Persistence and emergence of new neuropsychological deficits following SARS-CoV-2 infection : A follow-up assessment of the Geneva COVID-COG cohort

Article Article scientifique Article Persistence and emergence of new neuropsychological deficits following SARS-CoV-2 infection : A follow-up assessment of the Geneva COVID-COG cohort eng 2024-03-08 2024-03-08 author Voruz Philippe 0000-0001-6796-8807 Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland 804968 Section de psychologie (PSICO) author Jacot De Alcantara Isabele Harumi 0000-0002-2033-6287 Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland 837619 Section de psychologie (PSICO) author Nuber-Champier Anthony Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland 875567 Services communs du CISA (EMCO) Anthony Nuber author Cionca Alexandre Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland 973225 author Guerin Delphine Sophie Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland 923061 author Allali Gilles Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Switzerland 507314 Département des neurosciences cliniques (OTONO) author Benzakour Lamyae Faculty of Medicine, University of Geneva, Switzerland 889158 Département de psychiatrie (PSYAT) author Lalive d'Epinay Patrice Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Switzerland 636926 Département des neurosciences cliniques (OTONO) author Lövblad Karl-Olof Faculty of Medicine, University of Geneva, Switzerland 135154 Département de radiologie et informatique médicale (RADIO) author Braillard Olivia Thanh-Lan Division and Department of Primary Care, Geneva University Hospitals, Switzerland 543059 author Nencha Umberto Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Switzerland 991110 author Nehme Mayssam Division and Department of Primary Care, Geneva University Hospitals, Switzerland 840942 Département de santé et médecine communautaire (MECOM) author Coen Matteo 0000-0002-6156-1691 Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Switzerland 601519 Département de médecine (DEMED) author Serratrice Jacques Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Switzerland 836481 Département de médecine (DEMED) author Reny Jean-Luc 0000-0002-7528-7363 Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Switzerland 704339 Département de médecine (DEMED) author Pugin Jérôme Faculty of Medicine, University of Geneva, Switzerland 69624 Décanat et administration de la faculté de médecine (ADMED) author Guessous Idris Faculty of Medicine, University of Geneva, Switzerland 760565 Médecine de premier recours hospitalo-universitaire (MPRHU) author Landis Basile Nicolas Faculty of Medicine, University of Geneva, Switzerland 133537 Département des neurosciences cliniques (OTONO) author Assal Frédéric Department of Clinical Neurosciences, Neurology Department, Geneva University Hospitals, Switzerland 527005 Département des neurosciences cliniques (OTONO) author Peron Julie Anne Clinical and Experimental Neuropsychology Laboratory, Faculty of Psychology, University of Geneva, Geneva, Switzerland 705680 Section de psychologie (PSICO) 05008 10.7189/jogh.14.05008 38452292 2047-2978 PMC10919907 https://jogh.org/2024/jogh-14-05008 Background: Despite numerous observations of neuropsychological deficits immediately following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, little is known about what happens to these deficits over time and whether they are affected by changes in fatigue and any psychiatric symptoms. We aimed to assess the prevalence of neuropsychological deficits at 6-9 months and again at 12-15 months after coronavirus disease 2019 (COVID-19) and to explore whether it was associated with changes in fatigue and psychiatric symptoms. Methods: We administered a series of neuropsychological tests and psychiatric questionnaires to 95 patients (mean age = 57.12 years, standard deviation (SD) = 10.68; 35.79% women) 222 (time point 1 (T1)) and 441 (time point 2 (T2)) days on average after infection. Patients were categorised according to the severity of their respiratory COVID-19 symptoms in the acute phase: mild (no hospitalisation), moderate (conventional hospitalisation), and severe (hospitalisation in intensive care unit (ICU) plus mechanical ventilation). We ran Monte-Carlo simulation methods at each time point to generate a simulated population and then compared the cumulative percentages of cognitive disorders displayed by the three patient subgroups with the estimated normative data. We calculated generalised estimating equations for the whole sample to assess the longitudinal associations between cumulative neuropsychological deficits, fatigue, and psychiatric data (anxiety, depressive symptoms, posttraumatic stress disorder, and apathy). Results: Most participants (>50%) exhibited a decrease in their neuropsychological impairments, while approximately 25% showed an escalation in these cognitive deficits. At T2, patients in the mild subgroup remained free of accumulated neuropsychological impairments. Patients with moderate severity of symptoms displayed a decrease in the magnitude of cumulative deficits in perceptual and attentional functions, a persistence of executive, memory and logical reasoning deficits, and the emergence of language deficits. In patients with severe symptoms, perceptual deficits emerged and executive deficits increased, while attentional and memory deficits remained unchanged. Changes in executive functions were significantly associated with changes in depressive symptoms, but the generalised estimating equations failed to reveal any other significant effect. Conclusion: While most cumulative neuropsychological deficits observed at T1 persisted and even worsened over time in the subgroups of patients with moderate and severe symptoms, a significant proportion of patients, mainly in the mild subgroup, exhibited improved performances. However, we identified heterogeneous neuropsychological profiles both cross-sectionally and over time, suggesting that there may be distinct patient phenotypes. Predictors of these detrimental dynamics have yet to be identified. Aged COVID-19 Cognition Disorders / diagnosis Cognition Disorders / psychology Fatigue / epidemiology Female Follow-Up Studies Humans Male Middle Aged SARS-CoV-2 Dewey 616.8 Dewey 616.89 Dewey 613 Dewey 616.0757 Dewey 616 Dewey 617 Dewey 150 Dewey 618.97 Swiss National Science Foundation Short- and long-term neuropsychological impairment following COVID-19 198438 CH Programmes 62 Département de radiologie et informatique médicale 227 61 Département des neurosciences cliniques 226 60 Département de psychiatrie 225 201 Institut de médecine de premier recours 22A9 65 Département de réadaptation et gériatrie 22B 56 Département de médecine 221 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 108 Section de psychologie 71 false 470 Ischémie cérébrale et connectivité 801 11 Plaquettes et antithrombotiques 13 319 Groupe Perrier Arnaud (Médecine interne générale, de réhabilitation et de gériatrie) 585 1409 Neuropsychologie clinique et expérimentale (CENLab) 505 Scléroses en plaques, neuroimmunologie, encéphalite autoimmune expérimentale 843 321 Groupe Pugin Jérôme (Soins intensifs) 587 1313 Médecine de 1er recours 1020 928 Neuropsychologie et neurologie comportementale 951 Journal of global health 14 ccd42685-7728-44ee-b8c5-02bbe80f4a95 Article (Published version) Public jogh-14-05008.pdf 1436390 application/pdf CC BY-4.0 6f954d5550523b8d9290d7c96a944b48e2697966027a9a54cf449bd1007ea68a 94a7280d-3825-482d-84e9-7885c60cdceb Supplemental data Public jogh-14-05008-s001.pdf 218269 application/pdf 33cf85c6d67fa60982dd8a212a8d9d9e2679e40eb1f2b0ca8d5e8bb212a8c2bf openAccess Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques Faculté de médecine / Section de médecine clinique / Département de psychiatrie Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de médecine de premier recours Faculté de médecine / Section de médecine clinique / Département de réadaptation et gériatrie Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de psychologie et des sciences de l'éducation / Section de psychologie

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Persistence and emergence of new neuropsychological deficits following SARS-CoV-2 infection : A follow-up assessment of the Geneva COVID-COG cohort	Journal of global health	2024	130	166
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