Cognitive impairment after recovery from COVID-19: Frequency, profile, and relationships with clinical and laboratory indices
Silvana Galderisi, Andrea Perrottelli, Luigi Giuliani, Mariantonietta Pisaturo, Palmiero Monteleone, Pasquale Pagliano, Antonio Vita, María Lorenza Muiesan, Mario Amore, Matteo Bassetti, Alberto Siracusano, Armida Mucci, Paola Bucci, Giammarco Cascino, Sergio Barlati, Andrea Amerio, Giorgio Di Lorenzo, Cinzia Niolu, Nicola Coppola, Mario Maj, Lorenzo Onorato, Gennaro Giugliano, Maria Laura Livoti, Chiara Caulo, Rossella Ceres, Benedetto Maria Polverino, Gabriele Nibbio, Irene Calzavara Pinton, Emma Sala, Andrea Aguglia, Antonio Vena, Emanuela Barisione, Emanuela Bianciardi, Federico Fiori Nastro, Martina Pelle
Abstract
Cognitive impairment (CI) is regarded as a remarkable burden in COVID-19 survivors. Its prevalence and profile, and relationships with the disease clinical and laboratory indices, remain unclear. The present study investigated, in a large sample of patients recovered from COVID-19, the frequency of CI with both a face-to-face screening tool and comprehensive test battery (MCCB). The study also evaluated the profile of CI and its relationships with COVID-19 clinical and laboratory indices and with psychopathological features. Out of 1344 subjects assessed for eligibility, 736 completed the screening phase 11 months after the COVID-19 infection; 402 participated in the baseline phase and completed an in depth cognitive, clinical and laboratory assessment about one month later. More than one third of the screened subjects presented a CI (COG+); it was associated to age, education, male gender, COVID-19 severity, and presence of anosmia, dyspnea at rest and exertional dyspnea during the acute phase. COG+ subjects showed a higher severity of depression, anxiety and post-traumatic distress, and worse global functioning, than subjects without CI. The MCCB showed that 45% of the subjects had a CI involving attention, working memory, verbal learning, visual learning, and reasoning and problem solving. Finally, neurocognitive functioning was inversely correlated with LDH blood levels, a potential biomarker of disease severity. According to our findings, cognitive functioning should be routinely and periodically assessed in COVID-19 patients, especially in older subjects, who experienced more severe COVID-19 symptoms. In case of persisting dysfunctions cognitive training programs should be considered as treatment strategies.