Cognitive impairments as a symptom of Post-COVID syndrome in the context of a global pandemic
DOI:
https://doi.org/10.67667/NEU.v24i2.133Keywords:
cognitive impairments, long-COVID, neuroinflammation, pandemicAbstract
Post-COVID syndrome is a new condition, defined in the context of the 3-year long global COVID 19 pandemic. The syndrome itself presents with a wide range of non-specific complaints, most frequent of which are fatigue, shortness of breath and impaired cognitive functions. According to several studies, the incidence of postCOVID syndrome varies from 10% to 35% among non-hospitalized patients and up to 85% among hospitalized patients. The exact pathogenetic mechanisms, responsible for these prolonged neuropsychological manifestations of long COVID 19 are yet to be established but most authors assume that they are caused by chronic neuroinflammation.
The current literature review aims to offer a summary of the most frequently reported cognitive impairments in adults, suffering from post-COVID syndrome, thus outlining the possible clinical features of long-COVID and emphasizing its undeniable medico-social meaning. And given the progressively rising morbidity from this novel syndrome, a more precise description of these „cognitive difficulties” is required in order to formulate epidemiologically based health strategies and ensure early prevention, especially in patients in an active age.
References
Borah, P., Deb, P.K., Chandrasekaran, B., Goyal, M., Bansal, M., Hussain, S., Shinu, P., Venugopala, K.N., Al-Shar'i, N.A., Deka, S., Singh, V. Neurological Consequences of SARS-CoV-2 Infection and Concurrence of Treatment-Induced Neuropsychiatric Adverse Events in COVID-19 Patients: Navigating the Uncharted. Front Mol Biosci., 2021 Feb, 18, 8, 627723. https://doi.org/10.3389/fmolb.2021.627723
Blazhenets, G., Schroeter, N., Bormann, T., Thurow, J., Wagner, D., Frings, L., Weiller, C., Meyer, P.T., Dressing, A., Hosp, J.A. Slow but Evident Recovery from Neocortical Dysfunction and Cognitive Impairment in a Series of Chronic COVID-19 Patients. J Nucl Med., 2021 Jul 1, 62, 7, 910-915. https://doi.org/10.2967/jnumed.121.262128
Dąbrowska, E., Galińska-Skok, B., Waszkiewicz, N. Depressive and Neurocognitive Disorders in the Context of the Inflammatory Background of COVID-19. Life, Basel, 2021 Oct 8, 11, 10, 1056. https://doi.org/10.3390/life11101056
Evans, R.A., McAuley, H., Harrison, E.M., Shikotra, A., Singapuri, A., Sereno, M., Elneima, O., Docherty, A.B., Lone, N.I., Leavy, O.C., Daines, L., Baillie, J.K., Brown, J.S., Chalder, T., De Soyza, A., Diar Bakerly, N., Easom, N., Geddes, J.R., Greening, N.J., Hart, N., Heaney, L.G., Heller, S., Howard, L., Hurst, J.R., Jacob, J., Jenkins, R.G., Jolley, C., Kerr, S., Kon, O.M., Lewis, K., Lord, J.M., McCann, G.P., Neubauer, S., Openshaw, P.J.M., Parekh, D., Pfeffer, P., Rahman, N.M., Raman, B., Richardson, M., Rowland, M., Semple, M.G., Shah, A.M., Singh, S.J., Sheikh, A., Thomas, D., Toshner, M., Chalmers, J.D., Ho, L.P., Horsley, A., Marks, M., Poinasamy, K., Wain, L.V., Brightling CE; PHOSP-COVID Collaborative Group. Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation PHOSPCOVID: a UK multicentre, prospective cohort study. Lancet Respir Med., 2021 Nov, 9, 11, 1275-1287. https://doi.org/10.1016/S2213-2600(21)00383-0
Ferrucci, R., Dini, M., Groppo, E., Rosci, C., Reitano, M.R., Bai, F., Poletti, B., Brugnera, A., Silani, V., D’Arminio Monforte, A., Priori, A. Long-lasting cognitive abnormalities after COVID-19. Brain Sci., 2021, 11, 2, 235.
