[COVID-19, neuroCOVID-19 and cognitive impairment in elderly and old patients (literature review).]

The new coronavirus infection COVID-19 causes damage to many organs and systems, is a multi-organ disease. Many researchers are studying the relationship of the new coronavirus infection with polymorbid pathology, frailty, sarcopenia. The SARS-CoV-2 virus has the property of neurotropism, therefore, olfactory, taste disorders, as well as cognitive impairments can join the spectrum of clinical manifestations and consequences of the disease. Alzheimer's disease is the most common cause of dementia in the world. It is of interest that there is a link between the coronavirus infection and the development of cognitive impairment, including Alzheimer's disease.

Incidence of memory complaints during the COVID-19 pandemic in Southern Brazil: findings from PAMPA cohort.

Population-level studies investigating the incidence of memory complaints during the COVID-19 pandemic are scarce. Objective: This study aimed to examine the incidence of memory complaints over 15 months during the COVID-19 pandemic in adults from Southern Brazil. Methods: Data from the PAMPA (Prospective Study about Mental and Physical Health in Adults) cohort, a longitudinal study with adults residing in Southern Brazil, were analyzed. An online-based, self-administered questionnaire was used to assess self-rated memory. Participants rated their memories as excellent, very good, good, fair, or poor. Incident memory complaints were defined as worse memory perception from baseline to follow-up. Cox proportional hazard models were used to identify factors associated with the increased risk of memory complaints. Results: During follow-up, a cumulative incidence of 57.6% for memory complaints was observed. Female sex (hazard ratio [HR] 1.49; 95% confidence intervals [CI] 1.16-1.94), lack of access to prescribed medicine (HR: 1.54; 95%CI 1.06-2.23), and worsened anxiety symptoms (HR: 1.81; 95%CI 1.49-2.21) were associated with an increased risk of memory complaints. Regular practice of physical activity was associated with a reduced risk of memory complaints (HR: 0.65; 95%CI 0.57-0.74). Conclusion: Since the COVID-19 pandemic, 6 in 10 adults in Southern Brazil have developed memory complaints. Factors including sex and lack of medications increased the risk of incident memory complaints. Physical activity reduced the risk of incident memory complaints during the COVID-19 pandemic.

Estudos em nível populacional que investiguem a incidência de queixa na memória durante a pandemia de COVID-19 são escassos. Objetivo: Nosso objetivo foi examinar a incidência de queixa na memória, ao longo de 15 meses durante a pandemia de COVID-19, em adultos do Sul do Brasil. Métodos: Foram analisados dados da coorte Estudo Prospectivo sobre Saúde Mental e Física em Adultos (PAMPA), um estudo longitudinal com adultos residentes no Sul do Brasil. Um questionário autoadministrado online foi usado para avaliar a memória autorreferida. Os participantes classificaram sua memória como excelente, muito boa, boa, regular ou ruim. A queixa na memória incidente foi definida como pior percepção de memória desde a linha de base até o acompanhamento. Modelos de risco proporcional de Cox foram usados para identificar fatores associados ao aumento do risco de queixa na memória incidente. Resultados: Durante o seguimento, observou-se incidência cumulativa de 57,6% para queixa na memória. Sexo feminino (hazard ratio ­ HR 1,49; intervalo de confiança ­ IC 95% 1,16­1,94), falta de acesso ao medicamento prescrito (HR: 1,54; IC95% 1,06­2,23) e sintomas de ansiedade (HR: 1,81; IC95% 1,49­2,21) foram associados a risco aumentado de queixa na memória incidente. A prática regular de atividade física foi vista como fator protetor (HR: 0,65; IC95% 0,57­0,74). Conclusões: Desde a pandemia de COVID-19, seis em cada dez adultos no Sul do Brasil desenvolveram queixa na memória. Fatores como sexo e falta de medicamentos aumentaram o risco de queixa na memória incidente. A atividade física reduziu o risco de queixa na memória incidente durante a pandemia de COVID-19.

Brain fog in long COVID limits function and health status, independently of hospital severity and preexisting conditions.

