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Journal Article Ppublish 17 citations

PubMed: 38739263 DOI: 10.1007/s00406-024-01821-z

Characterization of cognitive symptoms in post COVID-19 patients.

Eur Arch Psychiatry Clin Neurosci 274(8):1923-1934

Authors: Michael Ruzicka, Simone Sachenbacher, Fides Heimkes, Aline Olivia Uebleis, Susanne Karch, Fabienne Grosse-Wentrup, Gerardo Jesus Ibarra Fonseca, Nora Wunderlich, Johannes Bogner, Julia Mayerle, Michael von Bergwelt-Baildon, Peter Falkai, Marion Subklewe, Thomas Ruzicka, Christopher Benesch, Elisabeth Valdinoci, Anna Pernpruner, Anabel Thomas, Bernhard Heindl, Hans Christian Stubbe, Kristina Adorjan

Affiliations

  • Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Munich, Germany.
  • Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany.
  • Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany.
  • Department of Medicine II, LMU University Hospital, LMU Munich, Munich, Germany.
  • Department of Medicine III, Ludwig Maximilian University (LMU) University Hospital, LMU Munich, Munich, Germany.
  • Faculty of Medicine, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland.
  • Stabstelle Strategische Unternehmenssteuerung, LMU Munich, Munich, Germany.

Abstract

Cognitive symptoms (CS) belong to the most common manifestations of the Post COVID-19 (PC) condition. We sought to objectify CS in PC patients using routine diagnostic assessments: neurocognitive testing (NCT) and brain imaging (BI). Further, we investigated possible associations of CS with patient reported outcomes (PROs), and risk factors for developing CS. Clinical data and PROs of 315 PC patients were assessed at a mean of 6 months after SARS-CoV-2 infection. 231 (73.3%) patients reported any sort of CS. Among them, 78 underwent NCT and 55 received BI. In NCT, the cognitive domains most affected were the working memory, attention, and concentration. Nonetheless, pathological thresholds were exceeded only in few cases. Neurocognitive performance did not differ significantly between patients complaining of severe (n = 26) versus non-severe (n = 52) CS. BI findings were abnormal in 8 (14.5%) cases with CS but were most likely not related to PC. Patients reporting high severity of CS scored worse in the PHQ-9, FSS, WHOQOL-BREF, were more likely to report impaired sleep, and had a higher prevalence of psychiatric diagnoses. Overall, NCT could confirm mild impairment in some but not all PC patients with CS, while BI studies were abnormal in only few cases. CS severity did not affect NCT results, but severe CS were associated with symptoms of depression (PHQ-9), fatigue (FSS), reduced quality of life (WHOQOL-BREF) and higher prevalence of psychiatric illnesses. These findings support the importance of NCT, BI, and neuro-psychological assessment in the work-up of PC patients reporting CS. TRIAL REGISTRATION: Trial registration number and date of registration: DRKS00030974, 22 Dec 2022, retrospectively registered.

MeSH

Neurobehavioral Manifestations, Signs And Symptoms, Covid-19, Work, Prevalence, Nervous System Diseases, Neurology, Psychiatry

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