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The number of people with long-term consequences of COVID-19 is increasing worldwide. The long-term prognosis for patients remains poorly understood. Objective. To study cardiometabolic and psychocognitive features in comorbid elderly patients with atrial fibrillation (AF), de-pending on the presence of post-COVID syndrome (PCS). Material and methods. The observational analytical cohort study included 223 patients with AF and comorbidity (coronary artery disease, hypertension, obesity, type 2 diabetes mellitus) aged 60-74, who were divided into two groups: group 1 included 123 patients without COVID-19 and group 2 included 110 patients with a history of COVID-19 and the presence of PCS. The study evaluated laboratory and instrumental tests, and a general clinical study assessing psychocognitive disorders using the SPMSQ and HADS questionnaires was conducted. Results and discussion. In COVID-19 survivors, compared with patients of group 1, there were more pronounced atherogenic changes in total cholesterol (TC) (p=0.003), low-density lipoprotein cholesterol (p<0.001), and triglycerides (p=0.011). Lower dia-stolic blood pressure was found in COVID-19 survivors (p<0.001). In addition, patients in group 2 had higher median pulse pressure (p<0.001) and heart rate (p<0.001). In group 2 patients, a larger ascending aorta diameter was observed (p<0.001). The anx-iety-depressive syndrome was more common in COVID-19 survivors with comorbidities, and a statistically significant difference was found in clinical anxiety (24%, p=0.041) and subclinical depression (21%, p=0.015). When assessing cognitive function, mod-erate cognitive impairment was detected in 22% (p=0.005) of patients with PCS and severe cognitive impairment in 2% (p=0.007). Conclusion. In comorbid elderly patients with the post-COVID syndrome, a high prevalence of psychocognitive disorders and adverse cardiometabolic changes were observed, supporting the need for long-term monitoring of the general clinical condition and psychocognitive status of COVID-19 survivors.Copyright © 2023, Media Sphera Publishing Group. All rights reserved.
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Agricultural tractor drivers experience a high amplitude of vibration, especially during soil tillage operations. In the past, most research studied vibration exposure with more focus on the vertical (z) axis than on the fore-and-aft (x) and lateral (y) axes. This study examines how rotary soil tillage affects the vibration acceleration and frequency, and the power spectral densities (PSDs) at the seat pan and head along three translational axes in a real-field multiaxis vibration context. Moreover, this study aimed to identify the characteristics of the seat-to-head transmissibility (STHT) response to identifying the most salient resonant frequencies along the x-, y-, and z-axes. Nine (9) male tractor drivers operated the tractor with a mounted rotary tiller throughout the soil tillage process. In the event of a COVID-19 pandemic, and to respect social distancing, this study developed an Internet of Things (IoT) module with the potential to integrate with existing data loggers for online data transmission and to make the experimentation process more effective by removing potential sources of experimenter errors. The raw acceleration data retrieved at the seat pan and the head were utilized to obtain daily exposure (A(8)), PSDs, and STHT along the x-, y-, and z-axes. The vibration energy was found to be dominant along the z-axis than the x- and y-axes. A(8) response among tractor drivers exceeds the exposure action value explicitly stated by Directive 2002/44/EU. PSDs along the x-, y-, and z-axes depicted the low-frequency vibration induced by rotary soil tillage operation. The STHT response exhibited a higher degree of transmissibility along the y- and z-axes when compared with that along the x-axis. The frequency range of 4-7 Hz may plausibly be associated with cognitive impairment in tractor drivers during rotary soil tillage.
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[...]flexibility ensures that students feel included and stay interested in learning. [...]dealing with varied genres allows students to get acquainted with different registers of the language. [...]the lack of physical classes also resulted in a lack of group activities. [...]as part of its policy of inclusion, JNU offers admission to students with visual impairment and also offers extra classes for them. [...]for overcoming the impersonal nature of online teaching, I made sure to get each student to speak in the class. The purpose was to ensure that students were active during the entire class. [...]I had to make sure that whilst recording the teaching session, I started recording only after having played the DW video.