Importance: The U.S. government has named post-acute sequelae of COVID-19 (longCOVID) as influential on disability rates. We previously showed that COVID-19 carries a medical/functional burden at 1 year, and that age and other risk factors of severe COVID-19 were not associated with increased longCOVID risk. Long-term longCOVID brain fog (BF) prevalence, risk factors and associated medical/functional factors are poorly understood, especially after mild SARS-CoV-2 infection. Methods: A retrospective observational cohort study was conducted at an urban tertiary-care hospital. Of 1,032 acute COVID-19 survivors from March 3-May 15, 2020, 633 were called, 530 responded (59.2 ± 16.3 years, 44.5% female, 51.5% non-White) about BF prevalence, other longCOVID, post-acute ED/hospital utilization, perceived health/social network, effort tolerance, disability. Results: At approximately 1-year, 31.9% (n = 169) experienced BF. Acute COVID-19 severity, age, and premorbid cardiopulmonary comorbidities did not differ between those with/without BF at 1 year. Patients with respiratory longCOVID had 54% higher risk of BF than those without respiratory longCOVID. BF associated with sleep disturbance (63% with BF vs.29% without BF, p < 0.0001), shortness of breath (46% vs.18%, p < 0.0001), weakness (49% vs.22%, p < 0.0001), dysosmia/dysgeusia (12% vs.5%, p < 0.004), activity limitations (p < 0.001), disability/leave (11% vs.3%, p < 0.0001), worsened perceived health since acute COVID-19 (66% vs.30%, p < 0.001) and social isolation (40% vs.29%, p < 0.02), despite no differences in premorbid comorbidities and age. Conclusions and relevance: A year after COVID-19 infection, BF persists in a third of patients. COVID-19 severity is not a predictive risk factor. BF associates with other longCOVID and independently associates with persistent debility.

[COVID-19, neuroCOVID-19 and cognitive impairment in elderly and old patients (literature review).]

The new coronavirus infection COVID-19 causes damage to many organs and systems, is a multi-organ disease. Many researchers are studying the relationship of the new coronavirus infection with polymorbid pathology, frailty, sarcopenia. The SARS-CoV-2 virus has the property of neurotropism, therefore, olfactory, taste disorders, as well as cognitive impairments can join the spectrum of clinical manifestations and consequences of the disease. Alzheimer's disease is the most common cause of dementia in the world. It is of interest that there is a link between the coronavirus infection and the development of cognitive impairment, including Alzheimer's disease.

Relationship between cognitive dysfunction and the promoter methylation of PER1 and CRY1 in patients with cerebral small vessel disease.

Background and purpose: The prevalence of cerebral small vessel disease (CSVD) is increasing due to the accelerating global aging process, resulting in a substantial burden on all countries, as cognitive dysfunction associated with CSVD is also on the rise. Clock genes have a significant impact on cognitive decline and dementia. Furthermore, the pattern of DNA methylation in clock genes is strongly associated with cognitive impairment. Thus, the aim of this study was to explore the connection between DNA promoter methylation of PER1 and CRY1 and cognitive dysfunction in patients with CSVD. Methods: We recruited patients with CSVD admitted to the Geriatrics Department of the Lianyungang Second People's Hospital between March 2021 and June 2022. Based on their Mini-Mental State Examination score, patients were categorized into two groups: 65 cases with cognitive dysfunction and 36 cases with normal cognitive function. Clinical data, 24-h ambulatory blood pressure monitoring parameters, and CSVD total load scores were collected. Moreover, we employed methylation-specific PCR to analyze the peripheral blood promoter methylation levels of clock genes PER1 and CRY1 in all CSVD patients who were enrolled. Finally, we used binary logistic regression models to assess the association between the promoter methylation of clock genes (PER1 and CRY1) and cognitive dysfunction in patients with CSVD. Results: (1) A total of 101 individuals with CSVD were included in this study. There were no statistical differences between the two groups in baseline clinical data except MMSE and AD8 scores. (2) After B/H correction, the promoter methylation rate of PER1 was higher in the cognitive dysfunction group than that in the normal group, and the difference was statistically significant (adjusted p < 0.001). (3) There was no significant correlation between the promoter methylation rates of PER1 and CRY1 in peripheral blood and circadian rhythm of blood pressure (p > 0.05). (4) Binary logistic regression models showed that the influence of promoter methylation of PER1 and CRY1 on cognitive dysfunction were statistically significant in Model 1 (p < 0.001; p = 0.025), and it still existed after adjusting for confounding factors in Model 2. Patients with the promoter methylation of PER1 gene (OR = 16.565, 95%CI, 4.057-67.628; p < 0.001) and the promoter methylation of CRY1 gene (OR = 6.017, 95%CI, 1.290-28.069; p = 0.022) were at greater risk of cognitive dysfunction compared with those with unmethylated promoters of corresponding genes in Model 2. Conclusion: The promoter methylation rate of PER1 gene was higher in the cognitive dysfunction group among CSVD patients. And the hypermethylation of the promoters of clock genes PER1 and CRY1 may be involved in affecting cognitive dysfunction in patients with CSVD.

