Skip to main content
Top
Published in: Neurological Sciences 8/2022

Open Access 23-05-2022 | SARS-CoV-2 | COVID-19

Cognitive phenotyping of post-infectious SARS-CoV-2 patients

Authors: Edoardo Nicolò Aiello, Alice Radici, Gabriele Mora, Debora Pain

Published in: Neurological Sciences | Issue 8/2022

Login to get access

Abstract

Background

SARS-CoV-2 infection entails neuroinvasive, neuroinflammatory, and treatment-related features accounting for cognitive deficits in COVID-19-recovered patients. Although screening for such dysfunctions in this population is considered clinically relevant, contributions to cognitive phenotyping including premorbid and disease-related confounders are scarcely represented. This study thus aimed at describing the cognitive outcome at the function-/domain-level of post-infectious SARS-CoV-2 patients being already at risk (RCD +) or not (RCD −) for cognitive decline.

Methods

Fifty-four COVID-19-recovered individuals were classified as either RCD + or RCD − according to medical records. The Mini-Mental State Examination (MMSE), Addebrooke Cognitive Examination-Revised (ACE-R), Frontal Assessment Battery (FAB), and Attentive Matrices (AM) were administered (N = 54, 34, 28, and 28 patients, respectively).

Results

Prevalence of defective (cutoff = 24.89) MMSE scores was 24.3% in RCD + patients and 5.9% in the RCD − group. ACE-R-total below cutoff scores were less frequent (RCD + : 5.4%; RCD − : 5.9%). Abnormal performances at the FAB an AM were respectively detected in 18.9% and 8.1% of RCD + patients and 0% and 11.8% of the RCD − group. Within the ACE-R subtests, those assessing orientation, attention, and fluency were the most frequently impaired in both groups. Disease-related variables were mostly unassociated with cognitive measures.