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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.
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BACKGROUND/AIMS: In this study, we aimed to make detailed neurocognitive assessments of patients who presented with brain fog after coronavirus disease-2019 (COVID-19) infection and to investigate their complaints after one-year of follow-up. MATERIALS AND METHODS: Patients who had COVID-19, which was not severe enough to require intensive care, and who subsequently applied to neurology due to cognitive complaints were included in this study. A neurocognitive test battery was applied to those patients who agreed to detailed examination (n=16). This battery consisted of the following tests: mini-mental test, enhanced cued recall test, phonemic fluency, categorical fluency, digit span, counting the months backwards, clock-drawing, arithmetic operations, trail-making, cube copying, intersecting pentagons, and the interpretation of proverbs and similes. At one year, the patients were called by phone and questioned as to whether their cognitive complaints had persisted. Those patients with ongoing complaints were invited to the hospital and re-evaluated via cognitive tests. The results are presented in comparison with age-matched healthy controls (n=15). RESULTS: Almost all of the patients' scores were within the "normal" range. The Spontaneous recall of the patients was statistically significantly lower than the controls (p=0.03). Although there were decreases in executive functions and central processing speed (trail making-A, trail making-B and reciting the months backwards tests) in the patient group, these differences were not statistically significant (p=0.07;p=0.14 and p=0.22, respectively) compared to the controls. We observed that the cognitive complaints of the patients had disappeared by the one-year follow-up. CONCLUSION: In our patients with brain fog, most of whom had mild COVID-19, we observed that among all cognitive functions, memory domain was most affected compared to the controls. At the one-year follow-up, COVID-related brain fog had disappeared.
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Objectives: Globally, cataract and glaucoma are the predominant causes of blindness. Screening glaucoma in patients referred for cataract surgery is a convenient tool for detecting glaucoma cases in rural population. The COVID period has adversely affected eye care as the routine screening and follow-ups at hospital were substantially reduced owing to pandemic restrictions. We aim to study the impact of COVID on detection of glaucoma in patients with cataract. Method(s): It was a retrospective study conducted to compare the prevalence of glaucoma in rural patients presenting with cataract pre- and post-COVID. Details of 975 consecutive patients each were taken prior to March 2020 (pre-COVID) and after October 2021 (post-COVID) from hospital database and patient case files. Result(s): The prevalence of glaucoma was higher during the pre-COVID time (3.8%) as compared to pre-COVID (3.8%), but the result was not statistically significant. In both the groups, primary open-angle glaucoma was the pre-dominant form of glaucoma, with prevalence being 1.5% and 2.2% in the pre-COVID and post-COVID groups, respectively. The mean intraocular pressure and mean VCDR values were higher in the post-COVID group as compared to the pre-COVID group, and the result was statistically significant. Conclusion(s): This was the first study to compare the prevalence of glaucoma in patients with cataract in rural population in the pre-COVID and post-COVID periods. In the aftermath of the pandemic, the present study emphasizes the role of screening and follow-ups in glaucoma management to prevent irreversible loss of vision.Copyright © 2023 The Authors.
