Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19.
Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19.
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COVID-19 住院康复患者客观认知缺陷的频率和概况。
DOI：
10.1038/s41386-021-00978-8
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发表时间：
2021-12
期刊：
影响因子：
--
通讯作者：
Gunning FM
中科院分区：
文献类型：
--
作者：
Jaywant A;Vanderlind WM;Alexopoulos GS;Fridman CB;Perlis RH;Gunning FM
早期报告和病例系列表明，一些COVID-19患者出现认知障碍。我们评估了从长期COVID-19住院中恢复并在出院前需要急性住院康复的患者的认知功能障碍的频率、严重程度和特征。我们分析了一组接受住院康复治疗的N = 57名COVID-19患者的简短记忆和执行测试（BMET）的横截面分数，根据神经心理学家诊断和年龄标准化BMET子测试计算受损频率。总计43例患者（75%）为男性，35例（61%）为非白人，平均年龄为64.5岁（SD = 13.9）。总共有48人（84%）以前独立生活在家里。两名患者记录了先前存在的认知功能障碍;没有已知的痴呆症。在初次入院后平均43.2（SD = 19.2）天对患者进行评估。总共有50名患者（88%）记录了低氧性呼吸衰竭，44名（77%）需要插管。 46名患者（81%）有认知障碍，从轻度到重度不等。常见的缺陷包括工作记忆（26/47 [55%]例患者）、定势转换（21/44 [47%]）、注意力分散（18/39 [46%]）和处理速度（14/35 [40%]）。执行功能障碍与插管长度或从拔管到评估、精神病诊断或既存心血管/代谢疾病的时间无显著相关性。COVID-19患者的注意力和执行功能经常受损，他们在出院前需要进行急性康复。尽管由于缺乏对照组而限制了解释，但这些结果为识别和表征COVID-19后的认知困难提供了早期基准。鉴于损伤的频率和模式，针对注意力和执行功能障碍的易于传播的干预措施可能对这一人群有益。
Early reports and case series suggest cognitive deficits occurs in some patients with COVID-19. We evaluated the frequency, severity, and profile of cognitive dysfunction in patients recovering from prolonged COVID-19 hospitalization who required acute inpatient rehabilitation prior to discharge. We analyzed cross-sectional scores from the Brief Memory and Executive Test (BMET) in a cohort of N = 57 COVID-19 patients undergoing inpatient rehabilitation, calculating the frequency of impairment based on neuropsychologist diagnosis and by age-normed BMET subtests. In total, 43 patients (75%) were male, 35 (61%) were non-white, and mean age was 64.5 (SD = 13.9) years. In total, 48 (84%) were previously living at home independently. Two patients had documented preexisting cognitive dysfunction; none had known dementia. Patients were evaluated at a mean of 43.2 (SD = 19.2) days after initial admission. In total, 50 patients (88%) had documented hypoxemic respiratory failure and 44 (77%) required intubation. Forty-six patients (81%) had cognitive impairment, ranging from mild to severe. Deficits were common in working memory (26/47 [55%] of patients), set-shifting (21/44 [47%]), divided attention (18/39 [46%]), and processing speed (14/35 [40%]). Executive dysfunction was not significantly associated with intubation length or the time from extubation to assessment, psychiatric diagnosis, or preexisting cardiovascular/metabolic disease. Attention and executive functions are frequently impaired in COVID-19 patients who require acute rehabilitation prior to discharge. Though interpretation is limited by lack of a comparator group, these results provide an early benchmark for identifying and characterizing cognitive difficulties after COVID-19. Given the frequency and pattern of impairment, easy-to-disseminate interventions that target attention and executive dysfunctions may be beneficial to this population.
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DOI：
10.1056/nejmoa1301372
发表时间：
2013-10-03
期刊：
The New England journal of medicine
影响因子：
--
作者：
Pandharipande PP;Girard TD;Jackson JC;Morandi A;Thompson JL;Pun BT;Brummel NE;Hughes CG;Vasilevskis EE;Shintani AK;Moons KG;Geevarghese SK;Canonico A;Hopkins RO;Bernard GR;Dittus RS;Ely EW;BRAIN-ICU Study Investigators
通讯作者：
BRAIN-ICU Study Investigators
影响因子：
3.7
作者：
Duggan MC;Wang L;Wilson JE;Dittus RS;Ely EW;Jackson JC
通讯作者：
Jackson JC
影响因子：
4.8
作者：
Uiterwijk R;van Oostenbrugge RJ;Huijts M;De Leeuw PW;Kroon AA;Staals J
通讯作者：
Staals J
影响因子：
9.9
作者：
Romero-Sanchez, Carlos Manuel;Diaz-Maroto, Inmaculada;Segura, Tomas
通讯作者：
Segura, Tomas
影响因子：
8.8
作者：
Norman, Brett C.;Jackson, James C.;Ely, E. Wesley
通讯作者：
Ely, E. Wesley