Neurological and cognitive sequelae of Covid-19: a four month follow-up

Abstract

Central and peripheral nervous system involvement during acute COVID-19 is well known. Although many patients report some subjective symptoms months after the infection, the exact incidence of neurological and cognitive sequelae of COVID-19 remains to be determined. The aim of this study is to investigate if objective neurological or cognitive impairment is detectable four months after SARS-CoV-2 infection, in a group of patients who had mild–moderate COVID-19. A cohort of 120 health care workers previously affected by COVID-19 was examined 4 months after the diagnosis by means of neurological and extensive cognitive evaluation and compared to a group of 30 health care workers who did not have COVID-19 and were similar for age and co morbidities. At 4 month follow-up, 118/120 COVID-19 cases had normal neurological examination, two patients had neurological deficits. COVID-19 patients did not show general cognitive impairment at MMSE. In COVID-19 cases the number of impaired neuropsychological tests was not significantly different from non COVID-19 cases (mean 1.69 and 1 respectively, Mann–Whitney p = n.s.), as well as all the mean tests’ scores. Anxiety, stress and depression scores resulted to be significantly higher in COVID-19 than in non COVID-19 cases. The results do not support the presence of neurological deficits or cognitive impairment in this selected population of mild–moderate COVID-19 patients four months after the diagnosis. Severe emotional disorders in patients who had COVID-19 in the past are confirmed.

Epidemiology, pathophysiology, and classification of the neurological symptoms of post-COVID-19 syndrome

“…In a series of 120 healthcare workers with history of moderate-to-severe COVID-19 4 months previously, no significant differences were observed in cognitive assessment results as compared against a control group of individuals with no history of COVID-19. 69 However, patients did present higher levels of stress, anxiety, and depression. In contrast, and as an example of the divergent findings, Woo et al 47 found moderate cognitive impairment in 14 of 18 young patients who had presented COVID-19 a median of 85 days previously, as compared to 10 healthy individuals.…”

Neurologic and cognitive sequelae after SARS-CoV2 infection: Different impairment for ICU patients

“…We have recently reported [10] no evidence of measurable cognitive impairment in a cohort of healthcare workers (HCW) in Brescia, Italy, previously infected by SARS-CoV-2 and undergoing an extensive neuropsychological test battery covering most cognitive functions four months after the disease. On the other hand, these patients showed significantly greater anxiety, depression and stress scores on psychological questionnaires, suggesting an emotional rather than cognitive disturbance as a main consequence of COVID-19.…”

Neurological sequelae of COVID-19: a review

“…Conversely, a study of 120 participants with mild–moderate COVID-19 observed that 98.3% (118/120) had normal cognitive functioning at 4-month follow-up. However, this group had a relatively low rate of comorbidities (15% hypertension, 8.3% obesity, 3.3% diabetes) and rarely received supplementary oxygen therapy (1.6%) [ 99 ]. Finally, inpatient rehabilitation was associated with significant improvement in memory and cognitive function in a cohort (n = 29) of hospitalized COVID-19 patients (mean hospital and intubation length 32.2 and 18.7 days, respectively), with 90% of patients discharged home after a mean of 16.7 of inpatient rehab [ 100 ], suggesting the importance of such care in recovery from COVID-19.…”