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Objectives: Many Americans experience continued symptoms after SARS-CoV-2 infection. In addition to people who leave the workforce after experiencing COVID, those who remain employed may experience loss of productivity from short-term absences (absenteeism) and reduced productivity while working (presenteeism). We examined reported losses of work productivity among adults who reported physician-identified Long COVID. Method(s): We conducted a retrospective, cross-sectional analysis of data from National Health and Wellness Survey (May-Aug 2022) respondents. We included employed adults who reported having experienced COVID in the past (no date specified), said their physician identified them as having Long COVID or COVID syndrome, and reported symptoms at the time of survey. Respondents were stratified by their magnitude of activity limitations reported on the Work Productivity and Activity Impairment questionnaire;we describe responses for the lowest (LT) and highest tertiles (HT). Work productivity (absenteeism, presenteeism, overall work limitations from either absenteeism or presenteeism), and mental health (anxiety via General Anxiety Disorder-7 questionnaire, depression via Patient Health Questionnaire-9), were compared across tertiles. Result(s): Among 1036 Long COVID respondents meeting inclusion criteria, presenteeism ranged from 24.2% of LT respondents (n=291) to 92.8% of HT respondents (n=304), and absenteeism ranged from 12.7% (LT respondents) to 47.3% (HT respondents). Almost all (99.7%) HT respondents reported their overall work productivity was reduced by 50% or more while 26.7% of LT respondents reported the same. The prevalence of moderate-to-severe depression (92.4% vs. 37.8%) and moderate-to-severe anxiety (84.2% vs. 26.1%) was higher among HT relative to LT (all p<.001). Conclusion(s): Adults with Long COVID exhibit substantial heterogeneity in activity limitations;however, work limitations were substantial in all groups. Our results suggest significant economic impacts of Long COVID through lower productivity among those who remain employed. Further work with a comparison group is important to understand Long COVID-related work impairments, limitations, and disability.Copyright © 2023
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This article aims to portray the continuing education of teachers and professionals to work in deafblindness and multiple sensory disability, in the functions of guide-interpreter and mediator instructor. The trainings took place during the COVID-19 pandemic between September 2020 and August 2021. The methodology is to present the organization of the course, totally remote, which occurred with the partnership between SMPED and the Brazil Group. We selected 70 professionals from the city of Sao Paulo, being teachers and interpreters of Libras, to participate in the course of guide-interpreter and 15 professionals from different cities of Brazil, among teachers and interpreters, for the function of instructor mediator. As a result, we highlight the way synchronous activities, practices and internships occurred, and ensured the effectiveness and participation of people with deafblindness and multiple sensory impairment in different situations of daily life, such as television news, reading books and participation in congresses.
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In elderly patients with COVID-19 cognitive functions decline;it has been suggested that SARS-CoV-2 infection may lead to the development of Alzheimer's disease (AD) and other long-term neurological consequences. We review several parallels between AD and COVID-19 in terms of pathogenetic mechanisms and risk factors. Possible mechanisms through which COVID-19 can initiate AD are discussed. These include systemic inflammation, hyperactivation of the renin-angiotensin system, innate immune activation, oxidative stress, and direct viral damage. It has been shown that increased expression of angiotensin-renin receptors (ACE2) may be a risk factor for COVID-19 in patients with AD. When entering the central nervous system, the SARS-CoV-2 virus can directly activate glial cell-mediated immune responses, which in turn can lead to the accumulation of beta-amyloid and the subsequent onset or progression of current AD. The involvement of inflammatory biomarkers, including interleukins (IL): IL6, IL1, as well as galectin-3, as a link between COVID-19 and AD is discussed. The rationale for the use of memantine (akatinol memantine) in patients with COVID-19 in order to prevent the development of cognitive deficits is discussed. Memantine has been shown to have a positive effect on neuroinflammatory processes in the onset or exacerbation of cognitive deficits, in reducing cerebral vasospasm and endothelial dysfunction in viral infections. Memantine therapy may improve everyday activity and reduce the risk of severe SARS-CoV-2 infection.Copyright © 2022 Ima-Press Publishing House. All rights reserved.