An exploratory factor analysis of long COVID

An exploratory factor analysis (EFA) can provide a window into the latent dimensions of a disease, such as Long COVID. Discovering the latent factors of Long COVID enables researchers and clinicians to better conceptualize, study and treat this disease. In this study, participants were recruited from social media sites dedicated to COVID and Long COVID. Among the 480 participants, those who completed at least 90% of the survey, reported symptoms for two or more months since COVID-19 symptom onset, and had not been hospitalized for COVID were used in the EFA. The mean duration since initial symptom onset was 74.0 (37.3) weeks. A new questionnaire called The DePaul Symptom Questionnaire-COVID was used to assess self-reports of the frequency and severity of 38 Long COVID symptoms experienced over the most recent month. The most burdensome symptoms were "Symptoms that get worse after physical or mental activities (also known as Post-Exertional Malaise)," "Fatigue/extreme tiredness," "Difficulty thinking and/or concentrating," "Sleep problems," and "Muscle aches." The EFA resulted in a three-factor model with factors labeled General, PEM/Fatigue/Cognitive Dysfunction, and Psychological, consisting of 16, 6, and 3 items respectively (25 items in total). The reliability of the items in the EFA was .90 using a split-half reliability test. Finally, participant self-reported level of functional impairment was analyzed across the three EFA factors. Interpretations and applications to research and practice are provided.

Year 2022 in review - anaesthesia.

By 2022, publishing has already returned to the standard. This means that the global SARS-CoV-2 pandemic for anaesthesiologists is all but forgotten, and the safety of anesthesia is again the dominant issue. However, in addition to the traditional search for answers to whether we should prefer regional or general anesthesia and for which procedures and what is the best prevention of PONV, there is now another associated topic - postoperative delirium and postoperative cognitive dysfunction. Although both entities are crucial to the overall perioperative course, they still need more attention. This is even though, especially in elderly patients, they have already been shown to significantly affect perioperative morbidity and mortality. Moreover, to the surprise of many, recent data show that their incidence is not so much dependent on the type of anesthesia but on the quality of its administration. This text aims to briefly summarize some key publications in the field of anesthesiology and to highlight papers that should not escape attention.Copyright © 2022, Czech Medical Association J.E. Purkyne. All rights reserved.

Long COVID brain fog and muscle pain are associated with longer time to clearance of SARS-CoV-2 RNA from the upper respiratory tract during acute infection.

