Neurologic and cognitive sequelae after SARS-CoV2 infection: Different impairment for ICU patients

• DOI: 10.1016/j.jns.2021.120061
• Publication Date: 2021-11-26T15:35:46Z
• Authors: Flavia Mattioli; Simone Piva; Chiara Stampatori; Francesca Righetti; Ilaria Mega; Elena Peli; Emma Sala; Cesare Tomasi; Anna Maria Indeli...; Nicola Latronico; Giuseppe De Palma
• Keywords: Intensive Care Units; 03 medical and health sciences; Cognition; 0302 clinical medicine; SARS-CoV-2; COVID-19; Humans; RNA, Viral; Article; 3. Good health

The exact incidence of neurological and cognitive sequelae of COVID-19 in the long term is yet unknown. The aim of this research is to investigate the type of neurological and cognitive impairment in COVID-19 cases of different severity. Two hundred fifteen patients, who had developed COVID-19, were examined 4 months after the diagnosis by means of neurological exam and extensive cognitive evaluation, investigating general cognition, memory, verbal fluency, visuospatial abilities and executive functions. Fifty-two of them were treated in intensive care unit (ICU patients), whereas 163 were not hospitalized (non-ICU patients). Neurological deficits were found in 2/163 (1.2%) of non-ICU and in 7/52 (13.5%) of the ICU cases, all involving the peripheral nervous system. ICU patients performed significantly worse in all the neuropsychological tests and showed a worse age- and education-corrected cognitive impairment: Cognitive Impairment Index (CII) was higher in ICU than in non-ICU patients (median ICU 3 vs 2, p = .001). CII significantly correlated with age in both groups, was unrelated to length of follow- up, diabetes and hypertension and - only for ICU patients- to PaO2/FiO2 at ICU admission. Obtained results support the greater susceptibility of COVID-19 patients, treated in ICU, to develop neurological deficits and cognitive impairment at a four-month follow up, as compared to cases with mild/moderate symptoms.