Multidomain cognitive impairment in non-hospitalized patients with the post-COVID-19 syndrome: results from a prospective monocentric cohort.

IF 4.8 2区 医学 Q1 CLINICAL NEUROLOGY Journal of Neurology Pub Date : 2023-03-01 DOI:10.1007/s00415-022-11444-w
Ann-Katrin Schild, Yasemin Goereci, Daniel Scharfenberg, Kim Klein, Joachim Lülling, Dix Meiberth, Finja Schweitzer, Sophie Stürmer, Philip Zeyen, Derya Sahin, Gereon R Fink, Frank Jessen, Christiana Franke, Oezguer A Onur, Josef Kessler, Clemens Warnke, Franziska Maier
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引用次数: 8

Abstract

Background: A fraction of patients with asymptomatic to mild/moderate acute COVID-19 disease report cognitive deficits as part of the post-COVID-19 syndrome. This study aimed to assess the neuropsychological profile of these patients.

Methods: Assessment at baseline (three months or more following acute COVID-19) of a monocentric prospective cohort of patients with post-COVID-19 syndrome. Multidomain neuropsychological tests were performed, and questionnaires on depression, anxiety, fatigue, sleep, and general health status were administered.

Results: Of the 58 patients screened, six were excluded due to possible alternative causes of cognitive impairment (major depression, neurodegenerative disease). Of the remaining 52 individuals, only one had a below-threshold screening result on Mini-Mental State Examination, and 13 scored below the cut-off on Montreal Cognitive Assessment. Extended neuropsychological testing revealed a neurocognitive disorder (NCD) in 31 (59.6%) participants with minor NCD in the majority of cases (n = 26). In patients with NCD, the cognitive domains learning/memory and executive functions were impaired in 60.7%, complex attention in 51.6%, language in 35.5%, and perceptual-motor function in 29.0%. Cognitive profiles were associated with daytime sleepiness but not with depression, anxiety, sleep quality, total general health status, or fatigue.

Conclusion: Neurocognitive impairment can be confirmed in around 60% of individuals with self-reported deficits as part of post-COVID-19 syndrome following a mild acute COVID-19 disease course. Notably, screening tests cannot reliably detect this dysfunction. Standard psychiatric assessments showed no association with cognitive profiles. Longitudinal studies are needed to further evaluate the course of neurocognitive deficits and clarify pathophysiology.

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非住院后covid -19综合征患者的多领域认知障碍:来自前瞻性单中心队列的结果
背景:一小部分无症状至轻/中度急性COVID-19疾病患者报告认知缺陷是COVID-19后综合征的一部分。本研究旨在评估这些患者的神经心理学特征。方法:在基线(急性COVID-19后3个月或更长时间)对一组COVID-19后综合征患者进行单中心前瞻性队列评估。进行多领域神经心理测试,并对抑郁、焦虑、疲劳、睡眠和一般健康状况进行问卷调查。结果:在筛选的58例患者中,6例因可能的其他认知障碍原因(重度抑郁症、神经退行性疾病)而被排除。在剩下的52个人中,只有1人在迷你精神状态检查中得分低于阈值,13人在蒙特利尔认知评估中得分低于临界值。扩展神经心理测试显示,31名(59.6%)参与者患有神经认知障碍(NCD),大多数情况下(n = 26)有轻微的NCD。在非传染性疾病患者中,60.7%的人认知领域学习/记忆和执行功能受损,51.6%的人复杂注意力受损,35.5%的人语言受损,29.0%的人感知运动功能受损。认知特征与白天嗜睡有关,但与抑郁、焦虑、睡眠质量、总体健康状况或疲劳无关。结论:在轻度急性COVID-19病程后,大约60%的自我报告缺陷的个体可以确认神经认知障碍,这是COVID-19后综合征的一部分。值得注意的是,筛选试验不能可靠地检测出这种功能障碍。标准的精神病学评估显示与认知特征没有关联。需要进行纵向研究以进一步评估神经认知缺陷的过程并阐明病理生理学。
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来源期刊
Journal of Neurology
Journal of Neurology 医学-临床神经学
CiteScore
10.00
自引率
5.00%
发文量
558
审稿时长
1 months
期刊介绍: The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
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