Introduction: The incidence of long COVID is substantial, even in people with mild to moderate acute COVID-19. The role of early viral kinetics in the subsequent development of long COVID is largely unknown, especially in individuals who were not hospitalized for acute COVID-19. Methods: Seventy-three non-hospitalized adult participants were enrolled within approximately 48 hours of their first positive SARS-CoV-2 RT-PCR test, and mid-turbinate nasal and saliva samples were collected up to 9 times within the first 45 days after enrollment. Samples were assayed for SARS-CoV-2 using RT-PCR and additional SARS-CoV-2 test results were abstracted from the clinical record. Each participant indicated the presence and severity of 49 long COVID symptoms at 1-, 3-, 6-, 12-, and 18-months post-COVID-19 diagnosis. Time from acute COVID-19 illness onset to SARS-CoV-2 RNA clearance greater or less than 28 days was tested for association with the presence or absence of each of 49 long COVID symptoms at 90+ days from acute COVID-19 symptom onset. Results: Self-reported brain fog and muscle pain at 90+ days after acute COVID-19 onset were negatively associated with viral RNA clearance within 28 days of acute COVID-19 onset with adjustment for age, sex, BMI ≥ 25, and COVID vaccination status prior to COVID-19 (brain fog: aRR 0.46, 95% CI 0.22-0.95; muscle pain: aRR 0.28, 95% CI 0.08-0.94). Participants reporting higher severity brain fog or muscle pain at 90+ days after acute COVID-19 onset were less likely to have cleared SARS-CoV-2 RNA within 28 days. The acute viral RNA decay trajectories of participants who did and did not later go on to experience brain fog 90+ days after acute COVID-19 onset were distinct. Discussion: This work indicates that at least two long COVID symptoms - brain fog and muscle pain - at 90+ days from acute COVID-19 onset are specifically associated with prolonged time to clearance of SARS-CoV-2 RNA from the upper respiratory tract during acute COVID-19. This finding provides evidence that delayed immune clearance of SARS-CoV-2 antigen or greater amount or duration of viral antigen burden in the upper respiratory tract during acute COVID-19 are directly linked to long COVID. This work suggests that host-pathogen interactions during the first few weeks after acute COVID-19 onset have an impact on long COVID risk months later.

Psychophysiological Correlates of Coping Behavior in Adolescents Who Have Undergone COVID-191

The global nature of the epidemiological situation associated with the spread of the new coronavirus infection COVID-19 and the multidisciplinary nature of the problem of psychophysiological disorders in people who have suffered from this disease has led to the need for a comprehensive study of the factors affecting postcovid recovery. Taking into account the nature of the problem posed, the purpose of the presented work was to study the relationship of psychophysiological parameters with indicators of stress-overcoming (coping) behavior in adolescents who have undergone COVID-19. The study included 54 students of Kemerovo State University, who were divided into a group of COVID-19 patients and a group without symptoms of the disease. To assess coping behavior, the questionnaire «Ways of Coping Questionnaire» was used (Folkman, Lazarus;adaptation of Kryukova et al.). An automated computer complex "PFK” was used to study psychophysiological indicators. The following psychophysiological indicators were evaluated: simple visual-motor reaction, complex visual-motor reaction, anticipations and delays in assessing the reaction to a moving object, concentration and volume of attention, brain performance, the level of functional mobility of nervous processes, short-term memory for numbers and words, random access memory. According to the results of the correlation analysis, the interrelations between avoidant forms of coping behavior, such as "distancing”, "escape-avoidance”, "positive reassessment” with indicators of memory, attention, mobility of nervous processes, the number of inaccurate reactions to a moving object and the working capacity of the brain were recorded, which indicates a link between the increase in psychophysiological and cognitive disorders and preference in choosing care from stressful situations after a disease. Deterioration of memory and functioning of the nervous system lead to more frequent requests for support from others to receive additional help from them. The weakening of the nervous system also leads to more frequent use of productive coping strategies "taking responsibility” and "planning problem solving”, which, at the same time, additionally make it possible to compensate for cognitive impairments by performing tasks more accurately. In the group that did not have symptoms of COVID-19, no significant correlations were found between coping avoidance strategies and psychophysiological or cognitive impairments. Based on the results obtained, it can be assumed that the restoration of cognitive functions during psychocorrective work will make it possible to actualize the patient's choice of productive coping strategies and switch to a healthy behavior model. © 2022 Tomsk State University. All rights reserved.

Physical, Psychological, and Cognitive Profile of Post-COVID Conditions in Healthcare Workers, Quebec, Canada.

