Institut de Psychologie, Université Lumière Lyon 2, 18 Quai Claude Bernard 69365 LYON Cedex 07, France.
UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London, WC1N 1EH, The United Kingdom of Great Britain and Northern Ireland.
Brain Behav Immun. 2024 Jul;119:989-994. doi: 10.1016/j.bbi.2024.05.001. Epub 2024 May 10.
Cognitive impairment is often reported after SARS-CoV-2 infection, yet evidence gaps remain. We aimed to (i) report the prevalence and characteristics of children and young people (CYP) reporting "brain fog" (i.e., cognitive impairment) 12-months post PCR-proven SARS-CoV-2 infection and determine whether differences by infection status exist and (ii) explore the prevalence of CYP experiencing cognitive impairment over a 12-month period post-infection and investigate the relationship between cognitive impairment and poor mental health and well-being, mental fatigue and sleep problems.
The Omicron CLoCk sub-study, set up in January 2022, collected data on first-time PCR-test-positive and PCR-proven reinfected CYP at time of testing and at 3-, 6- and 12-months post-testing. We describe the prevalence of cognitive impairment at 12-months, indicating when it was first reported. We characterise CYP experiencing cognitive impairment and use chi-squared tests to determine whether cognitive impairment prevalence varied by infection status. We explore the relationship between cognitive impairment and poor mental health and well-being, mental fatigue and trouble sleeping using validated scales. We examine associations at 3-, 6- and 12-months post-testing by infection status using Mann-Whitney U and chi-square tests.
At 12-months post-testing, 7.0 % (24/345) of first-positives and 7.5 % (27/360) of reinfected CYP experienced cognitive impairment with no difference between infection-status groups (p = 0.78). The majority of these CYP experienced cognitive impairment for the first time at either time of testing or 3-months post-test (no difference between the infection-status groups; p = 0.60). 70.8 % of first-positives experiencing cognitive impairment at 12-months, were 15-to-17-years-old as were 33.3 % of reinfected CYP experiencing cognitive impairment (p < 0.01). Consistently at all time points post-testing, CYP experiencing cognitive impairment were more likely to score higher on all Strengths and Difficulties Questionnaire subscales, higher on the Chalder Fatigue sub-scale for mental fatigue, lower on the Short Warwick-Edinburgh Mental Wellbeing Scale and report more trouble sleeping.
CYP have a fluctuating experience of cognitive impairment by 12-months post SARS-CoV-2-infection. Cognitive impairment is consistently correlated with poorer sleep, behavioural and emotional functioning over a 12-month period. Clinicians should be aware of cognitive impairment post-infection and its co-occurring nature with poorer sleep, behavioural and mental health symptoms.
新冠病毒感染后常报告认知障碍，但仍存在证据空白。我们旨在：（i）报告 PCR 证实的 SARS-CoV-2 感染后 12 个月报告“脑雾”（即认知障碍）的儿童和青少年（CYP）的患病率和特征，并确定感染状态是否存在差异；（ii）探讨感染后 12 个月内 CYP 出现认知障碍的患病率，并研究认知障碍与心理健康和幸福感差、精神疲劳和睡眠问题之间的关系。
Omicron CLoCk 子研究于 2022 年 1 月设立，在检测时以及检测后 3、6 和 12 个月收集首次 PCR 检测阳性和 PCR 证实再感染 CYP 的数据。我们描述了 12 个月时认知障碍的患病率，并指出何时首次报告。我们描述了经历认知障碍的 CYP，并使用卡方检验确定认知障碍的患病率是否因感染状态而异。我们使用经过验证的量表探讨认知障碍与心理健康和幸福感差、精神疲劳和睡眠问题之间的关系。我们通过感染状态使用 Mann-Whitney U 和卡方检验在检测后 3、6 和 12 个月时检查关联。
在检测后 12 个月时，7.0%（24/345）的初次感染者和 7.5%（27/360）的再感染者 CYP 出现认知障碍，两组感染状态之间无差异（p=0.78）。这些 CYP 中的大多数首次出现认知障碍的时间是在检测时或 3 个月后（两组感染状态之间无差异；p=0.60）。在 12 个月时经历认知障碍的初次感染者中，70.8%为 15 至 17 岁，而经历认知障碍的再感染者中，33.3%为 15 至 17 岁（p<0.01）。在所有检测后时间点，经历认知障碍的 CYP 更有可能在所有长处和困难问卷子量表上得分更高，在精神疲劳的 Chalder 疲劳量表上得分更高，在短沃里克-爱丁堡心理健康量表上得分更低，并且报告更多的睡眠问题。
CYP 在 SARS-CoV-2 感染后 12 个月内经历认知障碍的情况波动。认知障碍与 12 个月内睡眠、行为和情绪功能恶化持续相关。临床医生应注意感染后的认知障碍及其与睡眠、行为和精神健康症状同时发生的性质。
