Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables.
Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables.
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DOI：
10.1016/j.euroneuro.2021.03.019
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发表时间：
2021-05
期刊：
影响因子：
--
通讯作者：
Porsberg CM
中科院分区：
文献类型：
--
作者：
Miskowiak KW;Johnsen S;Sattler SM;Nielsen S;Kunalan K;Rungby J;Lapperre T;Porsberg CM
正在进行的2019冠状病毒病（COVID-19）大流行已经影响了1亿多人，正在建立诊所，用于诊断和治疗挥之不去的症状，即所谓的长期covid。一个关键的问题是神经和长期的认知并发症。与此同时，COVID-19认知后遗症的患病率和性质尚不清楚。本研究旨在探讨新型冠状病毒肺炎患者出院后3-4个月发生认知障碍的频率、模式、严重程度及其与主观认知主诉、生活质量和疾病变量的关系。我们招募了在比斯贝尔格哥本哈根大学医院呼吸门诊随访的患者，随访时间是在因COVID-19住院约四个月后。患者接受肺部、功能和认知评估。纳入29例患者。临床显著认知障碍患者的百分比从59%到65%不等，这取决于认知障碍临床相关性的应用截止值，言语学习和执行功能受到的影响最大。客观认知障碍与主观认知抱怨、工作功能下降和生活质量下降有关。认知障碍与急性疾病和残余肺功能障碍期间的d-二聚体水平有关。总之，这些发现为COVID-19常见的认知后遗症提供了新的证据，并表明其与肺部病变的严重程度和潜在的脑氧输送受限有关。此外，与生活质量和功能的关联要求对COVID-19重症康复后的患者进行系统的认知筛查，并对持续性认知障碍患者实施靶向治疗。
The ongoing Coronavirus Disease 2019 (COVID-19) pandemic has affected more than 100 million people and clinics are being established for diagnosing and treating lingering symptoms, so called long-COVID. A key concern are neurological and long-term cognitive complications. At the same time, the prevalence and nature of the cognitive sequalae of COVID-19 are unclear. The present study aimed to investigate the frequency, pattern and severity of cognitive impairments 3–4 months after COVID-19 hospital discharge, their relation to subjective cognitive complaints, quality of life and illness variables. We recruited patients at their follow-up visit at the respiratory outpatient clinic, Copenhagen University Hospital, Bispebjerg, approximately four months after hospitalisation with COVID-19. Patients underwent pulmonary, functional and cognitive assessments. Twenty-nine patients were included. The percentage of patients with clinically significant cognitive impairment ranged from 59% to 65% depending on the applied cut-off for clinical relevance of cognitive impairment, with verbal learning and executive functions being most affected. Objective cognitive impairment scaled with subjective cognitive complaints, lower work function and poorer quality of life. Cognitive impairments were associated with d-dimer levels during acute illness and residual pulmonary dysfunction. In conclusion, these findings provide new evidence for frequent cognitive sequelae of COVID-19 and indicate an association with the severity of the lung affection and potentially restricted cerebral oxygen delivery. Further, the associations with quality of life and functioning call for systematic cognitive screening of patients after recovery from severe COVID-19 illness and implementation of targeted treatments for patients with persistent cognitive impairments.
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