Relias Media - Continuing Medical Education Publishing

The trusted source for

healthcare information and

CONTINUING EDUCATION.

  • Sign In
  • Sign Out
  • MyAHC
    • Home
      • Home
      • Newsletters
      • Blogs
      • Archives
      • CME/CE Map
      • Shop
    • Emergency
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Hospital
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Clinical
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • All Access
      • My Subscription
      • Subscribe Now
    • My Account
      • My Subscriptions
      • My Content
      • My Orders
      • My CME/CE
      • My Transcript
    Home » Cognitive Deficits in Patients Recovering from COVID-19
    ABSTRACT & COMMENTARY

    Cognitive Deficits in Patients Recovering from COVID-19

    April 1, 2021
    No Comments
    Reprints
    Facebook Twitter Linkedin Share Share

    Related Articles

    Neuropathological Findings in the Brains of Patients Who Died from COVID-19

    COVID-19 Can Cause Neurological Symptoms and Strokes in Patients

    Neurologic Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China

    Related Products

    Alzheimer’s Disease: What the Primary Care Physician Needs to Know

    All Access Subscription: Online

    Keywords

    hospitalization

    cognition

    cognitive

    memory

    impairment

    COVID-19

    By Lisa Ravdin, PhD

    Associate Professor of Neuropsychology and Director of the Weill Cornell Neuropsychology Service, Department of Neurology & Neuroscience, New York Presbyterian Hospital/Weill Cornell Medical Center

    SYNOPSIS: Hospitalized COVID-19 patients with cognitive complaints demonstrate reduced attention and executive dysfunction on formal cognitive testing consistent with the same frequency and pattern of cognitive changes associated with critical illness.

    SOURCE: Jaywant A, Vanderlind WM, Alexopoulos GS, et al. Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19. Neuropsychopharmacology 2021; Feb 15:1-6. doi.org/10.1038/s41386-021-00978-8. [Online ahead of print].

    In 2020, hospital settings in pandemic hotspots became real-time clinical laboratories for studying the evolving knowledge of the effects of COVID-19 infection. Among the variety of symptoms associated with COVID-19, central nervous system (CNS) manifestations include headaches, dizziness, delirium, encephalopathy, and stroke. Cognitive complaints also have been reported in COVID-19 patients, yet there have been limited formal studies that incorporate objective cognitive measures to understand the nature of these complaints.

    Jaywant and colleagues sought to examine cognitive function in patients who underwent prolonged hospitalization for COVID-19 using objective cognitive measures. Subjects consisted of 57 individuals hospitalized for acute COVID-19 symptoms who also had suspected cognitive dysfunction. Participants were medically stable yet experiencing some form of impairment in mobility or activities of daily living that necessitated acute inpatient rehabilitation prior to discharge.

    Cognitive testing consisted of bedside administration of the Brief Memory and Executive Test (BMET), a paper and pencil measure that consists of multiple subtests of memory and executive function, including orientation, five-word immediate recall (working memory), five-word recall (delayed memory), five-word recognition (delayed recognition), rapid letter-number matching (divided attention), motor speed, rapid letter sequencing (visual attention and processing speed), and letter-number switching (mental set-shifting). Scores from the short form of the Activity Measure for Post-Acute Care closest to the time of admission to rehabilitation were collected to assess functional status. Impairment ratings were defined according to age-corrected normative data, with scores < 1 standard deviation (SD) below the mean interpreted as mild/borderline impaired and scores < 2 SD below the mean classified as impaired. Pearson correlations and Chi square analyses were used to examine relationships between cognition and patient variables.

    Impairment ratings reflecting mild cognitive impairment were a frequent finding (81%) in this sample of hospitalized COVID-19 patients, with deficits primarily on tasks of complex attention. In terms of memory, working memory (immediate recall) was affected more frequently as opposed to delayed recall, consistent with the pattern often observed in the context of compromised complex attention. The presence of cognitive deficits was not associated with the length of intubation, the time between extubation and assessment, or the presence of psychiatric symptoms. There was no significant association between cognition and preexisting cardiometabolic diagnosis, and the relationship between delirium and cognitive deficits was not statistically significant.

