ABSTRACT
Objective: The neuropsychological impact of COVID-19 is a budding area of research. Studies suggest greater neurological abnormalities in patients presenting with a severe illness course, particularly those with acute respiratory distress syndrome. The purpose of this case study was to characterize the neurocognitive and psychological profile of a 57-year-old male following prolonged hospitalization for COVID-19 in March 2020, including 42 days on mechanical ventilation. Method: Relevant data were collected via clinical interview, neuropsychological testing, and medical record review. Hospital course was notable for hypertension, acute kidney failure, and pressure ulcers. Computerized tomography and electroencephalogram revealed mild cortical atrophy and mild to moderate generalized slowing, respectively. Approximately 15 months post-discharge, subjective complaints during the evaluation included cognitive "fogginess," increased impulsivity, decreased frustration tolerance, forgetfulness, fatigue, mobility difficulties, and dyspnea upon exertion. Results: Neuropsychological testing, within the context of likely average premorbid functioning, revealed declines in motor functioning, confrontation naming, phonemic fluency, planning/organization, visual memory, and aspects of verbal memory. Poor performance on select memory tasks was likely driven by executive dysfunction. Behaviorally, the patient presented as disinhibited, impulsive and labile. Emotionally, he endorsed symptoms of posttraumatic stress, anxiety, and depression. These post-COVID-19 sequelae have impacted functioning across multiple domains including ability to work, medication and finance management, and complex decision-making. Conclusions: Results suggest bilateral frontal and temporal dysfunction rather than subcortical deficits from hypoxia. Similar to post-intensive care syndrome, the etiology of functional impairment in severely ill, hospitalized COVID-19 patients appears multifactorial. Likely mediating factors include COVID-19 itself, associated complications, intervention methods, and psychological distress. [ FROM AUTHOR] Copyright of Archives of Clinical Neuropsychology is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Objective: Recent studies exploring the psychological and cognitive effects of COVID-19 indicate decline in memory, language, and executive functioning, as well as symptoms of depression and anxiety. The objective of this study was to determine the relationship between acute COVID-19 symptom load and self-report of psychological, cognitive, and functional outcomes after recovery. Method: 65 adults treated by Staten Island University Hospital for COVID-19 participated in a brief battery of screening measures. The protocol included the Generalized Anxiety Disorder-2, Patient Health Questionnaire-2, Primary Care PTSD Screen for DSM-5, and World Health Organization Schedule Disability Assessment Schedule 2.0 (WHODAS). Participants were asked about 11 symptoms they may have experienced when acutely ill to determine the total COVID-19 symptom load (CSL) and current cognitive and psychological symptoms. Pearson’s correlation was used to investigate associations between variables. Results: CSL was not associated with total WHODAS score, although it was weakly associated with the Self-Care and Life Activities domains. Current cognitive symptom load was moderately associated with most WHODAS domains. It was most strongly associated with Understanding and Communication (r=0.36;p=0.003). All psychological domains were associated with greater WHODAS impairment, and depression had the strongest association (r=0.43;p< 0.001). Conclusions: CSL does not appear to predict the functional impacts of COVID-19. Psychological factors, particularly depression, appear to be slightly more associated with functional impairment than cognitive symptoms. Results highlight the importance of targeted intervention for current cognitive and psychological symptoms in recovered COVD-19 patients, regardless of CSL.
ABSTRACT
Most reported cases of human monkeypox occur in Central and West Africa, where the causing virus is endemic. We describe the identification and public health response to an imported case of West African monkeypox from Nigeria to the United Kingdom (UK) in May 2021. Secondary transmission from the index case occurred within the family to another adult and a toddler. Concurrent COVID-19-related control measures upon arrival and at the hospital, facilitated detection and limited the number of potential contacts.