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Cognitive dysfunction following COVID-19 infection

Rafi Hadad, Johad Khoury, Chen Stanger, Tali Fisher, Sonia Schneer, Rachel Ben‐Hayun, Katherine L. Possin, Victor Valcour, Judith Aharon‐Peretz, Yochai Adir

2022Journal of NeuroVirology70 citationsDOIOpen Access PDF

Abstract

The coronavirus (COVID-19) pandemic is still evolving, causing hundreds of millions of infections around the world. The long-term sequelae of COVID-19 and neurologic syndromes post COVID remain poorly understood. The present study aims to characterize cognitive performance in patients experiencing cognitive symptoms post-COVID infection. Patients evaluated at a post COVID clinic in Northern Israel who endorsed cognitive symptoms were referred for neurologic consultation. The neurologic work-up included detailed medical history, symptom inventory, neurological examination, the Montreal Cognitive Assessment (MoCA), laboratory tests and brain CT or MRI. Between December 2020 and June 2021, 46 patients were referred for neurological consultation (65% female), mean age 49.5 (19-72 years). On the MoCA test, executive functions, particularly phonemic fluency, and attention, were impaired. In contrast, the total MoCA score, and memory and orientation subscores did not differ from expected ranges. Disease severity, premorbid condition, pulmonary function tests and hypoxia did not contribute to cognitive performance. Cognitive decline may affect otherwise healthy patients post-COVID, independent of disease severity. Our examination identified abnormalities in executive function, attention, and phonemic fluency. These findings occurred despite normal laboratory tests and imaging findings.

Topics & Concepts

Montreal Cognitive AssessmentCognitionExecutive dysfunctionNeurologyMedicineCognitive testVerbal fluency testCognitive declineCoronavirus disease 2019 (COVID-19)Cognitive evaluation theoryFluencyMedical historyPsychologyPediatricsPsychiatryClinical psychologyDiseaseNeuropsychologyDementiaInternal medicineCognitive impairmentInfectious disease (medical specialty)Self-determination theoryPolitical scienceLawAutonomyMathematics educationLong-Term Effects of COVID-19Intensive Care Unit Cognitive DisordersCOVID-19 and Mental Health