Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany; Post COVID Center of the University Hospital of Erlangen, Germany.
J Psychosom Res. 2023 Oct;173:111441. doi: 10.1016/j.jpsychores.2023.111441. Epub 2023 Jul 31.
Persistent cognitive complaints belong to the most frequent symptoms after COVID-19. This study explored the neuropsychological profile, mental health and risk factors for cognitive impairment in post-COVID-19 patients.
The patients were recruited consecutively in the Post COVID Center of the University Hospital of Erlangen between 12/2022 and 05/2023. They underwent an extensive neuropsychological assessment including the Verbal Learning Memory Test (VLMT), the digit span backwards from the Wechsler Memory Scale-Revised (WMS-R), the Trail Making Test (TMT) Part A and B, the d2 Test of Attention and the Regensburger Verbal Fluency Test (RWT). For each cognitive domain we calculated the frequency of age-adjusted scores below the measure-specific norms. Depressive symptoms were measured with the Patient-Health-Questionnaire-9 (PHQ-9). Logistic regression analyses were computed.
In 110 patients (mean age: 42.5 ± 11.9 years; 68.2% women), the most frequent cognitive deficits were observed for verbal fluency, working speed, delayed recall and attention. In almost every cognitive domain high education levels were associated with a decreased risk for cognitive impairment. Higher age was a risk factor for working speed and delayed recall and a protective factor for verbal fluency. Clinically relevant depressive symptoms were associated with an elevated risk for an impairment regarding some cognitive functions.
Cognitive dysfunctions were common among the post-COVID-19 patients. Differentiated exploration of cognitive impairments is crucial for a proper characterization of the post-COVID syndrome. In future research parameters of cognitive impairment should be correlated to alterations in biological markers of the disease like markers of immunological and microcirculation change.
持续性认知主诉属于新冠病毒感染后最常见的症状之一。本研究旨在探索新冠病毒感染后患者的神经心理学特征、心理健康状况和认知障碍的危险因素。
患者于 2022 年 12 月至 2023 年 5 月在埃尔朗根大学医院的新冠后中心连续招募。他们接受了广泛的神经心理学评估，包括词语学习记忆测验（VLMT）、威斯康星卡片分类测验修订版（WMS-R）的数字倒背测验、连线测验 A 和 B、d2 注意力测验和雷根斯堡词语流畅性测验（RWT）。对于每个认知域，我们计算了年龄调整后低于特定测量标准的分数的频率。使用患者健康问卷-9（PHQ-9）测量抑郁症状。计算了逻辑回归分析。
在 110 名患者（平均年龄：42.5±11.9 岁；68.2%为女性）中，最常见的认知缺陷是词语流畅性、工作速度、延迟回忆和注意力。在几乎每个认知域中，较高的教育水平与认知障碍的风险降低相关。较高的年龄是工作速度和延迟回忆的危险因素，是词语流畅性的保护因素。有临床意义的抑郁症状与某些认知功能受损的风险增加相关。
新冠病毒感染后患者的认知功能障碍较为常见。对认知障碍进行差异化探索对于正确描述新冠后综合征至关重要。在未来的研究中，应将认知障碍的参数与疾病的生物标志物改变相关联，如免疫和微循环变化的标志物。