Background: The prevalence of post-COVID conditions (PCC) and associated physical, psychological, and cognitive symptoms was assessed among Quebec healthcare workers (HCWs) with coronavirus disease 2019 (COVID-19). Methods: This case-control study compared 6061 symptomatic HCWs with polymerase chain reaction-confirmed COVID-19 between July 2020 and May 2021 with a random sample of 4390 symptomatic HCWs who were test-negative controls. The prevalence of physical symptoms lasting ≥4 weeks (PCC4w) or ≥12 weeks (PCC12w) was estimated among hospitalized and nonhospitalized cases. In multivariate models, sociodemographic and clinical characteristics, as well as vaccine history, were evaluated as potential risk factors. Prevalence ratios compared 4 aspects of self-reported cognitive dysfunction among PCC cases to controls, adjusting for psychological distress and fatigue. Results: PCC4w and PCC12w prevalences of 46% (2746/5943) and 40% (653/1746), respectively, were observed among nonhospitalized cases and 76% (90/118) and 68% (27/37), respectively, among hospitalized cases. Hospitalization, female sex, and age were associated with higher PCC risk. A substantial proportion of nonhospitalized PCC4w cases often or very often reported cognitive dysfunction, including concentration (33%) or organizing (23%) difficulties, forgetfulness (20%), and loss of necessary items (10%). All 4 aspects of cognitive dysfunction were associated with PCC4w symptoms, psychological distress, and fatigue. Conclusions: PCC may be a frequent sequela of ambulatory COVID-19 in working-age adults, with important effects on cognition. With so many HCWs infected, the implications for quality healthcare delivery could be profound if cognitive dysfunction and other severe PCC symptoms persist in a professionally disabling way. Further evaluation of PCC prevalence and prognosis is warranted.

Prevalence and Associated Factors of Very Early Cognitive Impairment in COVID-19 Convalescents：a Study Using Data from a Questionnaire Survey

【】 Background COVID-19 may impair the central nervous system，but the prevalence and related factors of very early cognitive impairment in discharged COVID-19 convalescents are still unclear. Objective To assess the prevalence of very early cognitive impairment in discharged COVID-19 convalescents，and to identify its influencing factors. Methods This study included 574 COVID-19 convalescents from August 28 to September 30，2020，including individuals who were discharged from designated hospitals for treating COVID-19 in Wuhan from December 2019 to April 2020 randomly selected from the hospital information system，and those with informed consent recruited through news media. According to the Eight-item Informant Interview to Differentiate Aging and Dementia（AD8）score，the subjects were divided into a very early cognitive impairment group（AD8 ≥ 2）and a non-very early cognitive impairment group（AD8<2）. A questionnaire survey was conducted with the subjects by four investigators at Hubei Provincial Hospital of Traditional Chinese ＆amp;Western Medicine，using the General Information Questionnaire to collect demographic information and past disease history of the patients（including gender，age，underlying disease，classification of COVID-19 on admission，interval between discharge and the current survey，and various symptoms present at the time of follow-up），using the Generalized Anxiety Disorder-7（GAD-7），the PTSD Check List–Civilian Version（PCL-C），and the Short Form 36 Health Survey Questionnaire（SF-36）to assess patients' anxiety，post-traumatic stress disorder，and quality of life，respectively. Three hundred and eleven cases finally completed the cognitive function screening. Multiple Logistic regression was used to evaluate the effects of gender，age，underlying disease and admission classification of COVID-19 on very early cognitive impairment. A restricted cubic spline model was used to assess the quantitative relationship between anxiety level and very early cognitive impairment. Results 311（54.18%）who effectively responded to the survey was finally enrolled，including 170（54.7%）with very early cognitive impairment and 141（45.3%）without. 230 （23.9%）had residual symptoms after discharge. Comparisons of gender，age，insomnia，fatigue，chest tightness，shortness of breath，loss of appetite，generalized anxiety disorder，PTSD positive，and the score of each SF-36 entry among COVID-19 convalescents with and without very early cognitive impairment were statistically significant（P<0.05）. Multivariate Logistic regression analysis suggested that females〔OR（95%CI）=2.658（1.528，4.625）〕，advanced age〔OR（95%CI）=3.736（1.083，12.890）〕，and having generalised anxiety disorder〔OR（95%CI）=5.081（1.229，21.008）〕were influential factors in increasing very early cognitive impairment（P<0.05）. Restricted cubic spline models indicated a linear quantitative relationship between anxiety level and very early cognitive impairment，with higher levels of anxiety associated with a greater likelihood of very early cognitive impairment（P for non-linear test =0.132）. Conclusion The incidence of very early cognitive impairment is high in COVID-19 convalescents，and it may be higher in those who are older，female，or have generalized anxiety symptoms. Timely interventions for psychiatric problems and alleviation of anxiety symptoms in COVID-19 convalescents，especially in older women，may help to improve their cognitive function and Alzheimer's disease. © 2023 Chinese General Practice. All rights reserved.

