Instituto Mexicano del Seguro Social
Published November 1, 2023 | Version v1
Journal article Open

[Cognitive alterations in patients recovered from COVID-19 treated in Cardiopulmonary Rehabilitation]

Authors/Creators

  • 1. Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad Traumatología, Ortopedia y Rehabilitación, "Dr. Victorio de la Fuente Narváez", Unidad de Medicina Física y Rehabilitación Norte, Servicio de Rehabilitación Cardiopulmonar. Ciudad de México, México
  • 2. Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad Traumatología, Ortopedia y Rehabilitación, "Dr. Victorio de la Fuente Narváez", Unidad de Medicina Física y Rehabilitación Norte, Servicio de Psicología. Ciudad de México, México
  • 3. Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad Traumatología, Ortopedia y Rehabilitación, "Dr. Victorio de la Fuente Narváez", Unidad de Medicina Física y Rehabilitación Norte, Servicio de Rehabilitación. Ciudad de México, México

Description

Abstract 

Background: COVID-19 is associated with multiple complications, in addition to those produced at the pulmonary level. Post-COVID-19 cognitive deficits have been detected in the cognitive domain of attention and executive functions, even 4 months after COVID-19.

Objective: to determine the frequency of cognitive alterations in patients recovered from COVID-19.

Material and methods:  A cross-sectional, descriptive and analytical study was carried out. Records of patients in care after infection by SARS-CoV-2 were integrated, the Neuropsi test was applied. Descriptive statistics and association tests were used through the Chi square test, taking p < 0.05 as significant.

Results: Data from 44 files were integrated. The median age, I place them in the sixth decade of life. There was a predominance of men (63.6%). The most frequent comorbidities were systemic arterial hypertension (50%) and diabetes mellitus (40.9%). Most of the patients were managed only at home (61.4%) with a moderate-severe COVID-19 picture (68.2%). The most affected dimensions of the Neuropsi test were attention and concentration (47.7%, mild alteration) and short-term memory (77.3%, mild alteration).

Conclusions: Cognitive impairment in patients recovered from COVID-19 assessed through the Neuropsi test presented mild alterations in attention and concentration, as well as in short-term memory. These could affect functionality, quality of life and ability to perform work.

Abstract (English)

Background: COVID-19 is associated with multiple complications, in addition to those produced at the pulmonary level. Post-COVID-19 cognitive deficits have been detected in the cognitive domain of attention and executive functions, even 4 months after COVID-19.

Objective: to determine the frequency of cognitive alterations in patients recovered from COVID-19.

Material and methods:  A cross-sectional, descriptive and analytical study was carried out. Records of patients in care after infection by SARS-CoV-2 were integrated, the Neuropsi test was applied. Descriptive statistics and association tests were used through the Chi square test, taking p < 0.05 as significant.

Results: Data from 44 files were integrated. The median age, I place them in the sixth decade of life. There was a predominance of men (63.6%). The most frequent comorbidities were systemic arterial hypertension (50%) and diabetes mellitus (40.9%). Most of the patients were managed only at home (61.4%) with a moderate-severe COVID-19 picture (68.2%). The most affected dimensions of the Neuropsi test were attention and concentration (47.7%, mild alteration) and short-term memory (77.3%, mild alteration).

Conclusions: Cognitive impairment in patients recovered from COVID-19 assessed through the Neuropsi test presented mild alterations in attention and concentration, as well as in short-term memory. These could affect functionality, quality of life and ability to perform work.

Abstract (Spanish)

Introducción: la COVID-19 está asociada a múltiples complicaciones, además de las producidas a nivel pulmonar. Se han detectado déficits cognitivos post COVID-19 en el dominio cognitivo de atención y funciones ejecutivas, incluso 4 meses después del COVID-19.

Objetivo: determinar la frecuencia de alteraciones cognitivas en pacientes recuperados de COVID-19.

Material y métodos: se realizó un estudio transversal, descriptivo y analítico. Se integraron expedientes de pacientes en atención posterior a infección por SARS-CoV-2, se aplicó la prueba Neuropsi. Se utilizó estadística descriptiva y pruebas de asociación a través de la prueba Chi cuadrada, tomando como significativo p < 0.05.

