后持续数月，并主张将认知评估作为 COVID-19 后检查的一个规范化阶段。筛查措施可能不足以检测 COVID-19 后患者的认知功能障碍。