Ferrucci, R., Dini, M., Rosci, C., Capozza, A., Groppo, E., Reitano, M.R., Allocco, E., Poletti, B., Brugnera, A., Bai, F., Monti, A., Ticozzi, N., Silani, V., Centanni, S., D'Arminio Monforte, A., Tagliabue, L., Priori, A. One-year cognitive follow-up of COVID-19 hospitalized patients. Eur J Neurol, 2022 Jul, 29, 7, 2006-2014. https://doi.org/10.3390/brainsci11020235
Fortini, A., Torrigiani, A., Sbaragli, S., Lo Forte, A., Crociani, A., Cecchini, P., Innocenti Bruni, G., Faraone, A. COVID-19: persistence of symptoms and lung alterations after 3-6 months from hospital discharge. Infection, 2021, 49, 5, 1007-1015. https://doi.org/10.1007/s15010-021-01638-1
Frontera, J.A., Yang, D., Lewis, A., Patel, P., Medicherla, C., Arena, V., Fang, T., Andino, A., Snyder, T., Madhavan, M., Gratch, D., Fuchs, B., Dessy, A., Canizares, M., Jauregui, R., Thomas, B., Bauman, K., Olivera, A., Bhagat, D., Sonson, M., Park, G., Stainman, R., Sunwoo, B., Talmasov, D., Tamimi, M., Zhu, Y., Rosenthal, J., Dygert, L., Ristic, M., Ishii, H., Valdes, E., Omari, M., Gurin, L., Huang, J., Czeisler, B.M., Kahn, D.E., Zhou, T., Lin, J., Lord, A.S., Melmed, K., Meropol, S., Troxel, A.B., Petkova, E., Wisniewski, T., Balcer, L., Morrison, C., Yaghi, S., Galetta, S. A prospective study of long-term outcomes among hospitalized COVID-19 patients with and without neurological complications. J Neurol Sci., 2021, Jul 15, 426, 117486. https://doi.org/10.1016/j.jns.2021.117486
Graham, E. L., Clark, J. R., Orban, Z. S., Lim, P. H., Szymanski, A. L., Taylor, C., DiBiase, R. M., Jia, D. T., Balabanov, R., Ho, S. U., Batra, A., Liotta, E. M., Koralnik, I. J. , 2021. Persistent neurologic symptoms and cognitive dysfunction in non-hospitalized Covid-19 „long haulers”. Ann Clin Transl. Neurol., 2021 May, 8, 5, 1073-1085. https://doi.org/10.1002/acn3.51350
Kempuraj, D., Selvakumar, G. P., Ahmed, M. E., Raikwar, S. P., Thangavel, R., Khan, A., Zaheer, S. A., Iyer, S. S., Burton, C., James, D., & Zaheer, A. COVID-19, Mast Cells, Cytokine Storm, Psychological Stress and Neuroinflammation. Neuroscientist, 2020 Oct-Dec, 26, 5-6, 402-414. https://doi.org/10.1177/1073858420941476
Lamontagne, S. J., Winters, M. F., Pizzagalli, D. A., Olmstead, M. C. Post-acute sequelae of COVID-19: Evidence of mood & cognitive impairment. Brain, Behav Immun Health, 2021 Nov; 17, 100347. https://doi.org/10.1016/j.bbih.2021.100347
Latronico, N., Peli, E., Rodella F, Stefano, C., Rodella, F., Novelli, M.P., Cella, A., Marshall, J., Needham, D., Rasulo, F.A. and Piva, S, Center LOTO Research. Six-month outcome in survivors of COVID-19 associated acute respiratory distress syndrome. SSRN Electron J. Published online December 29, 2020. http://dx.doi.org/10.2139/ssrn.3756865
Logue, J. K., Franko, N. M., McCulloch, D. J., McDonald, D., Magedson, A., Wolf, C. R., Chu, H. Y. Sequelae in Adults at 6 Months After COVID-19 Infection. JAMA Netw Open, 2021 Feb 1, 4, 2, e210830. https://doi.org/10.1001/jamanetworkopen.2021.0830
Mao, L., Jin, H., Wang, M., Hu, Y., Chen, S., He, Q., Chang, J., Hong, C., Zhou, Y., Wang, D., Miao, X., Li, Y., Hu, B. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020 Jun 1, 77, 6, 683-690.
Matschke, J., Lütgehetmann, M., Hagel, C., Sperhake, J. P., Schröder, A. S., Edler, C., Mushumba, H., Fitzek, A., Allweiss, L., Dandri, M., Dottermusch, M., Heinemann, A., Pfefferle, S., Schwabenland, M., Sumner Magruder, D., Bonn, S., Prinz, M., Gerloff, C., Püschel, K., Krasemann, S., Glatzel, M. Neuropathology of patients with COVID-19 in Germany: a post-mortem case series., Lancet. Neurol., 2020 Nov, 19, 11, 919-929. https://doi.org/10.1001/jamaneurol.2020.1127
Mattioli, F., Stampatori, C., Righetti, F., Sala, E., Tomasi, C., De Palma, G. Neurological and cognitive sequelae of Covid-19: a four month follow-up. J Neurol. 2021 Dec, 268, 12, 4422-4428. https://doi.org/10.1007/s00415-021-10579-6
Mazza, M.G., Palladini, M., De Lorenzo, R., Magnaghi, C., Poletti, S., Furlan, R., Ciceri, F., Rovere-Querini, P., Benedetti, F., Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at threemonth follow-up. Brain Behav. Immun., 2021 May, 94, 138-147. https://doi.org/10.1016/j.bbi.2021.02.021
