Prevalence and prospective evaluation of cognitive dysfunctions after SARS due to SARS-CoV-2 virus. The COgnitiVID study.

OBJECTIVE: COVID-19 due to SARS-CoV-2 virus is a new cause of severe acute respiratory syndrome (SARS). Little is known about the short-term cognitive prognosis for these patients. We prospectively evaluated basic cognitive functions shortly after care in the intensive care unit (ICU) and three months later in post-ICU COVID-19 patients. MATERIAL AND METHODS: We performed a prospective single-center study in our institution in Paris. Patients with SARS-CoV-2 SARS were prospectively recruited via our ICU. Patients were evaluated using standardized cognitive tests at baseline and at three months' follow-up. Our primary endpoint was the evolution of the following five global tests: MMSE, FAB, oral naming test, Dubois five words test and MADRS. RESULTS: We explored 13 patients at baseline and follow-up. All patients had cognitive impairment at baseline but they all improved at three months, significantly on two of the five global tests after Bonferroni correction for multiple testing: MMSE (median 18 (IQR [15-22]) and 27 (IQR [27-29]) respectively, P=0.002) and FAB test (median 14 (IQR [14-17]) and 17 (IQR [17,18]) respectively, P=0.002). CONCLUSIONS: We report here the first longitudinal data on short-term cognitive impairment after intensive care in COVID-19 patients. We found acute and short-term cognitive impairment but significant improvement at three months. This pattern does not seem to differ from other causes of post-intensive care syndrome.

Effectiveness of mRNA BNT162b2 COVID-19 vaccine against SARS-CoV-2 Delta variant among elderly residents from a long-term care facility, South of France, May 2021.

OBJECTIVE: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Delta variant was classified as a variant of concern in May 2021 due to its increased transmissibility. It became dominant in Europe during the summer, raising concerns on the effectiveness of vaccines. We assessed the vaccine effectiveness (VE) of mRNA BNT162b2 (BioNTech-Pfizer) against SARS-CoV-2 Delta variant during an outbreak affecting long-term care facility (LTCF) residents in southern France, May 2021. MATERIALS AND METHODS: We conducted a retrospective cohort study among LTCF residents. We described sex, age, dependency level, reverse transcription PCR and sequencing results, clinical evolution, vaccination status. We compared attack rates of SARS-CoV-2 infection, symptomatic coronavirus disease 2019 (COVID-19), and severe COVID-19 (respiratory support, hospitalization, and/or death) by vaccination status (two doses administered vs. none) to estimate VE (1 - Relative Risk [RR]) with 95% confidence intervals (CI). VE was adjusted by age (Poisson regression). RESULTS: Among 72 LTCF residents, 75.0% (n=54) were women, mean age was 88.7 (SD 8.1) years, 69% (n=49/71) were severely dependent. SARS-CoV-2 infections were identified in 39 residents (54.2%), 11 with symptomatic, and eight with severe COVID-19. All sequenced samples (n=19, 48.7%) had the same Delta variant genomic sequence. Age-adjusted BNT162b2 VE against SARS-CoV-2 Delta variant infection was 11.2% (95% CI: 0.0-61.1%), it was 88.4% (95% CI: 59.9-96.7%) against symptomatic, and 93.5% (95% CI: 67.2-98.7%) against severe COVID-19. CONCLUSIONS: We found a high BNT162b2 VE against symptomatic and severe COVID-19 caused by SARS-CoV-2 Delta variant among LTCF elderly residents, but not against Delta variant infection. This supports vaccination rollout and the implementation of control measures for close contacts among vaccinated LTCF elderly residents.

Unusual Brain MRI Pattern in 2 Patients with COVID-19 Acute Respiratory Distress Syndrome.

We report the cases of 2 patients hospitalized in our intensive care unit with confirmed coronavirus disease 2019 infection in whom brain MR imaging showed an unusual DWI pattern with nodular and ring-shaped lesions involving the periventricular and deep white matter. We discuss the possible reasons for these findings and their relationship to the infection.