The cognitive and psychiatric subacute impairment in severe Covid-19

Abstract

Neurologic impairment persisting months after acute severe SARS-CoV-2 infection has been described because of several pathogenic mechanisms, including persistent systemic inflammation. The objective of this study is to analyze the selective involvement of the different cognitive domains and the existence of related biomarkers. Cross-sectional multicentric study of patients who survived severe infection with SARS-CoV-2 consecutively recruited between 90 and 120 days after hospital discharge. All patients underwent an exhaustive study of cognitive functions as well as plasma determination of pro-inflammatory, neurotrophic factors and light-chain neurofilaments. A principal component analysis extracted the main independent characteristics of the syndrome. 152 patients were recruited. The results of our study preferential involvement of episodic and working memory, executive functions, and attention and relatively less affectation of other cortical functions. In addition, anxiety and depression pictures are constant in our cohort. Several plasma chemokines concentrations were elevated compared with both, a non-SARS-Cov2 infected cohort of neurological outpatients or a control healthy general population. Severe Covid-19 patients can develop an amnesic and dysexecutive syndrome with neuropsychiatric manifestations. We do not know if the deficits detected can persist in the long term and if this can trigger or accelerate the onset of neurodegenerative diseases.

Figure 1

Plasma values of several chemokines and growth factors in control subjects (n = 45), mild cognitive impairment patients (MCI, n = 41) and COVID-19 patients (COVID+, n = 128) 3–4 months after hospital discharge. Kruskal–Wallis Analysis. *p < 0.01 versus control group. ^#p < 0.01 versus MCI group. Data in boxplots are means and 5–95 confidence intervals.

Figure 2

Graphical representation of the profile of the main test used in our study comparing the average vs maximum score.