Neuropsychological Features of Severe Hospitalized Coronavirus Disease 2019 Patients at Clinical Stability and Clues for Postacute Rehabilitation
Open accessAbstract
Objectives To report the cognitive features of patients with severe coronavirus disease 2019 (COVID-19) entering the postacute phase, to understand whether COVID-19 acute respiratory distress syndrome itself could result in long-term cognitive deficits, and to determine whether neuropsychological treatment after the acute stage might represent a specific rehabilitation need.Design Case series.Setting Rehabilitation hospital.Participants We assessed the general cognitive functioning through tablet-supported video calls in 9 of 12 consecutive patients (N=9) admitted to the hospital at least 30 days earlier for acute respiratory distress syndrome due to COVID-19. Three patients were excluded based on the exclusion criteria. None of the patients presented cognitive symptoms before hospitalization.Main outcome measure General cognitive functioning, measured using the Mini-Mental State Examination (MMSE) test.Results A general cognitive decay was observed in 3 patients (33.3%) who had a pathologic score on the MMSE, with a specific decline in attention, memory, language, and praxis abilities. The cognitive malfunctioning appears to be linearly associated with the length of stay (in d) in the intensive care unit (ICU). The longer the amount of time spent in the ICU, the lower the MMSE score, indicating a lower global cognitive functioning.Conclusions Our results indicate that some patients with COVID-19 might also benefit from neuropsychological rehabilitation, given their possible global cognitive decay. The link between neuropsychological functioning and the length of stay in the ICU suggests that neurocognitive rehabilitative treatments should be directed explicitly toward patients who treated in the ICU, rather than toward every patient who experienced acute respiratory distress syndrome owing to COVID-19. However, given the limitation of a case series study, those hypotheses should be tested with future studies with larger samples and a longer follow-up period.
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Preliminary studies of convalescent COVID-19 patients using comprehensive neuropsychological assessment showed cognitive impairment two to four weeks after infection.
“Preliminary studies of convalescent COVID-19 patients using comprehensive neuropsychological assessment showed cognitive impairment two to four weeks after infection.”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [141]
Attentional deficits were the most relevant changes in convalescent COVID-19 patients.
“Attentional deficits were the most relevant changes [140, 141].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [141]
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- Authors
- Negrini, F., Ferrario, I., Mazziotti, D., Berchicci, M., Bonazzi, M., de Sire, A., Negrini, S., & Zapparoli, L.
- Affiliations
- IRCCS Ospedale Galeazzi - Sant'Ambrogio (IT)
- Istituto Scientifico Italiano Colonna Vertebrale (IT)
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 102
- Issue
- 1
- Pages
- 155-158
- ISSN
- 0003-9993 (ISSN-L)
- PMC
- PMC7521874
- OpenAlex
- W3088369215
- Cited by
- 121
- References
- 18
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 14 · 2023: 27 · 2022: 31 · 2021: 34
- FWCI
- 9.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- BOA (University of Milano-Bicocca) (submittedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- Lirias (submittedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 pandemic, neuropsychological rehabilitation, acute respiratory distress syndrome, ICU length of stay, cognitive impairment, attention and memory deficits, Mini-Mental State Examination, hospitalized patients
- MeSH terms
- Mental Status and Dementia Tests, COVID-19, SARS-CoV-2, Adult, Aged, Cognition Disorders, Female, Hospitalization, Humans, Intensive Care Units, Length of Stay, Male, Middle Aged, Pneumonia, Viral, Risk Factors, Subacute Care
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