Neurology, Clalit Health Services, Haifa, Israel.
Stroke and Cognition Institute, Rambam Health Care Campus, Haifa, Israel.
J Neurovirol. 2022 Jun;28(3):430-437. doi: 10.1007/s13365-022-01079-y. Epub 2022 May 26.
The coronavirus (COVID-19) pandemic is still evolving, causing hundreds of millions of infections around the world. The long-term sequelae of COVID-19 and neurologic syndromes post COVID remain poorly understood. The present study aims to characterize cognitive performance in patients experiencing cognitive symptoms post-COVID infection. Patients evaluated at a post COVID clinic in Northern Israel who endorsed cognitive symptoms were referred for neurologic consultation. The neurologic work-up included detailed medical history, symptom inventory, neurological examination, the Montreal Cognitive Assessment (MoCA), laboratory tests and brain CT or MRI. Between December 2020 and June 2021, 46 patients were referred for neurological consultation (65% female), mean age 49.5 (19-72 years). On the MoCA test, executive functions, particularly phonemic fluency, and attention, were impaired. In contrast, the total MoCA score, and memory and orientation subscores did not differ from expected ranges. Disease severity, premorbid condition, pulmonary function tests and hypoxia did not contribute to cognitive performance. Cognitive decline may affect otherwise healthy patients post-COVID, independent of disease severity. Our examination identified abnormalities in executive function, attention, and phonemic fluency. These findings occurred despite normal laboratory tests and imaging findings.
新型冠状病毒(COVID-19)大流行仍在演变,在全球范围内导致数亿人感染。COVID-19 的长期后遗症和 COVID 后神经系统综合征仍知之甚少。本研究旨在描述 COVID 后感染出现认知症状的患者的认知表现。
在以色列北部的 COVID 后诊所评估的患者,如果有认知症状,会被转介给神经科医生进行咨询。神经科评估包括详细的病史、症状清单、神经系统检查、蒙特利尔认知评估(MoCA)、实验室检查以及脑部 CT 或 MRI。
2020 年 12 月至 2021 年 6 月期间,有 46 名患者因神经系统咨询而转介(女性占 65%),平均年龄 49.5 岁(19-72 岁)。在 MoCA 测试中,执行功能,尤其是语音流畅性和注意力受损。相比之下,MoCA 总评分、记忆和定向亚评分与预期范围无差异。疾病严重程度、发病前状况、肺功能检查和缺氧均未影响认知表现。
认知能力下降可能会影响 COVID 后原本健康的患者,而与疾病严重程度无关。我们的检查发现执行功能、注意力和语音流畅性异常。尽管实验室检查和影像学检查正常,但仍出现这些发现。