    COMMENTARY

    Jaywant et al expeditiously conducted this study early on at the height of the pandemic in the hotspot of New York City. They provided valuable descriptive information to inform our knowledge of the frequency and pattern of cognitive changes observed in hospitalized COVID-19 patients. The results are consistent with the literature on the rates of cognitive deficits in hospitalized critical care patients, with comparable numbers of patients (approximately 80%) experiencing some form of cognitive dysfunction.

    These preliminary data on COVID-19 patients set the stage for empirically designed controlled investigations that can explore the causation of cognitive changes over and beyond those that might be attributable to critical illness hospitalization. The literature suggests hospitalized critically ill patients tend to demonstrate the most significant cognitive deficits at or around the time of discharge, and this can persist for months to years after hospitalization. As in this study, often this occurs in the absence of pre-hospitalization cognitive impairment.

    Cognitive complaints also have been reported anecdotally in individuals with much milder symptom presentations of COVID-19 that do not require hospitalization, and this often is described by patients as “brain fog.” Studies investigating cognition post-COVID-19 infection should consider that cognitive complaints present at an unprecedented time during a pandemic where factors such as social isolation and change in work routines and daily activities as well as in sleep and mood typically are affected.

    In those who have survived the more significant physical effects of infection, the emotional response to serious medical illness also may affect the persistence of post-hospitalization symptoms. Consideration of these potential contributing factors to cognitive complaints can help guide intervention and treatment recommendations.

    Post a comment to this article

    Report Abusive Comment

    www.reliasmedia.com

    Neurology Alert

    View PDF
    Neurology Alert (Vol. 40, No. 8) - April 2021
    April 1, 2021

    Table Of Contents

    Phospho-Tau217 Blood Biomarker May Help to Diagnose Early Alzheimer’s Disease

    Cognitive Deficits in Patients Recovering from COVID-19

    Polyradiculoneuropathy from Immune Checkpoint Inhibitors

    Brain Cancer and Brain Injury Drive Systemic Immunosuppression

    Tenecteplase vs. Alteplase for Thrombolysis in Basilar Artery Occlusion

    Tranexamic Acid in Patients with Intracerebral Hemorrhage Does Not Improve Outcomes

    Atorvastatin and Low-Dose Dexamethasone for Treatment of Chronic Subdural Hematoma

    Begin Test

    Buy this Issue/Course

    Financial Disclosure: Dr. Isaacson (author) reports he is a consultant for Genentech/Roche and Biogen, Dr. Rubin (author) reports he is a consultant for Merck Sharpe & Dohme Corp., and Dr. Noch (author) reports he is a stockholder in Destroke, Inc. All of the relevant financial relationships listed for these individuals have been mitigated. None of the remaining authors or planners for this educational activity have relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

    Shop Now: Search Products

    • Subscription Publications
    • Books & Study Guides
    • Webinars
    • Group & Site
      Licenses
    • State CME/CE
      Requirements

    Webinars And Events

    View All Events
    • Home
      • Home
      • Newsletters
      • Blogs
      • Archives
      • CME/CE Map
      • Shop
    • Emergency
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Hospital
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • Clinical
      • All Products
      • Publications
      • Study Guides
      • Webinars
      • Group Sales
    • All Access
      • My Subscription
      • Subscribe Now
    • My Account
      • My Subscriptions
      • My Content
      • My Orders
      • My CME/CE
      • My Transcript
    • Help
    • Search
    • About Us
    • Sign In
    • Register
    Relias Media - Continuing Medical Education Publishing

    The trusted source for

    healthcare information and

    CONTINUING EDUCATION.

    Customer Service

    customerservice@reliasmedia.com

    U.S. and Canada: 1-800-688-2421 x 2

    International +1-404-262-5476 x 2

    Accounts Receivable

    1-800-688-2421 x 3
    ReliasMedia_AR@reliasmedia.com

    Sales

    1-800-688-2421 x 1

    Mailing Address

    • 1010 Sync St., Suite 100
      Morrisville, NC 27560-5468
      USA

    © 2022 Relias. All rights reserved.

    Do Not Sell My Personal Information  Privacy Policy  Terms of Use  Contact Us  Reprints  Group Sales

    For DSR inquiries or complaints, please reach out to Wes Vaux, Data Privacy Officer, DPO@relias.com

    Design, CMS, Hosting & Web Development :: ePublishing