Neuroscience Institute, Hospital Clinic, Barcelona, Spain.
Anaesthesiology Reanimation and Pain Therapy, Hospital Clinic, Barcelona, Spain.
Psychogeriatrics. 2024 Jul;24(4):765-777. doi: 10.1111/psyg.13113. Epub 2024 Apr 4.
Short-term cognitive impairment is associated with SARS-CoV-2 infection but the long-term impact is yet to be examined in detail. We aim to study the evolution of these symptoms in severe COVID-19 patients admitted to the intensive care unit (ICU) between April and December 2020 1 year after hospital discharge and to analyze its clinical correlates.
A total of 58 patients agreed to participate in the 6 months follow-up and 30 at 1 year after hospital discharge. Demographic, clinical and laboratory data were collected and a comprehensive neuropsychological battery including validated tests for the main cognitive domains was administered. To test the magnitude of neurocognitive sequelae, two standard deviations below normative group were considered. To compare the neuropsychological performance at 6 and 12 months follow-up we used repeated measures tests. Finally, regression analyses were performed to test the main effects of medical and psychological factors on multiple cognition.
Almost half of the sample continued to have impaired performance on neuropsychological tests at 12 months follow-up. In comparison with the results obtained at 6 months, significant improvements were found in immediate recall (d = 0.49), delayed recall (d = 0.45), and inhibitory control (d = 0.53). Medical variables predicted cognitive performance at 6 months but not at 12 months follow-up, while anxiety and depression predicted cognitive deficits in the long-term.
A generalised improvement was observed in severe COVID-19 patients at follow-up. This improvement was particularly notable in verbal memory and executive functioning. However, a considerable proportion of the sample continued to present deficits at 1 year follow-up.
与 SARS-CoV-2 感染相关的短期认知障碍,但长期影响尚未详细研究。我们旨在研究 2020 年 4 月至 12 月期间入住重症监护病房(ICU)的严重 COVID-19 患者在出院后 6 个月和 1 年后这些症状的演变,并分析其临床相关性。
共有 58 名患者同意参加 6 个月的随访,30 名患者在出院后 1 年参加。收集人口统计学、临床和实验室数据,并进行了一项综合神经心理学测试,包括主要认知领域的验证测试。为了测试神经认知后遗症的严重程度,将两个标准差以下的正常值作为标准。为了比较 6 个月和 12 个月随访时的神经心理学表现,我们使用重复测量检验。最后,进行回归分析以测试医学和心理因素对多种认知的主要影响。
几乎一半的样本在 12 个月的随访中仍然存在神经心理学测试受损的情况。与 6 个月时的结果相比,即时回忆(d=0.49)、延迟回忆(d=0.45)和抑制控制(d=0.53)的得分有显著提高。医学变量可预测 6 个月时的认知表现,但不能预测 12 个月时的认知表现,而焦虑和抑郁则可预测长期的认知缺陷。
在随访中,严重 COVID-19 患者的整体认知功能有所改善。这种改善在言语记忆和执行功能方面尤为明显。然而,相当一部分患者在 1 年后仍存在认知缺陷。