Cognitive and psychological outcomes and follow-up in severely affected COVID-19 survivors admitted to a rehabilitation hospital

Background The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) represents the most recent severe pandemic resulting in coronavirus disease 2019 (COVID-19). COVID-19 can damage the central nervous system, requiring admission to intensive care units (ICU) and aggressive treatments (long-term ventilatory assistance and sedation) to stabilize vitals. Most post-COVID-19 patients experience cognitive impairments and mood or stress disorders. We aimed to study the frequency of cognitive deficits in COVID-19 survivors, the relationship between clinical factors in the acute phase and cognitive outcomes, affective states, and quality of life. We explored cognitive reserve (CR) role, as a post-COVID-19 resilience factor. Methods Twenty-nine COVID-19 inpatients were assessed using a neuropsychological battery, mood scales, quality of life, and social integration questionnaires. Twenty-five were retained through telephone follow-up to monitor cognitive sequelae, affective states, and reintegration levels roughly 8 months after hospital discharge. We administered the Cognitive Reserve Index questionnaire.ResultsWe found most patients display no cognitive deficits. When they did, multi-domain impairment occurred most frequently, especially involving executive functions. Results revealed a significant correlation between depression levels and the interval between ICU admission and tracheal tube removal. We found increased levels of depression and anxiety at follow-up, a significant relationship between resuming daily life activities, high CR, and executive functions. ConclusionsThese findings suggest the importance of psychological support in the long term and the modulating role of cognitive reserve in quality of life after infection.

Automated summary

This study investigated the frequency of cognitive deficits in COVID-19 survivors and the relationship between clinical factors and cognitive outcomes, affective states, and quality of life. The majority of patients did not display cognitive deficits, but when present, multi-domain impairment, particularly involving executive functions, was most common. The study found a significant correlation between depression levels and the interval between ICU admission and tracheal tube removal. Follow-up assessments showed increased levels of depression and anxiety, and a significant relationship between resuming daily life activities, high cognitive reserve, and executive functions. These findings highlight the importance of long-term psychological support and the modulating role of cognitive reserve in quality of life after infection.