Cognitive and Neuropsychiatric Features of COVID-19 Patients After Hospital Dismission: An Italian Sample

Abstract

Background and AimsRecent studies suggest cognitive, emotional, and behavioral impairments occur in patients after SARS-CoV-2 infection. However, studies are limited to case reports or case series and, to our knowledge, few of them have control groups. This study aims to assess the prevalence of neuropsychological and neuropsychiatric impairment in patients after hospitalization.MethodsWe enrolled 29 COVID+ patients (M/F: 17/12; age 58.41 ± 10.00 years; education 11.07 ± 3.77 years, 2 left handers) who needed hospitalization but no IC, about 20 days post-dismission, and 29 COVID− healthy matched controls. Neuropsychological and neuropsychiatric assessments were conducted via teleneuropsychology using the following tests: MMSE, CPM47, RAVLT, CDT, Digit-Span Forward/Backward, Verbal fluencies; BDI-II, STAI. People with previous reported cognitive impairment and neurological or psychiatric conditions were excluded. Clinical and demographics were collected. Comparison between groups was conducted using parametric or non-parametric tests according to data distribution (T-test, Mann Withney-U test; Chi-square goodness of fit). Within COVID+ group, we also evaluated the correlation between the cognitive and behavioral assessment scores and clinical variables collected.ResultsAmong COVID+, 62% had at least one pathological test (vs. 13% in COVID−; p = 0.000) and significantly worst performances than COVID− in RAVLT learning (42.55 ± 10.44 vs. 47.9 ± 8.29, p = 0.035), RAVLT recall (8.79 ± 3.13 vs. 10.38 ± 2.19, p = 0.03), and recognition (13.69 ± 1.47 vs. 14.52 ± 0.63, p = 0.07). STAI II was higher in COVID− (32.69 ± 7.66 vs. 39.14 ± 7.7, p = 0.002). Chi-square on dichotomous values (normal/pathological) showed a significant difference between groups in Digit backward test (pathological 7/29 COVID+ vs. 0/29 COVID−; p = 0.005).ConclusionsPatients COVID+ assessed by teleneuropsychology showed a vulnerability in some memory and executive functions (working memory, learning, delayed recall, and recognition). Intriguingly, anxiety was higher in the control group. Our findings therefore confirm the impact of COVID-19 on cognition even in patients who did not need IC. Follow-up is needed to evaluate the evolution of COVID-19-related cognitive deficit.Clinical Trial Registration[ClinicalTrials.gov], identifier [NCT05143320].

The Impact of COVID-19 Lockdown Measures and COVID-19 Infection on Cognitive Functions: A Review in Healthy and Neurological Populations

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Persistent 18F-FDG Brain PET Fronto-Temporal Hypometabolism and Cognitive Symptoms Two Years after SARS-CoV-2 Infection: A Case Report

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Neurocognitive and Neuropsychiatric Sequelae in Long COVID-19 Infection

“…In summary, Perrottelli et al’s systematic review [ 48 ] indicated widespread neurocognitive impairment across a large majority of studies [ 5 , 36 , 42 , 43 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ], although several studies found no significant impairment in COVID-19 patients [ 37 , 45 , 75 , 76 , 77 , 78 , 79 ]. While most assessments used screening tests, providing valuable insights into COVID-19-related neurocognitive impairment, only a few studies employed a comprehensive neuropsychological battery.…”