Pacheco-Herrero, M., Soto-Rojas, L.O., Harrington, C.R., Flores-Martinez, Y.M., Villegas-Rojas, M.M., León-Aguilar, A.M., Martínez-Gómez, P.A., Campa-Córdoba, B.B., Apátiga-Pérez, R., Corniel-Taveras, C.N., Dominguez-García. J.J., Blanco-Alvarez, V.M., Luna-Muñoz, J. Elucidating the Neuropathologic Mechanisms of SARS-CoV-2 Infection. Front. Neurol., 2021 April 12, 660087. https://doi.org/10.3389/fneur.2021.660087
Proal, A. D., VanElzakker, M. B., 2021. Long COVID or Postacute Sequelae of COVID-19, PASC: An Overview of Biological Factors That May Contribute to Persistent Symptoms. Front. Microbiol., 2021 Jun 23, 12, 698169. https://doi.org/10.3389/fmicb.2021.698169
Ribeiro, D. E., Oliveira-Giacomelli, Á., Glaser, T., Arnaud-Sampaio, V. F., Andrejew, R., Dieckmann, L., Baranova, J., Lameu, C., Ratajczak, M. Z., Ulrich, H. Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology. Mol Psychiatry. 2021 Apr, 26, 4, 1044-1059. https://doi.org/10.1038/s41380-020-00965-3
Robinson-Agramonte, M. A., Gonçalves, C. A., Noris-García, E., Préndes Rivero, N., Brigida, A. L., Schultz, S., Siniscalco, D., & García García, R. J. Impact of SARS-CoV-2 on neuropsychiatric disorders. World J Psychiatry, 2021 Jul 19, 11, 7, 347-354. https://doi.org/10.5498/wjp.v11.i7.347
Soriano J.B.; Allan, M.; Alsokhn C., Alwan N.A., Askie L., Davis H.E., Diaz J.; Dua T.; Jakob, R.; Lado M.; Marshall J.; Murthy S.; Preller J.; Relan P.; Schiess N. and Seahwag A. A Clinical case definition of post COVID-19 condition by a Delphi consensus, Lancet Infect Dis., 2022 Apr, 22, 4, 102-107. https://doi.org/10.1016/S1473-3099(21)00703-9
Stefano, G. B., Büttiker, P., Weissenberger, S., Martin, A., Ptacek, R., Kream, R. M. Editorial: The Pathogenesis of Long-Term Neuropsychiatric COVID-19 and the Role of Microglia, Mitochondria, and Persistent Neuroinflammation: A Hypothesis. Med Sci Monit., 2021 May, 10, 27, 933015. https://doi.org/10.12659/MSM.933015
Sun, B., Tang, N., Peluso, M. J., Iyer, N. S., Torres, L., Donatelli, J. L., Munter, S. E., Nixon, C. C., Rutishauser, R. L., Rodriguez-Barraquer, I., Greenhouse, B., Kelly, J. D., Martin, J. N., Deeks, S. G., Henrich, T. J., Pulliam, L. Characterization and Biomarker Analyses of Post-COVID-19 Complications and Neurological Manifestations. Cells, 2021, 10, 2, 386. https://doi.org/10.3390/cells10020386
Varatharaj, A., Thomas, N., Ellul, M. A., Davies, N. W. S., Pollak, T. A., Tenorio, E. L., Sultan, M., Easton, A., Breen, G., Zandi, M., Coles, J. P., Manji, H., Al-Shahi Salman, R., Menon, D. K., Nicholson, T. R., Benjamin, L. A., Carson, A., Smith, C., Turner, M. R., Solomon, T., Kneen, R., Pett, S.L., Galea, I., Thomas R.H., Michael, B.D, CoroNerve Study Group. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UKwide surveillance study. Lancet Psychiatry. 2020 Oct; 7, 10, 875-882. https://doi.org/10.1016/S2215-0366(20)30287-X
Walle-Hansen, M. M., Ranhoff, A. H., Mellingsæter, M., Wang-Hansen, M. S., & Myrstad, M. Health-related quality of life, functional decline, and long-term mortality in older patients following hospitalisation due to COVID-19. BMC Geriatr., Mar 22, 21, 1, 199. https://doi.org/10.1186/s12877-021-02140-x
Whitaker, M., Elliott, J., Chadeau-Hyam, M., Riley, S., Darzi, A., Cooke, G., Ward, H., Elliott, P. Persistent COVID-19 symptoms in a community study of 606,434 people in England. Nat Commun 13, 1, 1957, 2022. https://doi.org/10.1038/s41467-022-29521-z
Woo, M. S., Malsy, J., Pöttgen, J., Seddiq Zai, S., Ufer, F., Hadjilaou, A., Schmiedel, S., Addo, M. M., Gerloff, C., Heesen, C., Schulze Zur Wiesch, J., Friese, M. A. Frequent neurocognitive deficits after recovery from mild COVID-19. Brain Commun. 2020 Nov 23, 2, 2, 205. https://doi.org/10.1093/braincomms/fcaa205
World Health Organization, A clinical case definition of post COVID-19 condition by a Delphi consensus, 2021 October 6.
https://www.who.int/data/gho/publications/world-health-statistics
Downloads
Published
How to Cite
Issue
Section
ARK
License
Copyright (c) 2023 Miroslava Hristova

This work is licensed under a Creative Commons Attribution 4.0 International License.