Subacute Cognitive Impairment in Individuals With Mild and Moderate COVID-19: A Case Series

• DOI: 10.3389/fneur.2021.678924
• Publication Date: 2021-08-04T08:47:12Z
• Authors: Aline de Moura Br...; Flavia Esper Dahy; João Victor Luisi...; Rosa Maria Nascim...; Andre Borges Ferr...; Fernanda Martins ...; Gustavo Bruniera ...; Alvina Clara Felix; Jerusa Smid; Jose Ernesto Vidal; Norberto Anizio F...; Jorge Casseb; Ava Easton; Tom Solomon; Steven S. Witkin; Camila Malta Romano; Augusto César Pen...
• Keywords: Montreal Cognitive Assessment

Background: Previous reported neurologic sequelae associated with SARS-CoV-2 infection have mainly been confined to hospital-based patients in which viral detection was restricted nasal/throat swabs or IgM/IgG peripheral blood serology. Here we describe seven cases from Brazil of outpatients previous mild moderate COVID-19 who developed subacute cognitive disturbances. Methods: From June 1 August 15, 2020, individuals 18 60 years old, confirmed mild/moderate and findings consistent encephalopathy were observed >7 days after respiratory symptom initiation, screened for dysfunction. Paired sera CSF tested (IgA, IgG ELISA, RT-PCR). Serum intrathecal antibody dynamics evaluated oligoclonal bands index. Cognitive dysfunction assessed by the Mini-Mental State Examination (MMSE), Montreal Assessment (MoCA), Clock Drawing Test (CDT). Results: All but one our female, mean age 42.6 years. Neurologic symptoms first a median 16 (IQR 15–33) initial symptoms. had headache altered behavior. phonemic verbal fluency (MoCA) six words/min 5.25–10.75) visuospatial construction four points 4–9) pleocytosis not detected, only patient positive SARS-Co Conclusions: A syndrome suggestive SARS-CoV-2-initiated damage cortico-subcortical associative pathways that could be attributed solely inflammation hypoxia present COVID-19.