Department of Neurology, Gulhane Training and Research Hospital, Ankara, Turkey.
Eur Rev Med Pharmacol Sci. 2022 Jan;26(2):678-685. doi: 10.26355/eurrev_202201_27894.
COVID-19 infection can cause impairments in many cognitive areas. The aim of the present study was to evaluate the cognitive functions of patients who had been infected with COVID-19.
The demographic and infection-related characteristics of patients who had been infected with COVID-19 were determined. Their cranial magnetic resonance imaging (MRI) and electroencephalography (EEG) findings were recorded. The Mini-Mental State Evaluation (MMSE), clock drawing test, forward and backward digit span tests, visual memory test, and Frontal Assessment Battery were applied to the patients. Finger agnosia and ideomotor apraxia were also determined.
The study included 176 patients [100 female (56.8%), 76 male (43.2%), mean age 66.09±13.96 years]. About half of the patients were hospitalized for symptoms of COVID-19 infection (n=82, 46.6%). One third of these patients required intensive care (n=26, 14.8%). While 50 (45.9%) of the 109 patients diagnosed with dementia before infection were hospitalized, 32 (47.8%) of the 67 patients without a diagnosis of dementia required hospitalization (p=0.46). The most common neurological finding during COVID-19 infection was insomnia (n=36, 20.5%). The MMSE and visual memory test scores of the patients who were hospitalized for severe respiratory distress were lower than those whose treatment at home was completed (respectively 17.92±7.69/20.59±7.01, p=0.02; 2.53 ±1.73/3.69±2.80, p=0.01). The patients with moderate to severe cognitive impairment had significantly higher CRP levels at admission than the others (37.52±43.09/20.93±31.74, p=0.01, respectively).
Cognitive damage in COVID-19 infection may be caused by ACE receptor density in the pial, hippocampal, and amygdala areas. In addition, the reason why people with severe dementia have a milder infection might be explained by the atrophy in these areas.
COVID-19 感染可导致许多认知领域的障碍。本研究旨在评估 COVID-19 感染患者的认知功能。
确定 COVID-19 感染患者的人口统计学和感染相关特征。记录他们的头颅磁共振成像（MRI）和脑电图（EEG）结果。对患者进行简易精神状态检查（MMSE）、画钟测验、顺背和倒背数字广度测验、视觉记忆测验和额叶评估电池测试。还确定了手指失认症和意念运动性失用症。
研究共纳入 176 例患者[100 例女性（56.8%），76 例男性（43.2%），平均年龄 66.09±13.96 岁]。约一半的患者因 COVID-19 感染症状住院（n=82，46.6%）。其中 14.8%（n=26）需要重症监护。在感染前被诊断为痴呆的 109 例患者中，有 50 例（45.9%）住院，而在未诊断为痴呆的 67 例患者中，有 32 例（47.8%）需要住院治疗（p=0.46）。COVID-19 感染期间最常见的神经系统表现为失眠（n=36，20.5%）。因严重呼吸窘迫住院的患者的 MMSE 和视觉记忆测验评分低于在家完成治疗的患者（分别为 17.92±7.69/20.59±7.01，p=0.02；2.53±1.73/3.69±2.80，p=0.01）。中度至重度认知障碍患者入院时的 CRP 水平明显高于其他患者（37.52±43.09/20.93±31.74，p=0.01）。
COVID-19 感染引起的认知损害可能是由于软脑膜、海马和杏仁核区域的 ACE 受体密度引起的。此外，严重痴呆患者感染较轻的原因可能是这些区域的萎缩。
