What are the neuropsychiatric consequences of SARS-CoV-2 infection?

In a recent study posted on medrex sib*Serber, researchers investigated cognitive deficits associated with acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Background

Previous studies have documented cognitive impairment after acute coronavirus disease (COVID-19) in 2019. However, the majority of such studies used few quantitative measures. Many of the patients who used quantitative measures for their assessment did not use control cohorts and limited their assessment to hospitalized patients. Furthermore, the neuropsychological assessments performed in these studies were neither detailed nor comprehensive, and some studies used unsupervised telephonic assessments of cognitive status (TICS).

About research

In this study, researchers recruited 45 participants aged 18 to 70 from the University of Maryland Clinic, USA. Of these, 11 participants had long-term COVID-19, 14 had acute COVID-19, and 20 had no history of COVID-19. They created three study cohorts.

Eleven participants with Long-COVID had persistent symptoms 16 weeks after initial infection. Clinicians with expertise in Long-COVID investigations interviewed these participants to ascertain the status of her initial SARS-CoV-2 infection. Additionally, we ensured that none of the participants had a substance use disorder or used alcohol, marijuana, or nicotine regularly in the past 90 days. They screened for these substances on the day of testing using a urine drug screen. In addition, we excluded participants with pregnancy, neurological disorders, incarcerated prisoners, and heart or lung disease.

the team made a quick attack antigen A test (RAT) to ensure that all study participants were free of acute COVID-19 infection on the day of entry. The researchers required all study participants to complete her eight-item online her questionnaire, which included questions about her COVID-19 status (e.g., status on date of vaccination, treatment).

More importantly, the team used the National Institutes of Health (NIH) toolbox to conduct behavioral assessments directly. I received This test included his 14 consecutive trials of 20 seconds each. They calculated the total number of items processed (TN), the percentage of errors (E%), and the number of correct items (TNE) for each participant. These values ​​helped researchers calculate the concentration performance (CP) of each participant.

In multiple regression analysis, the team used each demographic, such as age, gender, and education, as a fixed effect. Study results consisted of a Neuro-Quality of Life Questionnaire (Neuro-QoL) report and cognitive and sensorimotor measures. Finally, the researchers used Hotelling’s Her two-sample T2 multivariate test to examine differences in her Neuro-QoL response profiles for all participants.

Survey results

Participants in all three study cohorts were of similar age, sex, and education, and none failed a drug screening test.

Researchers found that Long-COVID participants, that is, those with persistent cognitive symptoms after the acute phase of the illness, experienced more anxiety, fatigue, sleep disturbance, apathy, and anxiety than individuals who did not experience COVID-19. We also noted that there was a lot of emotional dysregulation. In addition, these participants had cognitive decline. Similarly, Hotelling’s two-sample T2 test demonstrated these differences, with a T.2 value of 6.48. Except for depression, all other comparisons between long-term COVID and No-COVID based on the NIH toolbox Neuro-QoL score were statistically significant.

The extent of impairment across different neuropsychological domains also differed among participants in the three study groups. Results from the d2 Test of Attention provide evidence of impaired sustained attention, selective attention, and processing speed in the COVID-19 group. Similarly, the Erichsen Flanker task also demonstrated attentional dysfunction associated with SARS-CoV-2 infection. Her 9-hole pegboard test, a measure of visuomotor function, also showed that COVID-19 patients had abnormal motor skills, likely further enhanced due to attention deficits. Finally, the Mini-Mental Status Exam showed no cognitive impairment in her moderate COVID-19 patients compared to controls.

Similar to the study by Zhao et al., the results of the current study pointed to deficits in selective attention, sustained attention, and visuomotor coordination in the study population. It was likely due to the severity of the study participant’s infection, given that his 30.8% of study participants required hospitalization.

However, researchers were unable to identify objective biomarkers for predicting variations in cognitive and sensorimotor effects after SARS-CoV-2 infection. SARS-CoV-2 infection may therefore affect the brain only in a subgroup of infected individuals. Another interesting finding was that some of his COVID-19 participants who did not self-report cognitive problems performed poorly on psychometric tests, suggesting that SARS-CoV-2 infection was asymptomatic. Indicates that it may have an impact.

Conclusion

The current study showed deficits in attention, processing speed, visuomotor coordination, and declarative memory beyond 14 weeks after SARS-CoV-2 infection. Although the extent of impairment varied across neuropsychological domains, self-reported estimates of Neuro-QoL change may have been global.

As poor concentration and mental fatigue emerged as the main complaints of Long-COVID patients, future studies should investigate their underlying neuropathophysiological mechanisms. Additionally, research is needed to determine whether structural and functional brain changes cause these behavioral and performance deficits after acute COVID-19.

*Important Notices

medRxiv publishes non-peer-reviewed, preliminary scientific reports and should not be considered conclusive, to guide clinical practice/health-related actions, or to be treated as established information .