Cognitive Deficits among Individuals Admitted to a Post-Acute Pneumological Rehabilitation Unit in Southern Italy after COVID-19 Infection

Abstract

(1) Background: We investigated the differences in the neuropsychological profile as well as the pneumological and motor functions in two groups of patients admitted to rehabilitation who received different respiratory support during their COVID-19 infection. (2) Methods: Group-1 (n = 18; 15 male, median age 67.5) consisted of patients who received non-invasive mechanical ventilation; Group-2 (n = 19; 16 male, median age 63) consisted of patients who received invasive mechanical ventilation. All patients underwent a neuropsychological assessment including Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and the Repeatable Battery for the Assessment of Neuropsychological Status (R-BANS) to evaluate the patients’ cognition. Depression and anxiety were also measured at admission and discharge to rehabilitation. (3) Results: At admission, patients impaired at MMSE were 44% in Group-1 and 5% in Group-2, while patients impaired at FAB were 88% in Group-1 and 26% in Group-2. Wilcoxon’s effect size revealed meaningful differences between groups for FAB, R-BANS global score, immediate and delayed memory, and attention-coding task, with Group-2 performing better than Group-1 across all measures. At discharge, 52% of the 25 patients re-assessed still had mild to moderate cognitive deficits, while 19% had depression and 35% had anxiety. (4) Conclusions: Patients who received oxygen therapy experienced higher levels of acute and chronic stress compared to those who benefitted from invasive mechanical ventilation. Despite patients showing a meaningful improvement at discharge, cognitive impairment persisted in a great number of patients; therefore, long-term neuropsychological follow-up and treatment for COVID-19 patients are recommended.

Long-term cognitive dysfunction after COVID ARDS

“…Birberg Thornberg et all noted no correlation between need for ICU admission and either global RBANS score or in the affected indices 25 . Similar finding were reported by Langravinese et all who reported a decrease in attention and memory functions based on RBANS in hospitalized patient, with a more severe impact on ventilated patients 26 .…”

Psychological Distress in Patients Who Needed Invasive versus Non-Invasive Ventilation Following SARS-CoV-2 Viral Infection

“…These results are at variance with those of studies on the non-Covid population, indicating the prevalence of distress in patients who required IV (e.g., [ 8 ]) but consistent with previous evidence on COVID-19 patients, which indicated a limited effect of IV on affective factors [ 4 , 5 ]. Furthermore, our results also did not show significant differences between groups with regard to cognitive functioning, which should be considered as inclusive of both pre-morbid aspects and possible effects of the COVID-19 infection.…”

“…These long clinical pathways resulted in significant psychological distress, with frequent symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD) [ 2 , 3 ]. Some studies have focused on the effects of ventilation procedures administered in intensive care units, the experience of emotional distress, and cognitive processing in COVID-19 patients [ 4 , 5 ].…”

“…In the COVID-19 population, differences were reported depending on the type of respiratory assistance in cognitive processing but not in emotional reactions at admission [ 4 , 5 ]; however, this pattern could be ascribed to the modulating effect of aging [ 4 ]. In a study by Alemanno et al [ 4 ], a group of patients who had undergone invasive ventilation and sedation showed better cognitive performance; however, this group was younger than the other groups of patients who received non-invasive respiratory support in the acute phase of the disease.…”

Investigating the Role of Second Chance Schools and COVID-19 Pandemic on the Mental Health and Self-Image of Greek Adult Students

“…Moreover, regarding the factors of self-esteem and self-efficacy and the anti-COVID-19 measures, some studies did not find significant changes in the levels of those factors among the participants between anti-COVID-19 measures or afterward [ 135 ]. However, other studies have recorded lower levels of self-efficacy in underage students [ 136 ]. It should be noted that no research investigating the effect of the interaction between SCS and anti-COVID-19 measures on the mental health, self-image, anxiety, depression, well-being, self-esteem or self-efficacy of students was found, and this is another innovation of the present research.…”