Long-Covid: Neuropsychological function at 6 and 12months - relation to depression and self-reported symptoms

Objective: Studies have reported significant cognitive impairment following Covid-19, although the majority of reports rely on patients' self-report or short screening instruments to quantify cognitive function. Additionally, little is known about the development of cognitive impairment post Covid-19 and how these trajectories are related to psychiatric and medical variables. Method(s): Patients presenting a spectrum of neurological symptoms following Covid-19 infection were recruited from a national multicenter study. At 6 (N = 77) and 12 (N = 58) months post-covid infection, they completed a comprehensive neuropsychological assessment. At 6 months self-reported symptoms of cognitive dysfunction and fatigue were extracted from questionnaires and depression diagnoses from the MINI neuropsychiatric interview. A control group (N = 58), antibody verified Covid-19 negative, completed neuropsychological assessment. Result(s): At 6 months, verbal and visual memory, attention/working memory, and executive function were significantly reduced in patients compared to healthy controls. These impairments were not associated to acute illness severity indexes, and only moderately correlated to subjective cognitive complaints, level of fatigue, and diagnosis of depression at 6 months. There was a significant improvement in cognitive function across affected domains from 6 to 12 months post infection. This improvement was not associated with depression or self-report at 6 months, nor was the improvement related to acute illness severity. Conclusion(s): Covid-19 patients presenting with neurological symptoms showed significant cognitive impairment at 6 months. However, at 12 months their cognitive functions were normalized and no longer different from healthy controls. These results indicate a good prognosis regarding cognitive function in most patients following Covid-19 infection.Copyright © 2023

Donepezil Beyond Alzheimer’s Disease? A Narrative Review of Therapeutic Potentials of Donepezil in Different Diseases

Donepezil hydrochloride is an acetylcholine esterase inhibitor studied and approved to treat Alzheimer’s disease (AD). However, this drug can have positive therapeutic potential in treating different conditions, including various neurodegenerative disorders such as other types of dementia, multiple sclerosis, Parkinson’s disease, psychiatric and mood disorders, and even infectious diseases. Hence, this study reviewed the therapeutic potential of this drug in treating Alzheimer’s and other diseases by reviewing the articles from databases including Web of Science, Scopus, PubMed, Cochrane, and Science Direct. It was shown that donepezil could affect the pathophysiology of these diseases via mechanisms such as increasing the concentration of acetylcholine, modulating local and systemic inflammatory processes, affecting acetylcholine receptors like nicotinic and muscarinic receptors, and activating various cellular signaling via receptors like sigma-1 receptors. Despite many therapeutic potentials, this drug has not yet been approved for treating non-Alzheimer’s diseases, and more comprehensive studies are needed.

Neurocognitive and Psychological Profile of a 57-Year-Old Long-COVID Patient After 42 Days an a Ventilator

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.)

COGNITIVE and PSYCHOSOCIAL OUTCOME in CHILDREN with MULTISYSTEM INFLAMMATORY SYNDROME FOLLOWING SARS-COV-2 INFECTION

Background: Despite the low rate of neurological defcits following the SARS-COV-2 infection in the pediatric population, children and adolescents who develop multisystem infammatory syndrome (MIS-C) after being infected with SARS-COV-2 are at a higher risk for neurological abnormalities and brain injury, increasing the risk of adverse cognitive and psychiatric outcome. Objectives: Given the increased risk of central nervous system impairment we chose to conduct a prospective study looking at the cognitive and psychosocial outcome of patients with MIS-C. Methods: Our study included 27 of the 29 patients between 2 to 18 years of age (M = 11.1, SD = 4.4) who were treated for MIS-C from the onset of the SARS-COV-2 pandemic until the beginning of May 2021 at the only tertiary care pedi-atric immunology center in Slovenia. We assessed these patients 6 months after diagnosis using the age-appropriate Wechsler intelligence scales and a battery of neuropsychological test measuring attention, executive function, memory and fne motor skills. We also asked parents to report on patients' psychosocial outcome using the Achenbach Child Behavior Checklist. Results: By using Bayesian statistics to take into account parental education and any potential pre-morbid learning difficulties we found no evidence of impairment on measures of intelligence. However, the posterior distribution of scores on neuropsychological measures indicated that a signifcant proportion of patients scored 1SD bellow expected levels on measures of attention (31%), executive function (28%) and visual memory (35%). Increased symptoms of depression, anxiety and attention difficulties were also reported by parents, although their extent did not rise to a clinically signifcant level. Conclusion: The fndings from our cohort suggest that the cognitive and psychosocial outcome of patients with MIS-C is generally favorable, although up to 35% may experience specifc neuropsychological defcits more than 6 months after diagnosis. The most commonly impaired cognitive domains seem to be attention, executive function and visual memory.