Discussion

Both RCD + and RCD − COVID-19-recovered individuals might show cognitive deficits within the dysexecutive-inattentive and amnesic spectrum. Non-instrumental, executive/attentive dysfunctions are predominant in this population and can be detected by both screening and domain-specific psychometric tests—although the latter might be more sensitive in RCD − patients.
Literature
1.
go back to reference Alemanno F, Houdayer E, Parma A, Spina A, Del Forno A, Scatolini A, Angelone S, Brugliera L, Tettamanti A, Beretta L, Iannaccone S (2021) COVID-19 cognitive deficits after respiratory assistance in the subacute phase: a COVID-rehabilitation unit experience. PLoS One 16:e0246590CrossRef Alemanno F, Houdayer E, Parma A, Spina A, Del Forno A, Scatolini A, Angelone S, Brugliera L, Tettamanti A, Beretta L, Iannaccone S (2021) COVID-19 cognitive deficits after respiratory assistance in the subacute phase: a COVID-rehabilitation unit experience. PLoS One 16:e0246590CrossRef
2.
go back to reference Almeria M, Cejudo JC, Sotoca J, Deus J, Krupinski J (2020) Cognitive profile following COVID-19 infection: clinical predictors leading to neuropsychological impairment. Brain Behav Immun Health 9:100163CrossRef Almeria M, Cejudo JC, Sotoca J, Deus J, Krupinski J (2020) Cognitive profile following COVID-19 infection: clinical predictors leading to neuropsychological impairment. Brain Behav Immun Health 9:100163CrossRef
3.
go back to reference Chen F, Hao L, Zhu S, Yang X, Shi W, Zheng K, Wang T, Chen H (2021) Potential adverse effects of dexamethasone therapy on COVID-19 patients: review and recommendations. Infect Dis Ther 1–25 Chen F, Hao L, Zhu S, Yang X, Shi W, Zheng K, Wang T, Chen H (2021) Potential adverse effects of dexamethasone therapy on COVID-19 patients: review and recommendations. Infect Dis Ther 1–25
4.
go back to reference Daroische R, Hemminghyth MS, Eilertsen TH, Breitve MH, Chwiszczuk LJ (2021) Cognitive impairment after COVID-19 – a review on objective test data. Front Neurol 12:1238CrossRef Daroische R, Hemminghyth MS, Eilertsen TH, Breitve MH, Chwiszczuk LJ (2021) Cognitive impairment after COVID-19 – a review on objective test data. Front Neurol 12:1238CrossRef
5.
go back to reference Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, Kneen R, Defres S, Sejvar J, Solomon T (2020) Neurological associations of COVID-19. Lancet Neurol 19:767–783CrossRef Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, Kneen R, Defres S, Sejvar J, Solomon T (2020) Neurological associations of COVID-19. Lancet Neurol 19:767–783CrossRef
6.
go back to reference García CC, Sánchez EA, Huerta DH, Gómez-Arnau J (2020) Covid-19 treatment-induced neuropsychiatric adverse effects. Gen Hosp Psychiatry 67:163CrossRef García CC, Sánchez EA, Huerta DH, Gómez-Arnau J (2020) Covid-19 treatment-induced neuropsychiatric adverse effects. Gen Hosp Psychiatry 67:163CrossRef
7.
go back to reference Miskowiak KW, Johnsen S, Sattler SM, Nielsen S, Kunalan K, Rungby J, Lapperre T, Porsberg CM (2021) Cognitive impairments four months after COVID-19 hospital discharge: pattern, severity and association with illness variables. Eur Neuropsychopharmacol 46:39–48CrossRef Miskowiak KW, Johnsen S, Sattler SM, Nielsen S, Kunalan K, Rungby J, Lapperre T, Porsberg CM (2021) Cognitive impairments four months after COVID-19 hospital discharge: pattern, severity and association with illness variables. Eur Neuropsychopharmacol 46:39–48CrossRef
8.
go back to reference Wilson BA, Betteridge S, Fish J (2020) Neuropsychological consequences of COVID-19. Neuropsychol Rehabil 30:1625–1628CrossRef Wilson BA, Betteridge S, Fish J (2020) Neuropsychological consequences of COVID-19. Neuropsychol Rehabil 30:1625–1628CrossRef
9.
go back to reference Blazhenets G, Schröter N, Bormann T, Thurow J, Wagner D, Frings L, Weiller C, Meyer PT, Dressing A, Hosp JA (2021) Slow but evident recovery from neocortical dysfunction and cognitive impairment in a series of chronic COVID-19 patients. J Nucl Med Blazhenets G, Schröter N, Bormann T, Thurow J, Wagner D, Frings L, Weiller C, Meyer PT, Dressing A, Hosp JA (2021) Slow but evident recovery from neocortical dysfunction and cognitive impairment in a series of chronic COVID-19 patients. J Nucl Med
10.
