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Neurocognitive sequelae of COVID-19 after acute infection

 


The study Covered in this summary is published as a preprint on medRxiv.org and has not yet been peer-reviewed.

Important point

  • Self-reported post-acute sign and possible sequelae, especially the burden of fatigue and neurocognitive impairment, are 6-12 post-acute infection, even among young and middle-aged adults after mild acute SARS-CoV-2 infection. Months are still significant, overall health and work capacity.

  • Given the burden of COVID sequelae on individuals and society, it is important to quickly identify the underlying biological abnormalities and causes, determine appropriate treatment options, and develop effective rehabilitation measures.

Why this is important

  • Previous studies have shown that acute sequelae of COVID-19 are common, especially among patients hospitalized with COVID-19.

  • However, so far, a large study investigating the association between the symptoms and prevalence of post-COVID syndrome over 6 months after acute infection and the health-related quality of life, well-being, and work capacity of the population. Is almost nonexistent. Base non-clinical sample.

  • Self-reported complaints and symptoms after the acute phase vary. They are non-specific and sometimes have an unknown severity and functional association.

  • With this extensive population-based study, researchers provide evidence of persistent new symptom clusters (not present prior to acute infection) such as fatigue, neurocognitive impairment, chest symptoms, odor or taste disorders, and anxiety. is showing.depression It occurs more than 6 months after an acute infection. The prevalence of each of these five clusters is> 20%.

  • Researchers have also shown that the three most common symptoms (malaise, neurocognitive dysfunction, and chest symptoms) often disrupt daily activities and activities. These symptoms often occur together. Fatigue and neurocognitive dysfunction have the greatest impact on work performance.

  • Long-term sense of smell and dysosmia are documented relatively independently of other complaints.

  • In this cohort, age was not a major determinant of the prevalence of symptoms. The severity of the initial infection and the gender of the woman were consistent risk factors for the various symptoms of mid-term post-COVID syndrome. In addition, age is a risk factor for self-reported workforce decline, exceeding 10% at the overall and population levels.

Research design

  • Researchers conducted a population-based retrospective cohort study in four geographically defined regions of southern Germany.

  • They included individuals aged 18 to 65 years with SARS-CoV-2 infection confirmed by PCR between October 2020 and March 2021.

  • The researchers analyzed the frequency of symptoms 6-12 months after acute infection and before acute infection, expressed as prevalence difference (PD) and prevalence (PR).

  • Researchers measured the severity of symptoms and clustering, risk factors, association with general health recovery, and work capacity.

Main results

  • Of the 11,710 patients (mean age 44.1 years, 59.8% female, previously admitted with COVID-19 3.5%, mean follow-up 8.5 months), PD exceeded 20% and PR exceeded 5% most frequently. The high symptoms were rapid physical symptoms. Fatigue, shortness of breath, poor concentration, chronic fatigue, memory loss, changes in the sense of smell.

  • The main risk factors were the gender of the woman and the severity of the initial infection.

  • The prevalence was fairly high in both men and women with mild acute infections, and PCS significantly affected younger patients.

  • As symptomatic clusters, fatigue (PD, 37.2%) and neurocognitive dysfunction (PD, 31.3%) contributed most to health recovery and diminished work capacity.

  • Chest symptoms, anxiety / depression, which commonly occur and are associated with work capacity headache/ Dizziness and pain syndrome. There was some variation depending on gender and age.

  • The overall estimate of post-COVID syndrome was 28.5%, taking into account new symptoms with at least moderate disability in daily life and less than 80% recovery with general health or work capacity (age). And gender standardization rate, 26.5%).

Limitations

  • The nature of self-reporting of symptoms and sequelae without medical verification lies within the limits.

  • Reporting bias can play a role when individuals explain past symptoms, especially if they have neurocognitive sequelae.

  • There was a limited response with overestimation of the elderly and women.

  • The study area is located around a medium-sized university city, and respondents have completed more education than the general population, which may limit generalization.

  • Researchers have only compared before and after infected patients, so it is not possible to distinguish between the effects of the pandemic itself and its consequences. Non-pharmaceutical and public health interventions for symptoms and manifest reports can affect outcomes.

  • The authors use only one method for symptom clustering, and other approaches may characterize different, perhaps larger clusters.

Research disclosure

This is a preprint summary Research, “Prevalence, determinants, and effects on general health and work capacity of COVID-19 acute sequelae 6-12 months after infection: population-based retrospective cohort study from Southern Germany”, Ulm Raphael S. Peter A university in Ulm, Germany. Published on medRxiv and provided by Medscape. This study has not yet been peer-reviewed. The full study can be found at medRxiv.org.

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Sources

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2/ https://www.medscape.com/viewarticle/971129

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