Dados do Trabalho

Título

COVID19 and cognitive impairment - A follow-up study of a clinical hospital in São Paulo

Resumo

Introduction: Post-COVID19 syndrome is a condition characterized by signs and symptoms that occur within 3 months of the onset of COVID19 and that last for at least 2 months. In the past 2 years, cognitive impairment has frequently been associated with COVID19 with descriptions of attentional, executive, memory, and language disorders. Many studies have assessed these cognitive disturbances using online and telephone tests, often in isolated interviews. Moreover, some morphological and metabolic changes have been described in MRI and FDG PET-CT, respectively. There is no formal treatment for this condition, and more advanced knowledge in this important research in this field is needed.

Objectives: To characterize the cognitive profile of this population pre- and post-rehabilitation, including neuroimage patterns and the effect of cognitive rehabilitation.

Methods: We selected patients less than 65 years of age through social media with a history of COVID19, with at least 3 or more months of symptom and no more than 6 months, no relevant structural brain lesions, no history of neurodegenerative disease, important cognitive issues or psychiatric conditions and currently living in the city of São Paulo or nearby regions. They were evaluated in person or by remote video call 3 times by a neurologist (0, 3, and 6 months) with specific cognitive battery tests and questionnaires and then by a neuropsychologist for evaluation and training. Finally, some patients underwent neuroimaging.

Results: 39 patients performed the first baseline evaluation and 14 completed the 6-month follow-up, 34 completed or were in cognitive rehabilitation, and 19 patients with underwent functional and structural neuroimaging (FDG PET CT/MRI). This sample has a mean age of 46.2 (SD11.4) years, 53% of females, 13.4 (SD3.4) years of education, 18% of hypertension, 6.2% diabetes, 15.6% dyslipidemia, 15.1% stroke/TIA, and 25% obesity. 59% of the assessments were face-to-face, 41% by telemedicine. The cognitive evaluation depicted: 90% had memory complaints, MMSE of 26.6 (SD2.7), delayed recall of 9.2 (SD1.6) out 10; semantic verbal fluency of 16.5 (SD5.1), FAS fluency test 27 (SD12.2), clock drawing test of 8.8 (SD2.2), and Boston naming test of 13.1 (SD2.4) out 15.

Conclusion: post-COVID19 syndrome and cognitive impairment are relatively common, and we need prospective studies in our population and other low and middle-income countries.

Palavras Chave

Cognitive impairment; post-COVI19 syndrome; COVID19; neuroimage; cognitive rehabilitation