Prolonged clinical monitoring of cognitive performance and psychiatric symptoms among PACS

Background To date, follow-up neurocognitive evaluations in individuals with Post-acute COVID-19 Syndrome (PACS) indicate that some level of impaired performance persists in at least one cognitive domain, typically affecting the same functions initially compromised. In the present study, we aim to enrich longitudinal evidence on cognitive dysfunction and psychiatric symptoms in an Italian sample with PACS. Material and method All patients performed a neurocognitive assessment (NCA) of 20 tests across 5 cognitive domains (memory, attention, language, executive functions, speed of psycho-motor processing) and neuropsychiatric symptoms questionnaires (anxiety, depression and sleep quality) to evaluate their possible influence on neurocognitive performance (NP) at three time points. Categorical variables were analyzed using Chi-Square or Fisher's exact tests, and quantitative variables were compared using the non-parametric Friedman test. Results Overall, 42 patients, 35.7% female, with a median age of 57 years (IQR 38–81) and 13 years of education (IQR 8–18) performed NCA. NP of six cognitive functions improved over time (verbal short-term learning, p = 0.032; short-term memory for visuo-spatial stimuli, p < 0.0001; working memory, p = 0.002; constructional praxis, p = 0.018; phonological verbal fluency, p = 0.05; speed of psychomotor processing, p = 0.002). Also sleep quality improved over time, p < 0.0001 (Table 2). Conclusion This study shows improvement over time in memory, executive functions and language during over the 18-month follow-up period in PACS. However, specific areas of neuropsychological performance may remain stable or decline during the follow-up period.