go back to reference Woo MS, Malsy J, Pöttgen J, SeddiqZai S, Ufer F, Hadjilaou A, Schmiedel S, Addo MM, Gerloff C, Heesen C, Schulze ZurWiesch J (2020) Frequent neurocognitive deficits after recovery from mild COVID-19. Brain Commun 2:205CrossRef Woo MS, Malsy J, Pöttgen J, SeddiqZai S, Ufer F, Hadjilaou A, Schmiedel S, Addo MM, Gerloff C, Heesen C, Schulze ZurWiesch J (2020) Frequent neurocognitive deficits after recovery from mild COVID-19. Brain Commun 2:205CrossRef
11.
go back to reference Beaud V, Crottaz-Herbette S, Dunet V, Vaucher J, Bernard-Valnet R, Du Pasquier R, Bart PA, Clarke S (2021) Pattern of cognitive deficits in severe COVID-19. J Neurol Neurosurg Psychiatry 92:567–568CrossRef Beaud V, Crottaz-Herbette S, Dunet V, Vaucher J, Bernard-Valnet R, Du Pasquier R, Bart PA, Clarke S (2021) Pattern of cognitive deficits in severe COVID-19. J Neurol Neurosurg Psychiatry 92:567–568CrossRef
12.
go back to reference Ferrucci R, Dini M, Groppo E, Rosci C, Reitano MR, Bai F, Poletti B, Brugnera A, Silani V, D’Arminio Monforte A, Priori A (2021) Long-lasting cognitive abnormalities after COVID-19. Brain Sci 11:235CrossRef Ferrucci R, Dini M, Groppo E, Rosci C, Reitano MR, Bai F, Poletti B, Brugnera A, Silani V, D’Arminio Monforte A, Priori A (2021) Long-lasting cognitive abnormalities after COVID-19. Brain Sci 11:235CrossRef
13.
go back to reference Zhou H, Lu S, Chen J, Wei N, Wang D, Lyu H, Shi C, Hu S (2020) The landscape of cognitive function in recovered COVID-19 patients. J Psychiatr Res 129:98–102CrossRef Zhou H, Lu S, Chen J, Wei N, Wang D, Lyu H, Shi C, Hu S (2020) The landscape of cognitive function in recovered COVID-19 patients. J Psychiatr Res 129:98–102CrossRef
14.
go back to reference Aiello EN, Fiabane E, Manera MR, Radici A, Grossi F, Ottonello M, Pain D, Pistarini C (2021b) Screening for cognitive sequelae of SARS-CoV-2 infection: a comparison between the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Neurol Sci 43:81–84CrossRef Aiello EN, Fiabane E, Manera MR, Radici A, Grossi F, Ottonello M, Pain D, Pistarini C (2021b) Screening for cognitive sequelae of SARS-CoV-2 infection: a comparison between the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Neurol Sci 43:81–84CrossRef
15.
go back to reference Aiello EN, Fiabane E, Manera MR, Radici A, Grossi F, Ottonello M, Vassallo C, Pain D, Pistarini C (2021c) Episodic long-term memory in post-infectious SARS-CoV-2 patients. Neurol Sci 43:785–788CrossRef Aiello EN, Fiabane E, Manera MR, Radici A, Grossi F, Ottonello M, Vassallo C, Pain D, Pistarini C (2021c) Episodic long-term memory in post-infectious SARS-CoV-2 patients. Neurol Sci 43:785–788CrossRef
16.
go back to reference Manera MR, Fiabane E, Pain D, Aiello EN, Radici A, Ottonello M, Padovani M, Wilson BA, Fish J, Pistarini C (2021) Clinical features and cognitive sequelae in COVID-19: a retrospective study on N=152 patients. Neurol Sci 43:45–50CrossRef Manera MR, Fiabane E, Pain D, Aiello EN, Radici A, Ottonello M, Padovani M, Wilson BA, Fish J, Pistarini C (2021) Clinical features and cognitive sequelae in COVID-19: a retrospective study on N=152 patients. Neurol Sci 43:45–50CrossRef
17.
go back to reference Stracciari A, Bottini G, Guarino M, Magni E, Pantoni L (2021) Cognitive and behavioral manifestations in SARS-CoV-2 infection: not specific or distinctive features? Neurol Sci 42:2273–2281CrossRef Stracciari A, Bottini G, Guarino M, Magni E, Pantoni L (2021) Cognitive and behavioral manifestations in SARS-CoV-2 infection: not specific or distinctive features? Neurol Sci 42:2273–2281CrossRef
18.
go back to reference Aiello EN, Esposito A, Gramegna C, Gazzaniga V, Zago S, Difonzo T, Appollonio I, Bolognini N (2021) The Frontal Assessment Battery (FAB) and its sub-scales: validation and updated normative data in an Italian population sample. Neurol Sci 43:979–984CrossRef Aiello EN, Esposito A, Gramegna C, Gazzaniga V, Zago S, Difonzo T, Appollonio I, Bolognini N (2021) The Frontal Assessment Battery (FAB) and its sub-scales: validation and updated normative data in an Italian population sample. Neurol Sci 43:979–984CrossRef
19.
go back to reference World Health Organization (2020) Clinical management of COVID-19: interim guidance, 27 May 2020 (No. WHO/2019-nCoV/clinical/2020.5). World Health Organization World Health Organization (2020) Clinical management of COVID-19: interim guidance, 27 May 2020 (No. WHO/2019-nCoV/clinical/2020.5). World Health Organization
20.
go back to reference Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRef Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198CrossRef
21.