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Aim: Coronavirus disease 2019 (COVID-19) is complex multisystem disease. After 4 weeks of persistent symptoms, it is termed as Long COVID-19. Long COVID-19 causes a decrease in health-related quality of life (HRQoL). In this study, it was aimed to determine which symptoms were associated with lower HRQoL in Long COVID-19 in this study. Material(s) and Method(s): This cross-sectional study was conducted in a tertiary research hospital. Patients who have positive RT-PCR results at least 28 days and at most 180 days ago were selected for the study. Online survey was applied to 266 patients who had positive PCR test results for COVID-19. The EuroQoL 5D-3L scale was used to measure the HRQoL as a dependent variable. Socio-demographic features and symptoms were assessed by the survey as independent variables. Due to heteroscedasticity, a robust standard error regression analysis was conducted to make inferences on the effects of persistent symptoms on HRQoL. Result(s): Of the total 266 participants, 163 were females (63.3%). The mean age was 41.2 +/- 11.8 years. One hundred forty-two patients (53.3%) did not report any ongoing symptom. Female gender and lower education level as socio-demographic variables, visual problems and myalgia as persistent symptoms were identified as risk factors for reduced HRQoL in Long COVID-19 patients. Discussion(s): Long COVID-19 patients experience lower levels of HRQoL, especially those with visual problems and/or myalgia. Interventions to raise the HRQoL of Long COVID-19 patients should first target visual problems and myalgia.Copyright © 2023, Derman Medical Publishing. All rights reserved.
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Cognitive dysfunction is one of the manifestations of the neurological complications in coronavirus infection. In this article, we have collected material on the state of cognitive functions after suffering a coronavirus infection with aspects of possible pathogenetic mechanisms and a discussion on the prospects for treatment and rehabilitation. The COVID-19 pandemic, having manifested itself in December 2019, remains one of the most controversial topics in the world to the day. The growing number of reports about damage to the nervous system during coronavirus infection suggests that the virus is neurotropic. In the clinical picture of the disease, less attention is paid to such symptoms as severe weakness, fatigue, memory impairment. At the same time, it is this symptomatology that most often accompanies patients in the postcovid period and significantly reduces their quality of life, thereby making it difficult to adapt to social and work activities. The search was conducted for literatures published within the period from 2020 to the third quarter of 2021, domestic and foreign sources from the Web of Science, PubMed databases were analysed. The search queries were the following ones: "COVID-19", "cognitive impairment", "postcovid syndrome".Copyright © 2022, Krasnoyarsk State Medical University. All rights reserved.
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This chapter discusses social disability and impairment in childhood anxiety. The chapter starts with a discussion of clinical characteristics of the condition. Approaches to evidence-based assessment and cognitive-behavioral treatment are discussed. Future directions are highlighted. © Springer Nature Switzerland AG 2011, 2023. All rights reserved.
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Objectives: Health is distributed unequally by occupation (Ravesteijn,2013). This research aims to explore patient-reported outcomes by occupation profiles using the National Health and Wellness Survey (NHWS). Method(s): Data from the 2022 US NHWS included employed respondents at least 18 years of age with information on occupation profile, defined as 22 categories from the Bureau of Labor Statistics. Descriptive statistics were used to analyze respondent characteristics and outcomes such as COVID-19 diagnoses, healthcare resource use over the past six months, and work impairment as measured by the Work Productivity and Activity Impairment Questionnaire (WPAI). Result(s): A total of 35,789 respondents were employed and had occupation information. Respondents were predominantly white (62.0%) and male (53.9%). Sales and Related occupations had the greatest proportion of respondents reporting a COVID-19 diagnosis (16.1%) while Building and Grounds Cleaning and Maintenance had the lowest proportion (3.8%). Educational Instruction and Library had the most respondents reporting that they had received at least one dose of the COVID-19 vaccine (79.2%) while Farming, Fishing, and Forestry had the least respondents (52.9%). Life, Physical, and Social Science had the greatest COVID-19 vaccination rate over the past year (66.5%) while Farming, Fishing, and Forestry had the lowest (45.0%). Office and Administrative Support had the greatest proportion of respondents with a traditional healthcare provider visit (79.8%), but the lowest proportion with an emergency room (ER) visit (12.7%) or a hospitalization (8.1%). Farming, Fishing, and Forestry had the greatest proportion of respondents with an ER visit (41.6%) or hospitalization (41.6%). The greatest proportion of respondents with any overall work impairment or activity impairment was in Farming, Fishing, and Forestry (work: 91.1%, activity: 87.4%) while the lowest proportion was in Office and Administrative Support (work: 50.0%, activity: 53.3%). Conclusion(s): Certain occupation profiles consistently show higher impairment while others consistently show lower impairment.Copyright © 2023