Cognitive dysfunction, diabetes mellitus 2 and arterial hypertension: Sequelae up to one year of COVID-19.

BACKGROUND: Covid symptoms reflect its multisystem nature, in addition to its positive relationship between the severity of the condition and the severity of the long COVID. OBJECTIVE: To identify the factors associated with the prevalence of SEQUELAE DUE TO COVID-19 one year after their hospital discharge due to severe pneumonia. METHOD: Longitudinal, analytical, prospective and comparative study. 71 covid-19 pneumonia survivors were followed. Two telephone interviews were conducted to each patient; the first at 5 months of discharge and the second at 12 months from the mentioned date. We included questions of 40 symptoms, in addition to the questioning of diabetes mellitus and/or systemic hypertension with a mentioned onset during the hospitalization or after hospital discharge due to COVID-19. RESULTS: Of the 37 patients without complications and without comorbidities prior to hospitalization, 11 (29.7%) developed arterial hypertension during or after discharge and 17 (45.9%) developed diabetes mellitus before five months. Short-term memory loss was an upward sequel in the two measurements, 24.3% and 41.9% respectively. CONCLUSIONS: Type 2 diabetes mellitus and high blood pressure detected at five months was temporary and reversed in many cases at twelve months. It will be important to deepen the study of brain damage and cognitive dysfunction, characterized by memory loss.

Brain correlates of subjective cognitive complaints in COVID-19 survivors: A multimodal magnetic resonance imaging study.

Cognitive impairment represents a leading residual symptom of COVID-19 infection, which lasts for months after the virus clearance. Up-to-date scientific reports documented a wide spectrum of brain changes in COVID-19 survivors following the illness's resolution, mainly related to neurological and neuropsychiatric consequences. Preliminary insights suggest abnormal brain metabolism, microstructure, and functionality as neural under-layer of post-acute cognitive dysfunction. While previous works focused on brain correlates of impaired cognition as objectively assessed, herein we investigated long-term neural correlates of subjective cognitive decline in a sample of 58 COVID-19 survivors with a multimodal imaging approach. Diffusion Tensor Imaging (DTI) analyses revealed widespread white matter disruption in the sub-group of cognitive complainers compared to the non-complainer one, as indexed by increased axial, radial, and mean diffusivity in several commissural, projection and associative fibres. Likewise, the Multivoxel Pattern Connectivity analysis (MVPA) revealed highly discriminant patterns of functional connectivity in resting-state among the two groups in the right frontal pole and in the middle temporal gyrus, suggestive of inefficient dynamic modulation of frontal brain activity and possible metacognitive dysfunction at rest. Beyond COVID-19 actual pathophysiological brain processes, our findings point toward brain connectome disruption conceivably translating into clinical post-COVID cognitive symptomatology. Our results could pave the way for a potential brain signature of cognitive complaints experienced by COVID-19 survivors, possibly leading to identify early therapeutic targets and thus mitigating its detrimental long-term impact on quality of life in the post-COVID-19 stages.

Real world research on transcranial magnetic stimulation treatment strategies for neuropsychiatric symptoms with long-COVID in Japan.

