Pattern of cognitive deficits in severe COVID-19
Valérie Beaud, Sonia Crottaz‐Herbette, Vincent Dunet, Julien Vaucher, Raphaël Bernard‐Valnet, Renaud Du Pasquier, Pierre‐Alexandre Bart, Stéphanie Clarke
Abstract
The severe form of COVID-19 tends to be associated with neurological deficits.1 2 Among patients with acute respiratory distress syndrome (ARDS), who benefited from mechanical ventilation and were examined after discontinuation of sedation and neuromuscular blockade, 69% presented agitation, 65% confusion, 67% corticospinal tract signs and 33% dysexecutive syndrome.2 We describe here the pattern of cognitive deficits in a series of 13 consecutive inpatients hospitalised in the Lausanne University Hospital, whom we examined during the post-critical acute stage of severe COVID-19 (table 1). Inclusion criteria were COVID-19 diagnosed by PCR and ARDS that required intubation and mechanical ventilation in intensive care unit (ICU). Exclusion criteria were prior psychiatric or neurological diseases, including neurocognitive impairment or dementia. At the time of testing, patients were no longer sedated and ICU delirium symptoms, which were present in seven patients, resolved in six of them (P5–P7, P10, P11, P13) or subsided to a great extent (P12). View this table: Table 1 Patient (P1–P13) characteristics and performance in cognitive tests The neuropsychological evaluation comprised two standardised test batteries. The Montreal Cognitive Assessment (MoCA; https://www.mocatest.org), which covers main cognitive functions, revealed normal cognitive performances in four patients (table 1; P1–P4), mild deficits in four (P5–P8) and moderate to severe deficits in five (P9–P13). MoCA subtests revealed selective cognitive pattern with lower performances in executive functions for patients with normal MoCA scores and more extensive cognitive impairment in executive, memory, attentional and visuospatial …