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

https://doi.org/10.1016/j.jns.2021.120061Get rights and content

Highlights

  • Neurological and cognitive sequelae of COVID-19 in the long term are unknown.

  • Brain fog and memory deficits are frequently but not homogeneously reported by patients.

  • We compared neurological deficits and cognition in mild versus severe/critical COVID-19 (ICU) cases) after four months.

  • Neurological deficits and Cognitive Impairment were more frequent and severe in ICU cases.

  • PNS was prominently involved and executive functions were mostly impaired.

Abstract

The exact incidence of neurological and cognitive sequelae of COVID-19 in the long term is yet unknown. The aim of this research is to investigate the type of neurological and cognitive impairment in COVID-19 cases of different severity. Two hundred fifteen patients, who had developed COVID-19, were examined 4 months after the diagnosis by means of neurological exam and extensive cognitive evaluation, investigating general cognition, memory, verbal fluency, visuospatial abilities and executive functions. Fifty-two of them were treated in intensive care unit (ICU patients), whereas 163 were not hospitalized (non-ICU patients). Neurological deficits were found in 2/163 (1.2%) of non-ICU and in 7/52 (13.5%) of the ICU cases, all involving the peripheral nervous system. ICU patients performed significantly worse in all the neuropsychological tests and showed a worse age- and education-corrected cognitive impairment: Cognitive Impairment Index (CII) was higher in ICU than in non-ICU patients (median ICU 3 vs 2, p = .001). CII significantly correlated with age in both groups, was unrelated to length of follow- up, diabetes and hypertension and - only for ICU patients- to PaO2/FiO2 at ICU admission. Obtained results support the greater susceptibility of COVID-19 patients, treated in ICU, to develop neurological deficits and cognitive impairment at a four-month follow up, as compared to cases with mild/moderate symptoms.

Keywords

COVID-19
Intensive care unit
Cognitive impairment
Follow up

Cited by (0)

1

Present address: Via Nikolajewka 13, 25123 Brescia, Italy.

2

Present address: Piazza Spedali Civili 1, 25123 Brescia Italy; Viale Europa 11, 25123 Brescia, Italy.

3

Present address: Medical Director of the University Hospital ASST Spedali Civili of Brescia, Italy.

4

Nicola Latronico and Giuseppe De Palma contributed equally

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