Resultados: se integraron datos de 44 expedientes. La mediana de la edad los ubicó en la sexta década de la vida. Hubo predominio de pacientes hombres (63.6%). Las comorbilidades más frecuentes fueron: hipertensión arterial sistémica (50%) y diabetes mellitus (40.9%). La mayoría de los pacientes fueron manejados solamente en domicilio (61.4%) con un cuadro de COVID-19 moderado-severo (68.2%). Las dimensiones más afectadas de la prueba de Neuropsi fueron la atención y concentración (47.7%, alteración leve) y memoria a corto plazo (77.3%, alteración leve). 

Conclusiones: el deterioro cognitivo en pacientes recuperados de COVID-19 valorado a través de la prueba Neuropsi presentó alteraciones leves en la atención y concentración, así como en la memoria a corto plazo. Estas podrian afectar la funcionalidad, calidad de vida y capacidad de desempeño laboral.

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Additional details

Additional titles

Translated title (Spanish)
Alteraciones cognitivas en pacientes recuperados de COVID-19 atendidos en Rehabilitación Cardiopulmonar

Dates

Accepted
2023-07-25

References

  • 1. Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review. JAMA Neurol. 2020 Aug 1;77(8):1018–27.
  • 2. Solomon T. Neurological infection with SARS- CoV-2 — the story so far. Nat Rev. 2021;17(1):65–6. doi.org/10.1038/s41582-020-00453-w
  • 3. Miners S, Kehoe PG, Love S. Cognitive impact of COVID-19: looking beyond the short term. Alzheimer's Res Ther. 2020;12(1):1–16.
  • 4. Altuna M, Sánchez-Saudinós MB, Lleó A. Cognitive symptoms after COVID-19. Neurol Perspect. 2021;1:S16–24.
  • 5. Krishnan K, Lin Y, Prewitt K-RM, Potter DA. Multidisciplinary Approach to Brain Fog and Related Persisting Symptoms Post COVID-19. J Heal Serv Psychol. 2022;48(1):31–8. doi.org/10.1007/s42843-022-00056-7
  • 6. Asadi-Pooya AA, Akbari A, Emami A, Lotfi M, Rostamihosseinkhani M, Nemati H, et al. Long COVID syndrome-associated brain fog. J Med Virol. 2022;94(3):979–84.
  • 7. Guo P, Benito Ballesteros A, Yeung SP, Liu R, Saha A, Curtis L, Kaser M, Haggard MP and Cheke LG (2022) COVCOG 2: Cognitive and Memory Deficits in Long COVID: A Second Publication From the COVID and Cognition Study. Front. Aging Neurosci. 14:804937. doi: 10.3389/fnagi.2022.804937
  • 8. Lamontagne SJ, Winters MF, Pizzagalli DA, Olmstead MC. Post-acute sequelae of COVID-19: Evidence of mood & cognitive impairment. Brain, Behav Immun - Heal. 2021;17(May):100347. doi.org/10.1016/j.bbih.2021.100347
  • 9. Daroische R, Hemminghyth MS, Eilertsen TH, Breitve MH, Chwiszczuk LJ. Cognitive Impairment After COVID-19—A Review on Objective Test Data. Front Neurol. 2021;12(July):699582.
  • 10. Crivelli L, Calandri I, Corvalán N, Carello MA, Keller G, Martínez C, et al. Cognitive consequences of cOViD-19: results of a cohort study from South America. Arq Neuropsiquiatr. 2022;80(3):240–7.
  • 11. Almeria M, Cejudo JC, Sotoca J, Deus J, Krupinski J. Cognitive profile following COVID-19 infection: Clinical predictors leading to neuropsychological impairment. Brain, Behav Immun - Heal. 2020 Dec 1;9(100163).
  • 12. Querejeta AN, Sarquís YF, Moreno MA, Crostelli AL, Stecco JI, Venier A, et al. Test Neuropsi: Normas según edad y nivel de instrucción para Argentina. Cuad Neuropsicol. 2012; 6(2):48–58.
  • 13. González OMG, Ostrsoky SF. Deterioro Cognitivo en pacientes con Enfermedad de Parkinson. Rev Neuropsicol Neuropsiquiatría y Neurociencias, 2018;18(3):19–27.