The number of patients suffering from long-COVID is currently increasing rapidly, even after the acute symptoms of COVID-19 have improved. The objective of this study was to investigate the effects of a pilot transcranial magnetic stimulation (TMS) treatment on neuropsychiatric symptoms caused by long-COVID. In this study, we examined the efficacy of the TMS treatment protocol, which has been established to be effective in refractory depression, by applying it to patients who sought TMS treatment for neuropsychiatric symptoms caused by long-COVID at TMS clinics in Tokyo, Japan in the context of the real world TMS registry study in Japan. Of the 23 patients (13 females) with long-COVID included in this case series, the main neuropsychiatric symptoms were chronic fatigue (n = 12) and cognitive dysfunction (n = 11), but most patients also showed mild depressive symptoms. The mean score on the Montgomery-Åsberg Depression Rating Scale before TMS treatment was 21.2, which improved to 9.8 after treatment. Similarly, the score on the Performance Status, which assesses the degree of fatigue, improved from 5.4 to 4.2, and the score on the Perceived Deficits Questionnaire-Depression 5-item, which reflects cognitive function, improved from 10.0 to 6.3. Although a few patients complained of pain at the stimulation site during the TMS as a side effect, there were no serious adverse events. Despite the limitations of this open-label pilot study, the TMS protocol implemented in this study may have beneficial effects on neuropsychiatric symptoms caused by long-COVID, including depressive symptoms, chronic fatigue, and cognitive impairment. These preliminary findings warrant further validation in randomized controlled trials.

SARS-CoV-2 Spike protein induces TLR4-mediated long-term cognitive dysfunction recapitulating post-COVID-19 syndrome in mice.

Cognitive dysfunction is often reported in patients with post-coronavirus disease 2019 (COVID-19) syndrome, but its underlying mechanisms are not completely understood. Evidence suggests that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike protein or its fragments are released from cells during infection, reaching different tissues, including the CNS, irrespective of the presence of the viral RNA. Here, we demonstrate that brain infusion of Spike protein in mice has a late impact on cognitive function, recapitulating post-COVID-19 syndrome. We also show that neuroinflammation and hippocampal microgliosis mediate Spike-induced memory dysfunction via complement-dependent engulfment of synapses. Genetic or pharmacological blockage of Toll-like receptor 4 (TLR4) signaling protects animals against synapse elimination and memory dysfunction induced by Spike brain infusion. Accordingly, in a cohort of 86 patients who recovered from mild COVID-19, the genotype GG TLR4-2604G>A (rs10759931) is associated with poor cognitive outcome. These results identify TLR4 as a key target to investigate the long-term cognitive dysfunction after COVID-19 infection in humans and rodents.

Psychophysiological Correlates of Coping Behavior in Adolescents Who Have Undergone COVID-19

The global nature of the epidemiological situation associated with the spread of the new coronavirus infection COVID-19 and the multidisciplinary nature of the problem of psychophysiological disorders in people who have suffered from this disease has led to the need for a comprehensive study of the factors affecting postcovid recovery. Taking into account the nature of the problem posed, the purpose of the presented work was to study the relationship of psychophysiological parameters with indicators of stress-overcoming (coping) behavior in adolescents who have undergone COVID-19. The study included 54 students of Kemerovo State University, who were divided into a group of COVID-19 patients and a group without symptoms of the disease. To assess coping behavior, the questionnaire << Ways of Coping Questionnaire >> was used (Folkman, Lazarus;adaptation of Kryukova et al.). An automated computer complex "PFK" was used to study psychophysiological indicators. The following psychophysiological indicators were evaluated: simple visual-motor reaction, complex visual-motor reaction, anticipations and delays in assessing the reaction to a moving object, concentration and volume of attention, brain performance, the level of functional mobility of nervous processes, short-term memory for numbers and words, random access memory. According to the results of the correlation analysis, the interrelations between avoidant forms of coping behavior, such as "distancing", "escape-avoidance", "positive reassessment" with indicators of memory, attention, mobility of nervous processes, the number of inaccurate reactions to a moving object and the working capacity of the brain were recorded, which indicates a link between the increase in psychophysiological and cognitive disorders and preference in choosing care from stressful situations after a disease. Deterioration of memory and functioning of the nervous system lead to more frequent requests for support from others to receive additional help from them. The weakening of the nervous system also leads to more frequent use of productive coping strategies "taking responsibility" and "planning problem solving", which, at the same time, additionally make it possible to compensate for cognitive impairments by performing tasks more accurately. In the group that did not have symptoms of COVID-19, no significant correlations were found between coping avoidance strategies and psychophysiological or cognitive impairments. Based on the results obtained, it can be assumed that the restoration of cognitive functions during psychocorrective work will make it possible to actualize the patient's choice of productive coping strategies and switch to a healthy behavior model.

