The Impact of Cognitive Function on Health-Related Quality of Life in Persons with Post-COVID-19 Condition: A Randomized Controlled Trial on Vortioxetine
Moiz Lakhani1, Angela Kwan1, Kayla M. Teopiz2, Ziji Guo2, Arshpreet Singh Manku3, Greg Rhee4, Joshua D. Rosenblat5, Roger S. McIntyre2
1Faculty of Medicine, University of Ottawa, 2Brain and Cognition Discovery Foundation, 3Faculty of Medicine, University of British Columbia, 4Department of Psychiatry, University of Pittsburgh School of Medicine, 5Department of Psychiatry, University of Toronto
Objective:

Our objective was to investigate the effects of cognitive function on health-related quality of life (HRQoL) in individuals with post-COVID-19 condition (PCC). Additionally, we aimed to determine whether vortioxetine modulates the relationship between cognitive function and HRQoL.

Background:

PCC manifests as debilitating symptoms that impact multiple cognitive domains and negatively affect HRQoL. Targeting the mediators of HRQoL in PCC could potentially enhance patient-reported outcomes (PROs), providing a basis for therapeutic strategies aimed at enhancing overall quality of life.

Design/Methods:

Participants aged 18-65 years were randomized to receive either vortioxetine or placebo for 8 weeks. HRQoL was assessed using the World Health Organization Wellbeing Scale 5-item, while cognitive function was measured using the Digit Symbol Substitution Test and the Trail-Making Test A/B. Generalized estimating equations were used to model the relationship between cognition and HRQoL for each treatment group.

Results:

147 participants (75.5% females) were included. At baseline, there was a statistically significant positive association between WHO-5 scores and combined DSST z-scores (β = 0.090, 95% CI [0.051, 0.129], p < 0.001). Conversely, there were statistically significant negative associations with TMT-A (β = −0.007, 95% CI [-0.011, −0.003], p < 0.001) and TMT-B (β = −0.002, 95% CI [-0.003, 0.000], p = 0.024) scores. A significant interaction among treatment, time, and combined DSST z-scores on changes in overall WHO-5 total scores was observed (χ² = 15.481, p = 0.004). After adjusting for the type of cognitive test, a significant between-group difference was noted (mean change = 1.77, SEM = 0.868, p = 0.042), favoring vortioxetine.

Conclusions:

Cognitive function is significantly associated with HRQoL in individuals with PCC, with better cognitive functioning correlating with improved HRQoL. Vortioxetine has demonstrated effectiveness in enhancing HRQoL by improving cognitive function, highlighting cognitive enhancement as a potential therapeutic target in PCC. Future studies should explore pro-cognitive therapeutic strategies.

10.1212/WNL.0000000000209083
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