Sekendiz Zennur, Morozova Olga, Carr Melissa A, Fontana Ashley, Mehta Nikhil, Ali Alina, Jiang Eugene, Babalola Tesleem, Clouston Sean A P, Luft Benjamin J
Department of Medicine-World Trade Center Health Program, Stony Brook University, Commack, NY, USA.
Department of Public Health Sciences, The University of Chicago Division of Biological Sciences, Chicago, IL, USA.
Am J Med Open. 2024 Aug 13;12:100076. doi: 10.1016/j.ajmo.2024.100076. eCollection 2024 Dec.
Research into COVID-19-related cognitive decline has focused on individuals who are cognitively impaired following hospitalization for COVID-19. Our objective was to determine whether cognitive decline emerged after the onset of COVID-19 and was more pronounced in patients with postacute sequelae of SARS-CoV-2 infection (PASC).
We analyzed longitudinal cognitive data collected during a cohort study of essential workers at midlife that continued through the COVID-19 pandemic. We used longitudinal discontinuity models, a form of causal modeling, to examine the change in cognitive performance among 276 participants with COVID-19 in comparison to contemporaneously-collected information from 217 participants who did not have COVID-19. Cognitive performance across four domains was measured before and after the pandemic. Eligible study participants were those with validated COVID-19 diagnoses who were observed before having a verified COVID-19 infection who survived their initial infection, and for whom post-COVID-19 information was also available.
The mean age of the COVID-19 group was 56.0 ± 6.6 years old, while the control group was 58.1 ± 7.3 years old. Longitudinal models indicated a significant decline in cognitive throughput (β = -0.168, P = .001) following COVID-19, after adjustment for pre-COVID-19 functioning, demographics, and medical factors. Associations were larger in those with more severe COVID-19 and those who reported PASC. Observed changes in throughput were equivalent to 10.6 years of normal aging.
Findings from this longitudinal causal modeling study revealed that COVID-19 and PASC appeared to cause clincially relevant cognitive deterioration.
对新冠病毒感染相关认知功能下降的研究主要集中在新冠病毒感染住院后出现认知障碍的个体。我们的目标是确定新冠病毒感染发病后是否会出现认知功能下降，以及在新冠病毒感染后急性后遗症（PASC）患者中是否更为明显。
我们分析了一项针对中年关键岗位工作人员的队列研究中收集的纵向认知数据，该研究持续到新冠疫情期间。我们使用纵向不连续模型（一种因果建模形式），比较276名新冠病毒感染参与者与217名未感染新冠病毒参与者同时期收集的信息，以研究认知表现的变化。在疫情前后测量了四个领域的认知表现。符合条件的研究参与者是那些新冠病毒感染诊断得到验证的人，他们在确诊新冠病毒感染之前被观察到，在最初感染中存活下来，并且也有新冠病毒感染后的信息。
新冠病毒感染组的平均年龄为56.0±6.6岁，而对照组为58.1±7.3岁。纵向模型表明，在调整了新冠病毒感染前的功能、人口统计学和医学因素后，新冠病毒感染后认知通量显著下降（β=-0.168，P=0.001）。在新冠病毒感染更严重的人和报告有PASC的人中，这种关联更大。观察到的通量变化相当于正常衰老10.6年。
这项纵向因果建模研究的结果表明，新冠病毒感染和PASC似乎会导致临床上相关的认知衰退。