Association between COVID-19 Anxiety and Cognitive Failure and Temperament Components in the Personnel of an Iranian Hospital, Iran, 2021

Background: The outbreak of COVID-19 has a serious crisis for health systems in different countries. This study aimed to investigate the association between COVID-19 anxiety and cognitive failure and temperament components in the personnel of a hospital in the Yazd Province. Materials and Methods: This was a cross-sectional study. The participants were the personnel of a hospital. The convenience sampling method was used for the sampling purpose. The participants were the personnel of COVID-19 and non-COVID-19 sections of a hospital. Data collection tools included a demographic questionnaire, the Corona Disease Anxiety Scale (CDAS), the Cognitive Failure Questionnaire (CFQ), and the Emotionality Activity Sociability (EAS) Questionnaire. Data analysis was performed in SPSS-24 software. Results: The mean age of the participants was 33.45 (6.42) years. COVID-19 anxiety was significantly higher in the non-COVID-19 personnel than in the COVID-19 personnel (P < 0.001). In addition, a positive correlation was found between COVID-19 anxiety scores and cognitive failure scores (P = 0.04). After investigating the simultaneous relation of COVID-19 anxiety with cognitive failure and temperament components, the model results showed that cognitive failure (P = 0.02) and sociability (P < 0.001) had a significant effect on COVID-19 anxiety. Conclusions: High levels of COVID-19 anxiety in non-COVID-19 section personnel indicated the importance of paying more attention to all hospital occupations. To reduce cognitive failure and anxiety, it is recommended to provide psychological training, workloads reduction, and the number of personnel be increased. © The Author(s) 2022;All rights reserved. Published by Rafsanjan University of Medical Sciences Press.

COVID-19 and diabetes mellitus in cognitive impairment: an undrawn relationship

Cognitive impairment is a potential short- and long-term disease consequence of COVID-19 virus, the exact mechanism is still in debate. One of their potential linking is with diabetes. Diabetes and COVID-19 infection have possible multiple common mechanisms that could ensue cognitive impairment as pulmonary microthrombi (silent hypoxia);endothelial dysfunction;cerebral vascular injury oxidative stress;renin-angiotensin-aldosterone system;and galectine and interferon responses. In addition, histological markers as amyloid AB plaques and neurofibrillary tangle of Tau protein are common in both pathologies. Despite of this evidence, diabetes mellitus and COVID-19 in cognitive impairment are establishing a bright light in terms of neurological progress. This article describes the relationship between diabetes mellitus and COVID-19 as potential cause of cognitive impairment. (English) [ FROM AUTHOR]

Review on the possible effects of COVID-19 pandemic on the cognitive function of older people

Risk and protective factors for cognitive impairment and mental health in older people are widely identified. However, the impact of COVID-19 pandemic on cognitive functioning and neuropsychiatric symptoms in older people is not well known. Therefore, we carried out a systematic review on the impact of COVID-19 pandemic on cognitive functioning and mental health of older people, identifying risk and protective factors. We used the criteria and flowchart established in PRISMA statement, considering studies from PubMed, Scopus and Web of Science databases between the years 2019 and 2021. The search fetched 55 final articles, where the analysis was carried out. The evidence suggests that the Covid 19 Pandemic had a direct and indirect impact on the cognitive function, mental and physical health of older people and variables such as resilience and personality characteristics moderated the consequences of this crisis. © 2022 Sociedad Medica de Santiago. All rights reserved.