go back to reference Carpinelli Mazzi M, Iavarone A, Russo G, Musella C, Milan G, D’Anna F, Garofalo E, Chieffi S, Sannino M, Illario M, De Luca V (2020) Mini-Mental State Examination: new normative values on subjects in Southern Italy. Aging Clin Exp Res 32:699–702 Carpinelli Mazzi M, Iavarone A, Russo G, Musella C, Milan G, D’Anna F, Garofalo E, Chieffi S, Sannino M, Illario M, De Luca V (2020) Mini-Mental State Examination: new normative values on subjects in Southern Italy. Aging Clin Exp Res 32:699–702
22.
go back to reference Mioshi E, Dawson K, Mitchell J, Arnold R, Hodges JR (2006) The Addenbrooke’s Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. Int J Geriatr Psychiatry 21:1078–1085CrossRef Mioshi E, Dawson K, Mitchell J, Arnold R, Hodges JR (2006) The Addenbrooke’s Cognitive Examination Revised (ACE-R): a brief cognitive test battery for dementia screening. Int J Geriatr Psychiatry 21:1078–1085CrossRef
23.
go back to reference Siciliano M, Raimo S, Tufano D, Basile G, Grossi D, Santangelo F, Trojano L, Santangelo G (2016) The Addenbrooke’s Cognitive Examination Revised (ACE-R) and its sub-scores: normative values in an Italian population sample. Neurol Sci 37:385–392CrossRef Siciliano M, Raimo S, Tufano D, Basile G, Grossi D, Santangelo F, Trojano L, Santangelo G (2016) The Addenbrooke’s Cognitive Examination Revised (ACE-R) and its sub-scores: normative values in an Italian population sample. Neurol Sci 37:385–392CrossRef
24.
go back to reference Dubois B, Slachevsky A, Litvan I, Pillon B (2000) The FAB: a frontal assessment battery at bedside. Neurology 55:1621–1626CrossRef Dubois B, Slachevsky A, Litvan I, Pillon B (2000) The FAB: a frontal assessment battery at bedside. Neurology 55:1621–1626CrossRef
25.
go back to reference Spinnler H, Tognoni G (1987) Standardizzazione e taratura italiana di test neuropsicologici. Neurol Sci 6:1–120 Spinnler H, Tognoni G (1987) Standardizzazione e taratura italiana di test neuropsicologici. Neurol Sci 6:1–120
26.
go back to reference Capitani E, Laiacona M (2017) Outer and inner tolerance limits: their usefulness for the construction of norms and the standardization of neuropsychological tests. Clin Neuropsychol 31:1219–1230CrossRef Capitani E, Laiacona M (2017) Outer and inner tolerance limits: their usefulness for the construction of norms and the standardization of neuropsychological tests. Clin Neuropsychol 31:1219–1230CrossRef
27.
go back to reference Guedj E, Million M, Dudouet P, Tissot-Dupont H, Bregeon F, Cammilleri S, Raoult D (2021) 18 F-FDG brain PET hypometabolism in post-SARS-CoV-2 infection: substrate for persistent/delayed disorders? Eur J Nucl Med Mol Imaging 48:592–595CrossRef Guedj E, Million M, Dudouet P, Tissot-Dupont H, Bregeon F, Cammilleri S, Raoult D (2021) 18 F-FDG brain PET hypometabolism in post-SARS-CoV-2 infection: substrate for persistent/delayed disorders? Eur J Nucl Med Mol Imaging 48:592–595CrossRef
28.
go back to reference Toniolo S, Di Lorenzo F, Scarioni M, Frederiksen KS, Nobili F (2021) Is the frontal lobe the primary target of SARS-CoV-2? J Alzheimers Dis 1–7 Toniolo S, Di Lorenzo F, Scarioni M, Frederiksen KS, Nobili F (2021) Is the frontal lobe the primary target of SARS-CoV-2? J Alzheimers Dis 1–7
29.
go back to reference Søraas A, Bø R, Kalleberg KT, Støer NC, Ellingjord-Dale M, Landrø NI (2021) Self-reported memory problems 8 months after COVID-19 infection. JAMA Netw Open 4:e2118717–e2118717CrossRef Søraas A, Bø R, Kalleberg KT, Støer NC, Ellingjord-Dale M, Landrø NI (2021) Self-reported memory problems 8 months after COVID-19 infection. JAMA Netw Open 4:e2118717–e2118717CrossRef
30.
go back to reference Mattioli F, Piva S, Stampatori C, Righetti F, Mega I, Peli E, Sala E, Tomasi C, Indelicato AM, Latronico N, De Palma G (2021) Neurologic and cognitive sequelae after SARS-CoV2 infection: different impairment for ICU patients. J Neurol Sci 120061 Mattioli F, Piva S, Stampatori C, Righetti F, Mega I, Peli E, Sala E, Tomasi C, Indelicato AM, Latronico N, De Palma G (2021) Neurologic and cognitive sequelae after SARS-CoV2 infection: different impairment for ICU patients. J Neurol Sci 120061
Metadata
Title
Cognitive phenotyping of post-infectious SARS-CoV-2 patients
Authors
Edoardo Nicolò Aiello
Alice Radici
Gabriele Mora
Debora Pain
Publication date
23-05-2022
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 8/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-022-06130-8

Other articles of this Issue 8/2022

Neurological Sciences 8/2022 Go to the issue