The effect of donepezil hydrochloride on post-COVID memory impairment: A randomized controlled trial, 2023, Pooladgar et al

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EndME

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The effect of donepezil hydrochloride on post-COVID memory impairment: A randomized controlled trial



Abstract

Background: Post-Coronavirus Disease (COVID-19) condition, known as "post-COVID syndrome," is associated with a range of complications persisting even after recovery. Among these complications, cognitive dysfunction, including memory impairment, has been relatively common observed, impacting executive function and quality of life. To date, no approved treatment exists for this specific complication. Therefore, the present clinical trial aimed to investigate the impact of Donepezil Hydrochloride on post-COVID memory impairment.

Methods: A randomized, controlled trial (Approval ID: IRCT20210816052203N1) was conducted, enrolling 25 patients with post-COVID memory impairment. Participants with a history of hospitalization were randomly assigned to either the drug group (n = 10) or the control group (n = 15). Memory indices were assessed at baseline, one month, and three months later using the Wechsler Memory Scale-Revised test. SPSS software and appropriate statistical tests were employed for data analysis.

Results: The statistical analysis revealed no significant difference in WMS-R subtest and index scores between the drug and control groups at the 4-week and 12-week follow-up periods. However, within the drug group, there was a notable increase in the visual reproduction I and verbal paired associates II subtests during the specified time intervals.

Conclusion: While donepezil 5 mg did not exhibit a significant overall increase in memory scales compared to the control group over time, our findings suggest that this medication may exert a positive effect on specific memory subtests. Further research and exploration are warranted to better understand the potential benefits of donepezil in managing post-COVID-related memory impairment.

https://pubmed.ncbi.nlm.nih.gov/37952347/
 
Results: The statistical analysis revealed no significant difference in WMS-R subtest and index scores between the drug and control groups at the 4-week and 12-week follow-up periods. However, within the drug group, there was a notable increase in the visual reproduction I and verbal paired associates II subtests during the specified time intervals.
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The full text doesn't seem to be open access. It might be interesting to see a table of data.

Given that there was no between group difference on any of the subscores, it must be irrelevant that there was a within group change on a couple of scores. That surely means the control group also improved on those scores, so the drug has not been shown to have any effect.

Looks like a case of cherry picking, presumably so they can try to justify getting funding to do further research.
 
I wouldn't go so far as to say 100 participants are needed, but yes, 10 for the treatment group is just hopeless.

It's worse than that, because these people had been hospitalised with Covid-19. So, there are reasons other than PCS why they might be having cognitive dysfunction. If you only have 10 people given the drug and one of those was developing dementia anyway, and a couple are suffering from brain damage due to a lack of oxygen during their acute disease, even a moderate effect will be buried in noise.
 
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