  • 14. Olarte SM de L, Quintanar OF, González CRALM, García R-LCJ. Relación de áreas neuropsicológicas, evaluadas con Neuropsi en un grupo de pacientes con Alzheimer y un Perfil Gerontológico del personal según el FIIRAV. Universidad Nacional Autónoma de México; 2015.
  • 15. Varela LB, Correa F, Cazaux A, Spaccesi A, Salica DA, Vanoni S. Stable Chronic Obstructive Pulmonary Disease Associated With Cognitive Impairment: Possible Causality Factor. Rev Fac Cienc Med Cordoba [Internet]. 2021;78(2):97–102.
  • 16. Becker JH, Lin JJ, Doernberg M, Stone K, Navis A, Festa JR, et al. Assessment of Cognitive Function in Patients After COVID-19 Infection. JAMA Netw Open. 2021 Oct 22;4(10):1–4.
  • 17. Bonizzato S, Ghiggia A, Ferraro F, Galante E. Cognitive, behavioral, and psychological manifestations of COVID-19 in post-acute rehabilitation setting: preliminary data of an observational study. Neurol Sci. 2022 Jan 1;43(1):51–8.
  • 18. Sasannejad C, Ely EW, Lahiri S. Long-term cognitive impairment after acute respiratory distress syndrome: A review of clinical impact and pathophysiological mechanisms. Crit Care. 2019 Nov 12; 23(352):1–12.
  • 19. Stallmach A, Kesselmeier M, Bauer M, Gramlich J, Finke K, Fischer A, et al. Comparison of fatigue, cognitive dysfunction and psychological disorders in post-COVID patients and patients after sepsis: is there a specific constellation? Infection. 2022;50(3):661–9. doi.org/10.1007/s15010-021-01733-3
  • 20. Arce-Salinas CA, López-Herrera D, Hernández-Alarcón A, Luna-Rivera EM, Bejarano-Juvera AA, Bustamante-Flores AK, et al. Epidemiología de COVID-19 en un hospital de tercer nivel mexicano. Gac Med Mex. 2021;157(3):267–72.
  • 21. Deng J, Zhou F, Hou W, Silver Z, Wong CY, Chang O, et al. The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: a meta-analysis. Ann N Y Acad Sci. 2021;1486(1):90–111.
  • 22. Rabiee A, Nikayin S, Hashem MD, Huang M, DInglas VD, Bienvenu OJ, et al. Depressive Symptoms after Critical Illness: A Systematic Review and Meta-Analysis. Crit Care Med. 2016;44(9):1744–53.
  • 23. Ollila H, Pihlaja R, Koskinen S, Tuulio-Henriksson A, Salmela V, Tiainen M, et al. Long-term cognitive functioning is impaired in ICU-treated COVID-19 patients: a comprehensive controlled neuropsychological study. Crit care. 2022 Dec 20; 26(226):1–11.
  • 24. Blomberg B, Mohn KGI, Brokstad KA, Zhou F, Linchausen DW, Hansen BA, et al. Long COVID in a prospective cohort of home-isolated patients. Nat Med. 2021 Jun 23;27(9):1607–13.
  • 25. Di Stadio A, Brenner MJ, De Luca P, Albanese M, D'ascanio L, Ralli M, et al. Olfactory Dysfunction, Headache, and Mental Clouding in Adults with Long-COVID-19: What Is the Link between Cognition and Olfaction? A Cross-Sectional Study. Brain Sci. 2022 Feb 1;12(2).
  • 26. Liu YH, Wang YR, Wang QH, Chen Y, Chen X, Li Y, et al. Post-infection cognitive impairments in a cohort of elderly patients with COVID-19. Mol Neurodegener. 2021;16(1):1–10.
  • 27. Garg M, Maralakunte M, Garg S, Dhooria S, Sehgal I, Bhalla AS, et al. The conundrum of 'long-covid-19ʹ: A narrative review. Int J Gen Med. 2021;14(1):2491–506.
  • 28. Merkler AE, Parikh NS, Mir S, Gupta A, Kamel H, Lin E, et al. Risk of Ischemic Stroke in Patients with Coronavirus Disease 2019 (COVID-19) vs Patients with Influenza. JAMA Neurol. 2020 Nov;77(11):1366–72.