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Background The COVID-19 pandemic coincides with growing concern regarding the mental health of young people. Older adolescents have faced a particular set of pandemic-related challenges and demonstrate heightened vulnerability to affective disorders (particularly anxiety). Anxiety symptoms are associated with a range of cognitive difficulties. Older adolescents may therefore be susceptible to pandemic-related declines in wellbeing and associated cognitive difficulties. Methods At three timepoints, independent samples of young people aged 16-18 years (N = 607, 242, 618 respectively) completed an online survey. Data collection coincided with periods of lockdown (timepoints 1 and 3) and young people returning to school (timepoint 2). The survey assessed subjective impacts of the pandemic on overall wellbeing, anxiety and cognitive function. Results Findings demonstrated the detrimental impact of the COVID-19 pandemic on older adolescents' psychological wellbeing-a finding that was consistent across samples. The majority of young people at each timepoint experienced heightened anxiety. Crucially, pandemic-related anxiety was associated with self-identified cognitive difficulties, a pattern of association that was evident at all three timepoints. The nature and extent of these difficulties were predictive of specific pandemic-related concerns in this age group. Conclusions Older adolescents' experiences of the pandemic are characterised by subjective declines in wellbeing and stable patterns of association between anxiety and self-identified cognitive difficulties. Implications are discussed with reference to future research and intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Aim: To determine the frequency of ear, nose and throat related disorders of covid disease in PCR proven positive Covid-19 patients. Method(s): This prospective study included 320 Covid-19 positive patients and was conducted at ENT Department of MTI Hayatabad Medical Complex, Peshawar from May 1, 2021 to April 30, 2022. The acute phase of covid-19 was taken as the time interval between the onsets of symptoms as day 1 today 30th post infection. Questions were asked about the following symptoms;flu, sore throat, sinus involvement, taste disturbances, smell disturbances, hoarseness and hearing loss. Clinical examination and relevant investigations were carried out to make a diagnosis. The data was documented on a proforma & analyzed using SPSS 26.0 for windows to determine the frequencies of signs & symptoms related to ENT. Result(s): A total of 320 patients were included in the study. The ages ranged from 18-50 years with mean age of 33.96 years. The age group 18-25 years mostly presented with symptoms related to ENT. Upper respiratory tract infection was the commonest symptom (60.6%) followed by sore throat (57.5%). Smell and taste disturbances accounted for in 46.3% & 15.3 % of the patients respectively. Fungal rhinosinusitis was observed in 6.9% of the patients. As there is a wide variation of the ENT symptoms in covid disease, it is important to know the predictive symptoms so that appropriate measures can be adopted. Identification & isolation of patients will prevent spread of disease and focused therapy and investigations. Practical implication Conclusion(s): The portal of entry for the SARS-CoV-2 is through the upper airway. It is important to know the symptoms related to ENT to make an early diagnosis and therefore, institute measures for management and prevention of further spread of the disease.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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Aim: In this study, we aimed to assess the frequency of patient emergency visits to the Otorhinolaryngology (ORL) Department during coronavirus COVID-19 pandemic and compare it with that before coronavirus COVID-19. Material(s) and Method(s): A retrospective comparative study was performed at Al-Al-Hada Armed Forces Hospital, Taif (Saudi Arabia), and data regarding various diagnoses of ORL cases were collected from medical records of patients who visited/admitted to ORL-ED during the lockdown (Group 1) and those who visited/ admitted to ORL-ED before the pandemic (Group 2). Result(s): Group 2 had a significantly higher percentage of cases who had no ENT-related disorders, hypertrophy inferior turbinate (HIT), stridor, obstructive sleep apnea (OSA), epistaxis and who had no complications, had general ENT, foreign body ingestion-aspiration, trauma, otology and who had more than one disorder and Group 1 had a significantly higher percentage of those having nasal obstruction, tonsil hypertrophy grade 3, had emergency head and neck cancer, had deep neck space infections and who had complicated. Discussion(s): During coronavirus COVID-19 pandemic period, cold ENT visits were much less and foreign body ingestion remains the highest reason for ENT visits. Additionally, telemedicine has been shown to be effective in reducing ED visits during the pandemic period. Furthermore, older cases with chronic ENT problems who had regular follow-up ENT visits were less likely to visit ED during the pandemic.Copyright © 2022, Derman Medical Publishing. All rights reserved.
