Abstract
The coronavirus disease 19 (COVID-19) can cause neurological, psychiatric, psychological, and psychosocial impairments. Literature regarding cognitive impact of COVID-19 is still limited. The aim of this study was to evaluate cognitive deficits and emotional distress among COVID-19 and post–COVID-19 patients who required functional rehabilitation. Specifically, this study explored and compared cognitive and psychological status of patients in the subacute phase of the disease (COVID-19 group) and patients in the postillness period (post–COVID-19 group). Forty patients admitted to rehabilitation units were enrolled in the study and divided into two groups according to the phase of the disease: (a) COVID-19 group (n = 20) and (b) post–COVID-19 group (n = 20). All patients underwent a neuropsychological assessment including Mini-Mental State Evaluation (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Rating Scale for Depression, and Impact of Event Scale–Revised (IES-R). A larger part of the COVID group showed neuropsychological deficits in the total MMSE (35%) compared to the post-COVID group (5%), whereas the majority of both groups (75–70%) reported cognitive impairments in the total MoCA. The post-COVID group reported significantly higher score in MMSE subtests of language (p = 0.02) and in MoCA subtests of executive functions (p = 0.05), language (p = 0.01), and abstraction (p = 0.02) compared to the COVID group. Regarding emotional disturbances, ~40% of patients presented with mild to moderate depression (57.9–60%). The post–COVID-19 group reported significantly higher levels of distress at the IES-R compared to the COVID group (p = 0.02). These findings highlight the gravity of neuropsychological and psychological symptoms that can be induced by COVID-19 infection and the need for tailored rehabilitation, including cognitive training and psychological support.
Highlights
In December 2019, a new disease, the coronavirus disease 2019 (COVID-19), emerged in China and rapidly spread over the world, resulting in a global pandemic on March 11, 2020.Scientific literature suggests that COVID-19 is associated with adverse mental health consequences for general population, hospital staff, and patients, leading to dramatic relapses in the healthcare system worldwide [1, 2].Several studies confirmed high levels of posttraumatic stress disorder (PTSD) symptoms, distress, anxiety, and depression among COVID-19 patients [3, 4]
The total sample for this study included 20 inpatients admitted to a COVID-19 rehabilitation unit and 20 patients admitted to a post–COVID-19 rehabilitation unit in Northern Italy
These results brought further evidence that patients who recovered in COVID and post-COVID functional rehabilitation units presented with cognitive deficits, confirming the results of Alemanno et al [19]
Summary
In December 2019, a new disease, the coronavirus disease 2019 (COVID-19), emerged in China and rapidly spread over the world, resulting in a global pandemic on March 11, 2020.Scientific literature suggests that COVID-19 is associated with adverse mental health consequences for general population, hospital staff, and patients, leading to dramatic relapses in the healthcare system worldwide [1, 2].Several studies confirmed high levels of posttraumatic stress disorder (PTSD) symptoms, distress, anxiety, and depression among COVID-19 patients [3, 4]. Most of studies have explored mental health and psychological consequences of patients with COVID-19, and there is a lack of scientific studies investigating the effects of COVID-19 on cognitive functions [9,10,11]. It is well-known that impairment of cognitive function is common following acute respiratory distress syndrome (ARDS) [12, 13]. In severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), after recovery from the infection, memory and concentration deficits were found in more than 15% of patients up to 39 months following the infection [5]
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