Perceived Cognitive Deficits in Patients With Symptomatic SARS-CoV-2 and Their Association With Post–COVID-19 Condition, 2023, Liu et al

Perceived Cognitive Deficits in Patients With Symptomatic SARS-CoV-2 and Their Association With Post–COVID-19 Condition

Teresa C. Liu, Sun M. Yoo, Myung. S. Sim, Yash Motwani, Nisha Viswanathan, Neil S. Wenger


Abstract

Importance Neuropsychiatric symptoms are common in acute SARS-CoV-2 infection and in post–COVID-19 condition (PCC; colloquially known as long COVID), but the association between early presenting neuropsychiatric symptoms and PCC is unknown.

Objective To describe the characteristics of patients with perceived cognitive deficits within the first 4 weeks of SARS-CoV-2 infection and the association of those deficits with PCC symptoms.

Design, Setting, and Participants This prospective cohort study was conducted from April 2020 to February 2021, with follow-up of 60 to 90 days. The cohort consisted of adults enrolled in the University of California, Los Angeles, SARS-CoV-2 Ambulatory Program who had a laboratory-confirmed symptomatic SARS-CoV-2 infection and were either hospitalized in a University of California, Los Angeles, hospital or one of 20 local health care facilities, or were outpatients referred by a primary care clinician. Data analysis was performed from March 2022 to February 2023.

Exposure Laboratory-confirmed SARS-CoV-2 infection.

Main Outcomes and Measures Patients responded to surveys that included questions about perceived cognitive deficits modified from the Perceived Deficits Questionnaire, Fifth Edition, (ie, trouble being organized, trouble concentrating, and forgetfulness) and symptoms of PCC at 30, 60, and 90 days after hospital discharge or initial laboratory-confirmed infection of SARS-CoV-2. Perceived cognitive deficits were scored on a scale from 0 to 4. Development of PCC was determined by patient self-report of persistent symptoms 60 or 90 days after initial SARS-CoV-2 infection or hospital discharge.

Results Of 1296 patients enrolled in the program, 766 (59.1%) (mean [SD] age, 60.0 [16.7] years; 399 men [52.1%]; 317 Hispanic/Latinx patients [41.4%]) completed the perceived cognitive deficit items at 30 days after hospital discharge or outpatient diagnosis. Of the 766 patients, 276 (36.1%) perceived a cognitive deficit, with 164 (21.4%) having a mean score of greater than 0 to 1.5 and 112 patients (14.6 %) having a mean score greater than 1.5. Prior cognitive difficulties (odds ratio [OR], 1.46; 95% CI, 1.16-1.83) and diagnosis of depressive disorder (OR, 1.51; 95% CI, 1.23-1.86) were associated with report of a perceived cognitive deficit. Patients reporting perceived cognitive deficits in the first 4 weeks of SARS-CoV-2 infection were more likely to report symptoms of PCC than those without perceived cognitive deficits (118 of 276 patients [42.8%] vs 105 of 490 patients [21.4%]; χ21, 38.9; P < .001). Adjusting for demographic and clinical factors, perceived cognitive deficits in the first 4 weeks of SARS-CoV-2 were associated with PCC symptoms (patients with a cognitive deficit score of >0 to 1.5: OR, 2.42; 95% CI, 1.62-3.60; patients with cognitive deficit score >1.5: OR, 2.97; 95% CI, 1.86-4.75) compared to patients who reported no perceived cognitive deficits.

Conclusions and Relevance These findings suggest that patient-reported perceived cognitive deficits in the first 4 weeks of SARS-CoV-2 infection are associated with PCC symptoms and that there may be an affective component to PCC in some patients. The underlying reasons for PCC merit additional exploration.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2804555

 

Honestly it's getting easy to see why medicine has made zero progress in diseases like Alzheimer's. Recent news of such progress aside, let's see if it even holds up. You'd think that they could take disabling cognitive impairment like this seriously, but wow would that be a wrong assumption. They just can't.

They just don't know what to do here, don't even know how to get started when all they have to work with are symptoms and lots and lots of evidence but nothing that is universal. When they don't know the biology it's just spiritualism and weird woo. And when you don't get the same outcome every time it's like they just freeze and have to blame any random thing instead.

It's been 3 years and they're still publishing this weak intro level stuff with the same old boring default to "uh, must be the feelings, I guess". It's really looking like most progress here is just brute force. Get millions of people to work on stuff for a long time and they can't really fail to find some things, but they'll still miss most things because nothing ever builds on itself.

The whole process is barely as smart as slime mold going around finding a path. It's just random. Except worse, because random doesn't somehow keep using the same handful of numbers over and over again. Well, pseudorandom generators do, so I guess that's that. It's not even random, it's pseudorandom, literally worse than random.

I didn't even know failure of this scale existed anymore. It seems so unrealistic, farcical even.

 

Science Media Centre's (UK) take on this:

Dr Michael Zandi, Consultant Neurologist, UCL, said:

“The authors present a study looking at factors that go hand in hand with memory and other cognitive symptoms after Covid, and show that these symptoms are common and can predict the development of long covid.

"The authors show an association between the presence of cognitive symptoms and the presence of preceding depression and anxiety symptoms and also with other long covid symptoms.

"Correlation is not causation, and while psychological factors are important to address where present in patients after Covid, we cannot assume that cognitive symptoms are caused by these factors alone.

"There is an urgent need to understand the biology underlying these symptoms to allow selection of patients for treatments in drug trials in parallel with appropriate rehabilitation.”


Declared interests
Dr Michael Zandi: “I am involved in Covid (COVID CNS study) and long Covid (STIMULATE ICP trial, MODEL COV) research, but have no financial interests in these nor in any companies or covid treatments. I see patients with long covid neurological symptoms as part of the UCLH service.”



https://www.sciencemediacentre.org/...-covid-and-their-association-with-long-covid/