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Objective: To determine the impact of Covid-19 vaccines on sperm quality. Study Design: Case control study Place and Duration of Study: Department of Diabetes & Endocrinology, Chandka Medical College Hospital Larkana from 1st July 2022 to 31st December 2022. Methodology: Patients were enrolled as 50 those who had PCR confirmed Covid 19 history and 50 those who never got Covid-19. On this basis those cases who had a Covid-19 history were placed in group A while those who did not had Covid-19 history were placed in Group B. Patients clinical history including anamnesis, marital status, cryptorchidism, operative varicocele, or any chronic ailment were documented. A counting chamber was used for sperm count in a 100 square area. Spermatozoa was measured as either rapid-progressively motile (Type a), or as slow-progressively-motile (Type b), or as situ motile (Type c), and finally as immobile (Type d). The total semen sperm count was gained by multiplication of concentration of sperm with its volume. Result(s): Volume and concentration was significantly different in both study groups. Difference in tail anomaly was also observed. In group A, it was 29.20 +/- 10.26 while 27.59 +/- 12.31 was the value of group B. Almost equal number of participants were married. Azoospermia was only found among Covid patients. Conclusion(s): Azoospermia was only found in Covid patients and no such results were obtained from Covid negative patients.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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AIM: To study the efficacy and safety of a drug product based on the succinic acid complex with trimethylhydrazine used to treat patients with asthenic syndrome after a new coronavirus infection (COVID-19). MATERIALS AND METHODS: A prospective, multicenter, comparative, randomized, double-blind, placebo-controlled study of the safety and efficacy of sequential therapy with Brainmax® enrolled 160 patients 12-16 weeks after coronavirus infection (no more than 12 months). The study was conducted at 6 healthcare centers in different regions of the Russian Federation. At the enrollment, clinical and neurological examination and the following tests were performed: complete blood count, urinalysis, blood chemistry, coagulation test, pulse oximetry, electrocardiography, glomerular filtration rate calculation (according to Cockcroft-Gault formula) were performed. Also, the patients were assessed using the following tools: VAS headache rating scale, MFI-20 asthenia scale, PSQI index, FAS-10 fatigue assessment scale, Dizziness Handicap Inventory (DHI), MoCA-test for cognitive impairment assessment, Beck Anxiety Inventory, Kérdö Autonomic Index. RESULTS: The primary endpoint was the mean reduction in the MFI-20 asthenia scale score after the therapy (Visit 5, 41st day of therapy) compared to data from Visit 0 (beginning of therapy). A clinically significant advantage of the study drug versus the placebo was demonstrated, with a median absolute change in the MFI-20 score of -19.5 [-27; -11] points in the Brainmax® drug group and -3 [-7; 1] score in the placebo group (p<0.001). A significant sleep quality improvement according to the PSQI index was shown in the study group: by -2.5 [-4; -1] points versus no improvement in the placebo group (0 [-3; 0], p<0,001). Significant differences were also noted for the following secondary endpoints: PSQI sleep quality scale, FAS-10 fatigue assessment scale, DHI, and Beck Anxiety and Depression Inventory. There was also a decrease in patients' complaints of cognitive deterioration according to the CGI scale. CONCLUSION: Our study clearly demonstrated the efficacy and high safety profile of Brainmax® in a representative sample of patients with the post-COVID syndrome.
