146: Prevalence and Characteristics of Memory Deficits in Covid-19 Survivors

Grewal, Sahib; Alismail, Abdullah; Kim, Veronica; MONTERROSO, P.; Arias, Christian; Patel, Pranjal; Jeganathan, Niranjan

doi:10.1097/01.ccm.0000806908.75497.fa

Cited by 1 publication

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“… 31 Memory types most commonly described included memories of real events and emotions, with fewer reports of delusional memories. These results are consistent with the recent data thus far available from critical COVID-19 survivors 37 – 39 and are also in agreement with previous studies assessing the prevalence of post-discharge ICM memory types in non-COVID critically ill populations, although their frequency varies considerably in the literature. 25 – 27 , 31 …”

Section: Discussionsupporting

confidence: 93%

“…Previous studies analyzing post-discharge memories in COVID-19 survivors have primarily focused on describing the prevalence of memory impairments in this group. 35 – 38 Yet, whether sedation was an independent predictor of detrimental ICM memory categories linked to unfavorable outcomes had not been previously ascertained, and our study provides novel insights for a better understanding of the potential adverse effects stemming from exposure to sedation during ICM admission. This suggests that strategies targeted to minimize sedation during ICM stay should be favored.…”

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

“…This was the most distinct finding arising from this study and is in line with earlier non-COVID ICM-memory studies 27,31 as well as recent available data from critical COVID-19 survivors, which have described a significant rate of recall of delusional memories in this population, with reported estimates ranging from 50% to 57%. 37,38 Accumulating evidence also points to a possible contribution of the presence of real memories for preventing the development of chronic stress-related symptoms. 26,32 In this study, deep sedation did not independently influence the recall of real or emotional memories.…”

Section: Discussionmentioning

confidence: 99%

“… 36 On the other hand, in the context of severe disease, 2 additional small-sized observational studies assessing ICM memory subtypes at 3 months post-infection suggested an elevated frequency of recall of delusional memories in this population of nearly 50% to 57%, which could influence long-term recovery. 37 , 38 Another recent study that included critical COVID-19 survivors indicated an association between the presence of depressive/anxiety symptoms and the recall of emotional and delusional memory categories. 39 Nevertheless, there is still a paucity of data on the full range of long-term post-ICM memories in critical COVID-19 survivors, and influence of deep sedation has not been fully defined.…”

Section: Introductionmentioning

confidence: 99%

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Influence of Deep Sedation in Intensive Care Medicine Memories of Critical COVID-19 Survivors

BRAGA

Martins

Ferreira

et al. 2023

J Intensive Care Med

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Introduction: Critical care survivors sustain a variety of sequelae after intensive care medicine (ICM) admission, and the Coronavirus Disease 2019 (COVID-19) pandemic has added further challenges. Specifically, ICM memories play a significant role, and delusional memories are associated with poor outcomes post-discharge including a delayed return to work and sleep problems. Deep sedation has been associated with a greater risk of perceiving delusional memories, bringing a move toward lighter sedation. However, there are limited reports on post-ICM memories in COVID-19, and influence of deep sedation has not been fully defined. Therefore, we aimed to evaluate ICM-memory recall in COVID-19 survivors and their relation with deep sedation. Materials/Methods: Adult COVID-19 ICM survivors admitted to a Portuguese University Hospital between October 2020 and April 2021 (second/third “waves”) were evaluated 1 to 2 months post-discharge using “ICU Memory Tool,” to assess real, emotional, and delusional memories. Results: The study included 132 patients (67% male; median age = 62 years, Acute Physiology and Chronic Health Evaluation [APACHE]-II = 15, Simplified Acute Physiology Score [SAPS]-II = 35, ICM stay = 9 days). Approximately 42% received deep sedation (median duration = 19 days). Most participants reported real (87%) and emotional (77%) recalls, with lesser delusional memories (36.4%). Deeply sedated patients reported significantly fewer real memories (78.6% vs 93.4%, P = .012) and increased delusional memories (60.7% vs 18.4%, P < .001), with no difference in emotional memories (75% vs 80.4%, P = .468). In multivariate analysis, deep sedation had a significant, independent association with delusional memories, increasing their likelihood by a factor of approximately 6 (OR = 6.274; 95% confidence interval = 1.165-33.773, P = .032), without influencing real ( P = .545) or emotional ( P = .133) memories. Conclusions: This study contributes to a better understanding of the potential adverse effects of deep sedation on ICM memories in critical COVID-19 survivors, indicating a significant, independent association with the incidence of delusional recalls. Although further studies are needed to support these findings, they suggest that strategies targeted to minimize sedation should be favored, aiming to improve long-term recovery.

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