Cognitive impairment in long-COVID and its association with persistent dysregulation in inflammatory markers

Abstract

ObjectiveTo analyze the potential impact of sociodemographic, clinical and biological factors on the long-term cognitive outcome of patients who survived moderate and severe forms of COVID-19.MethodsWe assessed 710 adult participants (Mean age = 55 ± 14; 48.3% were female) 6 to 11 months after hospital discharge with a complete cognitive battery, as well as a psychiatric, clinical and laboratory evaluation. A large set of inferential statistical methods was used to predict potential variables associated with any long-term cognitive impairment, with a focus on a panel of 28 cytokines and other blood inflammatory and disease severity markers.ResultsConcerning the subjective assessment of cognitive performance, 36.1% reported a slightly poorer overall cognitive performance, and 14.6% reported being severely impacted, compared to their pre-COVID-19 status. Multivariate analysis found sex, age, ethnicity, education, comorbidity, frailty and physical activity associated with general cognition. A bivariate analysis found that G-CSF, IFN-alfa2, IL13, IL15, IL1.RA, EL1.alfa, IL45, IL5, IL6, IL7, TNF-Beta, VEGF, Follow-up C-Reactive Protein, and Follow-up D-Dimer were significantly (p<.05) associated with general cognition. However, a LASSO regression that included all follow-up variables, inflammatory markers and cytokines did not support these findings.ConclusionThough we identified several sociodemographic characteristics that might protect against cognitive impairment following SARS-CoV-2 infection, our data do not support a prominent role for clinical status (both during acute and long-stage of COVID-19) or inflammatory background (also during acute and long-stage of COVID-19) to explain the cognitive deficits that can follow COVID-19 infection.

Post-COVID-19 condition: systemic inflammation and low functional exercise capacity

“…An evaluation of the plasma metabolome of patients with PCC showed alterations in metabolites related to mitochondrial dysfunction, 2 years after SARS-CoV-2 infection, indicating metabolic alterations persistence ( 14 ). Furthermore, cognitive symptoms are highly prevalent in people with PCC, but in a previous study with the same cohort, we failed to find clear association between systemic inflammation and the specific neuro-cognitive alterations ( 15 ).…”

Long-Term Risk of Reduced Cognitive Performance and Associated Factors in Discharged Older Adults with COVID-19: A Longitudinal Prospective Study

“… 42 ) Education is associated with long-term cognitive performance. 43 , 44 ) The number of formal years of education completed by individuals is positively associated with cognitive function throughout adulthood and predictive of a lower risk of dementia in later stages of life. 45 ) A study conducted in China showed a decreasing risk for each year of education (β=-0.098, p=0.013), whereas a study in New York showed that an education level of <12 years was a significant risk factor for long-term reduced cognitive performance after COVID-19 (OR=5.21; 95% CI 2.25–12.09).…”

Evaluation of the Levels of Selected Cytokines and Their Possible Influence on the Development of Cardiovascular and Pulmonary Complications in Patients after COVID-19

“…In the available literature, it is possible to find data showing that “long COVID” symptoms were reported by up to 80% of patients, irrespective of the severity of the disease, but were more common in patients who required hospitalization [ 14 ].…”