ABSTRACT
Cognitive impairment is a prominent symptom of the post-COVID syndrome (PCS). However, the correspondence between subjective cognitive complaints (SCC) and objective results is inconsistent. Here, we investigated this discrepancy. This longitudinal study included N = 42 individuals who reported SCC as PCS after mild infection at inclusion. Data collection comprised questionnaires and neuropsychological assessment at baseline and follow-up (FU). At FU - on average 15 months after acute COVID-19 - 88 % of patients reported persisting SCC. There was an approx. 40 % discrepancy between subjective report and test results at both visits. Patients with SCC and objective impairment indicated elevated fatigue and reduced quality of life compared to patients without SCC at FU. A growing number of patients is anticipated to request neuropsychological assessments even after mild infections.
ABSTRACT
The German Society of Pneumology initiated 2021 the AWMF S1 guideline Long COVID/Post-COVID. In a broad interdisciplinary approach, this S1 guideline was designed based on the current state of knowledge.The clinical recommendations describe current Long COVID/Post-COVID symptoms, diagnostic approaches, and therapies.In addition to the general and consensus introduction, a subject-specific approach was taken to summarize the current state of knowledge.The guideline has an explicit practical claim and will be developed and adapted by the author team based on the current increase in knowledge.
Subject(s)
COVID-19 , Post-Acute COVID-19 Syndrome , HumansABSTRACT
Background and aims: Register studies and cohort analyses of clinical data are essential to study neurological manifestations of COVID-19 at a large scale. Methods: We analyzed neurological manifestations in COVID-19 patients, diagnosed before Aug 25th 2020, and registered in the European multinational LEOSS registry. Results: Of the 3127 COVID-19 patients, 95.2% were hospitalized. In 54.4% at least one neurological symptom, and in 3.3% a new neurological complication occurred. Preexisting neurological comorbidities were reported in 18.1% of the patients. Neurological symptoms were excessive tiredness (27.6%), headache (15.3%), nausea/emesis (14.0%), muscular weakness (13.2%), smell (6.9%), taste disorder (8.3%) and delirium (6.3%). Intracerebral bleeding occurred in 1.2%, ischemic stroke in 0.5%, and meningitis/ encephalitis in 0.4%. Overall, the death rate was 17.5%. It was higher in patients with the following neurological comorbidities: dementia 38.0%, movement disorders 32.8%, and prior cerebrovascular disease 32.3%. A multivariable logistic regression model found age (OR 1.53), cardiovascular diseases (OR 1.74), muscle weakness (OR 1.40), pulmonary diseases (1.49) and male gender (OR 1.52) to be associated with a significantly increased risk for a critical COVID-19 disease course, failed recovery, and death. Conclusion: The neurological manifestations revealed in COVID-19 patients of this study are mostly in agreement with previously published data. Several neurological conditions, such as prior cerebrovascular diseases or dementia appeared to be associated with a higher risk in unadjusted analyses, which was not confirmed in a multivariable analysis adjusting for confounding variables such as age and sex. These findings contrast previously published studies and stress the importance of considering putative confounds in medical statistics carefully.