tetano
Editor, Senior Moderator
Neurol Sci
. 2021 Nov 15.
doi: 10.1007/s10072-021-05744-8. Online ahead of print.
Clinical features and cognitive sequelae in COVID-19: a retrospective study on N=152 patients
Marina Rita Manera[SUP] #[/SUP][SUP] 1 [/SUP], Elena Fiabane[SUP] #[/SUP][SUP] 2 [/SUP], Debora Pain[SUP] #[/SUP][SUP] 3 [/SUP], Edoardo Nicolò Aiello[SUP] 4 [/SUP], Alice Radici[SUP] 3 [/SUP], Marcella Ottonello[SUP] 2 [/SUP], Mariacristina Padovani[SUP] 1 [/SUP], Barbara Ann Wilson[SUP] 5 [/SUP], Jessica Fish[SUP] 6 [/SUP], Caterina Pistarini[SUP] 7 [/SUP]
Affiliations
Abstract
Background: The novel human coronavirus (SARS-CoV-2) shows neurotropism and systemically affects the central nervous system (CNS). Cognitive deficits have been indeed reported as both short- and long-term sequelae of SARS-CoV-2 infection. However, the association between these disturbances and background/disease-related clinical features remains elusive. This work aimed at exploring how post-infective cognitive status relates to clinical/treatment outcomes by controlling for premorbid/current risk factors for cognitive deficits.
Methods: Cognitive measures (Mini-Mental State Examination, MMSE) of N=152 COVID-19 patient were retrospectively assessed in relation to disease severity, intensive care unit (ICU) admission, steroidal treatment, and occurrence of other viral/bacterial infections by controlling for remote/recent/COVID-19-related risk factors for cognitive deficits (at-risk vs. not-at-risk: Neuro+ vs. Neuro-).
Results: Descriptively, impaired MMSE performances were highly prevalent in mild-to-moderate patients (26.3%). ICU-admitted patients made more errors (p=.021) on the MMSE than those not admitted when partialling out risk factors and age-the latter negatively influencing performances. When addressing Neuro- patients only, steroidal treatment appears to improve MMSE scores among those suffering from other infections (p=.025).
Discussion: Cognitive sequelae of COVID-19 are likely to arise from a complex interplay between background/clinical premorbid features and disease-related/interventional procedures and outcomes. Mild-to-moderate patients requiring assistive ventilation who however are not admitted to an ICU are more likely to suffer from cognitive deficits-despite their etiology remaining elusive.
Keywords: COVID-19; ICU; Neuropsychology; Premorbid; SARS-CoV-2; Steroid.
. 2021 Nov 15.
doi: 10.1007/s10072-021-05744-8. Online ahead of print.
Clinical features and cognitive sequelae in COVID-19: a retrospective study on N=152 patients
Marina Rita Manera[SUP] #[/SUP][SUP] 1 [/SUP], Elena Fiabane[SUP] #[/SUP][SUP] 2 [/SUP], Debora Pain[SUP] #[/SUP][SUP] 3 [/SUP], Edoardo Nicolò Aiello[SUP] 4 [/SUP], Alice Radici[SUP] 3 [/SUP], Marcella Ottonello[SUP] 2 [/SUP], Mariacristina Padovani[SUP] 1 [/SUP], Barbara Ann Wilson[SUP] 5 [/SUP], Jessica Fish[SUP] 6 [/SUP], Caterina Pistarini[SUP] 7 [/SUP]
Affiliations
- PMID: 34779965
- DOI: 10.1007/s10072-021-05744-8
Abstract
Background: The novel human coronavirus (SARS-CoV-2) shows neurotropism and systemically affects the central nervous system (CNS). Cognitive deficits have been indeed reported as both short- and long-term sequelae of SARS-CoV-2 infection. However, the association between these disturbances and background/disease-related clinical features remains elusive. This work aimed at exploring how post-infective cognitive status relates to clinical/treatment outcomes by controlling for premorbid/current risk factors for cognitive deficits.
Methods: Cognitive measures (Mini-Mental State Examination, MMSE) of N=152 COVID-19 patient were retrospectively assessed in relation to disease severity, intensive care unit (ICU) admission, steroidal treatment, and occurrence of other viral/bacterial infections by controlling for remote/recent/COVID-19-related risk factors for cognitive deficits (at-risk vs. not-at-risk: Neuro+ vs. Neuro-).
Results: Descriptively, impaired MMSE performances were highly prevalent in mild-to-moderate patients (26.3%). ICU-admitted patients made more errors (p=.021) on the MMSE than those not admitted when partialling out risk factors and age-the latter negatively influencing performances. When addressing Neuro- patients only, steroidal treatment appears to improve MMSE scores among those suffering from other infections (p=.025).
Discussion: Cognitive sequelae of COVID-19 are likely to arise from a complex interplay between background/clinical premorbid features and disease-related/interventional procedures and outcomes. Mild-to-moderate patients requiring assistive ventilation who however are not admitted to an ICU are more likely to suffer from cognitive deficits-despite their etiology remaining elusive.
Keywords: COVID-19; ICU; Neuropsychology; Premorbid; SARS-CoV-2; Steroid.