Description of cognitive and imaging function in a cohort of COVID-19 survivors in a tertiary hospital in Mexico City.
RAUL ANWAR GARCIA SANTOS1, Mónica Saray rodriguez rodriguez2, Antonio Arauz3, Alonso Gutierrez Romero3, francisco Javier soto moreno2, Diana Sarai Lopez Hernandez4, Yaneth Rodríguez Agudelo3, Francisco Paz Rodriguez3, Mireya Chávez Oliveros 3, Susana Lozano Tovar Susana 3, Manuel Alejandro Del Río Quiñones 3, Karina González Alonso 3, Roger Carrillo-Mezo 3, Oscar Marrufo Meléndez 3
1Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Insituto Nacional de Enfermedades Respiratorias, 2NEUROLOGY, Instituto Nacional de Enfermedades Respiratorias, 3Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, 4Insituto Nacional de Enfermedades Respiratorias
Objective:
DTo escribe cognitive function in COVID-19 survivors who may persist through long COVID-19, correlation with imaging lesions.
Background:
several studies have been done to describe them and to find the predisposing factors without finding the precise aetiology of these alterations.
Design/Methods:
Cohort of patients in 1 hospital in Mexico City who survived COVID-19 and were evaluated after 12 weeks of hospital discharge from December 2020 to April 2021, those with 26 points or less on MoCA test and/or cognitive complaint, underwent neuropsychological testing and cranial MRI. Those who had invasive mechanical ventilatory support (IMV) and those who had non-invasive mechanical ventilation (NMV-I) were classified into two groups. The main objective of this study was to describe cognitive function, its correlations with magnetic resonance imaging and markers of inflammation and functional status post COVID-19.
Results:
total 375 patients were evaluated, 315 were excluded for not meeting criteria and follow-up. 60 patients completed the study, 41 had VMI and 19 VMn-I patients, 66.6% where amle with a mean age 58.5, mean MoCA scale score 25.8. The VMn-I group presented higher scores on the FMVC scale (23.6 points) p=0.007. Failures in executive functions with the Trail Making Test in 33% of both groups, as well as in the Verbal Phonological Fluency test in 31.6% and in the attention domain with the Retention of Progressive Digits test in 26.8%, no statistical significance. Failures in attention and processing speed were associated with frontal atrophy, and failures in memory and executive functions were associated with frontotemporal atrophy (p=0.008 and 0.034 respectively). Other factors associated with functional disability were anxiety (p=<0.001), depression (p=<0.001), elevated D-dimer levels (p=0.002), increased days of intubation (p=0.005) and neuropathy (p=0.030).
Conclusions:
SARS CoV-2 infection leaves persistent symptoms in cognitive functions such as executive functions, attention and memory. These cognitive failures are independent of disease severity.