Subject(s)
COVID-19 , Post-Acute COVID-19 Syndrome , Humans , Asthenia/drug therapy , Asthenia/etiology , Prospective Studies , Fatigue , Double-Blind Method , Treatment OutcomeABSTRACT
Concentration and memory impairment (named "brain fog") represents a frequent and disabling neuropsychological sequela in post-acute COVID-19 syndrome (PACS) patients. The aim of this study was to assess whether neurocognitive function could improve after a multidisciplinary rehabilitation program enhanced with individualized neuropsychological treatment. A prospective monocentric registry of PACS patients consecutively admitted to our Rehabilitation Unit was created. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive impairment at admission and discharge. A total of sixty-four (64) PACS patients, fifty-six (56) of them with brain fog, were treated with a day-by-day individualized psychological intervention of cognitive stimulation (45 min) on top of a standard in-hospital rehabilitation program. The mean duration of the acute-phase hospitalization was 55.8 ± 25.8 days and the mean in-hospital rehabilitation duration was 30 ± 10 days. The mean age of the patients was 67.3 ± 10.4 years, 66% of them were male, none had a previous diagnosis of dementia, and 66% of the entire sample had experienced severe COVID-19. At admission, only 12% of the patients had normal cognitive function, while 57% showed mild, 28% moderate, and 3% severe cognitive impairment. After psychological treatment, a significant improvement in the MoCA score was found (20.4 ± 5 vs. 24.7 ± 3.7; p < 0.0001) as a result of significant amelioration in the following domains: attention task (p = 0.014), abstract reasoning (p = 0.003), language repetition (p = 0.002), memory recall (p < 0.0001), orientation (p < 0.0001), and visuospatial abilities (p < 0.0001). Moreover, the improvement remained significant after multivariate analysis adjusted for several confounding factors. Finally, at discharge, 43% of the patients with cognitive impairment normalized their cognitive function, while 4.7% were discharged with residual moderate cognitive impairment. In conclusion, our study provides evidence of the effects of multidisciplinary rehabilitation enhanced with neuropsychological treatment on improvement in the cognitive function of post-acute COVID-19 patients.
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A plethora of evidence links SARS-CoV-2 infection with concomitant cognitive dysfunction, which often persists weeks to months after the acute stages of illness and affects executive function, attention, memory, orientation, and movement control. It remains largely unclear which conditions or factors exacerbate the recovery. In a cohort of N=37 Slovenian patients (5 females, aged M = 58, SD = 10.7 years) that were hospitalized because of COVID-19, the cognitive function and mood states were assessed immediately after discharge and 2-months later to investigate the early post-COVID recovery changes. We assessed the global Montreal Cognitive Assessment (MoCA), Simple and Choice Reaction Times, executive functions (Trail-Making Test - TMT-A and TMT-B), short-term memory (Auditory Verbal Learning Test - AVLT), and visuospatial memory. We monitored depressive and anxiety symptoms and applied general self-efficacy and cognitive complaints questionnaires. Our results showed a global cognitive impairment (MoCA, Z = 332.5; p = 0.012), poorer performance on executive functions (TMT-A, Z = 188; p = 0.014; and TMT-B, Z = 185; p = 0.012), verbal memory (AVLT, F = 33.4; p < 0.001), and delayed recall (AVLT7, F = 17.1; p < 0.001), and higher depressive (Z = 145; p = 0.015) and anxiety (Z = 141; p = 0.003) symptoms after hospital discharge compared to 2-month follow-up, indicating that SARS-CoV-2 may transiently impair cognitive function and adversely affect the mood. No improvement in MoCA was observed in 40.5% of the patients at follow-up, indicating possible long-term effects of COVID-19 on global cognitive performance. Medical comorbidities (p = 0.035) significantly predicted the change in MoCA score over time, while fat mass (FM, p = 0.518), Mediterranean diet index (p = .0.944), and Florida Cognitive Activities Score (p = 0.927) did not. These results suggest that the patients' medical comorbidities at the time of SARS-CoV-2 infection could importantly contribute to the acute impairment of cognitive function and stress the importance of systemic implementation of countermeasures to limit the negative consequences on public health.