Long COVID Neuropsychological Deficits after Severe, Moderate, or Mild Infection

  1. Philippe Voruz
  2. Gilles Allali
  3. Lamyae Benzakour
  4. Anthony Nuber-Champier
  5. Marine Thomasson
  6. Isabele Jacot de Alcântara
  7. Jordan Pierce
  8. Patrice H. Lalive
  9. Karl-Olof Lövblad
  10. Olivia Braillard
  11. Matteo Coen
  12. Jacques Serratrice
  13. Jérôme Pugin
  14. Radek Ptak
  15. Idris Guessous
  16. Basile N. Landis
  17. Frédéric Assal
  18. Julie A. Péron

Reviewed by

Read the full article

Listed in

Log in to save this article

Abstract

There is growing awareness that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, even in its mild or moderate respiratory forms, can include long-term neuropsychological deficits. Standardized neuropsychological, psychiatric, neurological, and olfactory tests were administered to 45 patients 236.51 ± 22.54 days after hospital discharge following severe, moderate, or mild respiratory severity from SARS-CoV-2 infection (severe = intensive care unit hospitalization, moderate = conventional hospitalization, mild = no hospitalization). Deficits were found in all domains of cognition, and the prevalence of psychiatric symptoms was relatively high in the three groups. The severe infection group performed more poorly on long-term episodic memory tests and exhibited greater anosognosia than did the other two groups. Those with moderate infection had poorer emotion recognition, which was positively correlated with persistent olfactory dysfunction. Individuals with mild infection were more stressed, anxious, and depressed. The data support the hypothesis that the virus targets the central nervous system (notably the limbic system) and the notion that there are different neuropsychological phenotypes.

Article activity feed

  1. Version published to 10.3390/ctn6020009
  2. Version published to 10.21203/rs.3.rs-383226/v1 on Research Square
  3. ScreenIT

    SciScore for 10.1101/2021.02.24.21252329: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: After being given a complete description of the study, participants provided their written informed consent.
    IRB: The study was conducted in accordance with the Declaration of Helsinki, and the study protocol was approved by the cantonal ethics committee of Geneva (CER-02186).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The present study had several limitations that need to be acknowledged and addressed before we can draw any inferences from our results. The first drawback was a possible recruitment bias. By enrolling volunteers, we may have selected the most severe cases in the mild group (who were interested in the study because of their cognitive complaints), while we may not have recruited the most cognitively affected in the severe group, because they were too disabled to join the study. Second, we had greater proportions of men and diabetics in the severe group. These factors may have had an influence on the cognitive deficits observed in this group, as diabetes is known to impact cognition (McCrimmon, Ryan, & Frier, 2012), and gender on depression (Spagnolo, Manson, & Joffe, 2020), with a greater prevalence in women (Mazza et al., 2020). That said, although the proportion of women was higher for both the mild and moderate groups, the mean depression scores by gender in the mild (women: 13.50 ± 9.10; men: 12.57 ± 8.52) and moderate (women: 6.11 ± 5.25; men: 13.33 ± 11.25) groups did not indicate a greater proportion of women with depressive symptoms. Third, stroke is more prevalent in patients after a severe SARS-CoV-2 infection (Merkler et al., 2020; Nannoni et al., 2020), and may have gone unseen during the acute phase. In our study, no patient had any central neurological deficit excluding major stroke, but minor stroke cannot be ruled out. Two patients in the severe group reported ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a protocol registration statement.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2021.02.24.21252329v1 on medRxiv