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1.
J Hosp Infect ; 2022.
Article in English | ScienceDirect | ID: covidwho-2031453

ABSTRACT

INTRODUCTION: The role of fomites in the transmission of SARS-CoV-2 is unclear. Our objective was to assess whether SARS-CoV-2 can be transmitted through fomites, using evidence from viral culture studies. METHODS: We conducted searches in the WHO Covid-19 Database, PubMed, LitCovid, medRxiv, and Google Scholar to 31 December 2021. We included studies that investigated fomite transmission and performed viral culture to assess the cytopathic effect (CPE) of positive fomite samples and confirmation of SARS-CoV-2 as the cause of the CPE. We assessed the risk of bias using a checklist modified from the QUADAS-2 criteria. RESULTS: We included 23 studies. The overall risk of bias was moderate. Five studies demonstrated replication-competent virus from fomite cultures and three used genome sequencing to match fomite samples with human clinical specimens. The mean Ct of samples with positive viral culture was significantly lower compared with cultured samples that returned negative results: SMD -1.45, 95%CI -2.00 to -0.90, I(2)=0%;P<0.00001. The likelihood of isolating replication-competent virus was significantly greater when the Ct was <30: RR 3.10 (95%CI 1.32 to 7.31, I(2)=71%, P=0.01). Infectious specimens were mostly detected within 7 days of symptom onset. One study showed possible transmission of SARS-CoV-2 from fomites to humans. CONCLUSION: The evidence from published studies suggests that replication-competent SARS-CoV-2 is present on fomites. Replication-competent SARS-CoV-2 is significantly more likely when the PCR Ct for clinical specimens and fomite samples is <30. Further studies should investigate the duration of infectiousness of SARS-CoV-2 and the frequency of transmission from fomites.

2.
Wiad Lek ; 75(8 pt 1):1868-1875, 2022.
Article in English | PubMed | ID: covidwho-2026697

ABSTRACT

OBJECTIVE: The aim: To study the structure of cognitive impairment in patients who were hospitalized with moderate to severe COVID-19 pneumonia. Investigate the correlation with demographic, biochemical parameters, as well as the emotional state of the patient. PATIENTS AND METHODS: Materials and methods: Cognitive functions were assessed using the MOCA test. PHQ-9 depression and GAD-7 anxiety questionnaires were used to study psychopathological symptoms. Demographic, clinical and laboratory data were extracted from medical records. RESULTS: Results: Cognitive performance is impaired in 94% of patients with COVID-19. This allows to suggest that COVID-19 has a serious impact on cognition, especially in elder people. Among different domains only visuospatial and executive functioning, thinking, attention and delayed recall were severely impaired, while other domains stayed relatively intact. Patients after COVID-19 also tend to have a mild depressive and anxiety state. Anxiety levels were higher than depressive levels, but not connected to cognitive functioning. Also, there was seen a positive correlation between anxiety and pO2 and negative between anxiety and comorbid cardiac pathology. However, this requires further studies to reveal. Another interesting finding was non-linear relationship between cognitive performance and depression, that allows to suggest rapidly evolving depressive mood in persons with severe cognitive impairment after COVID-19. Cognitive and emotional state of patients after COVID-19 was also highly connected with working status. CONCLUSION: Conclusion: Significant cognitive impairment was presented in almost all patients with COVID-19. There was a selective impairment in domains of visuospatial/ executive functioning, thinking, attention and delayed recall. Conclusions: Significant cognitive impairment was presented in almost all patients with COVID-19. There was a selective impairment in domains of visuospatial/ executive functioning, thinking, attention and delayed recall.

3.
Frontiers in Psychiatry ; 13, 2022.
Article in English | Web of Science | ID: covidwho-2022909

ABSTRACT

IntroductionFew studies have objectively evaluated cognitive deficits after the acute phase of COVID-19 disease. Moreover, the role of apolipoprotein E (APOE) genotypes in cognitive decline in patients with COVID-19 has not been evaluated yet. MethodsThis cross-sectional study was conducted in confirmed cases of COVID-19 patients with neurological symptoms that persisted for more than 3 months from the onset. We determined APOE genotypes. ResultsThe final sample consisted of 141 patients. The most frequent APOE genotype was E3/E3 (N = 95;67.3%). In total, 93 patients (65.9%) had memory impairment symptoms as the main complaint, objectively confirmed through screening tests in 25 patients (17.7%). Patients with cognitive impairment had a lower frequency of anosmia than the normal and subjective cognitive decline (SCD) groups (p = 0.005). In addition, depression was recurrent in the cognitive impairment group and the SCD group (p = 0.046). Cognitive impairment was significantly more frequent in hospitalized patients and those with a lower education level. Cognitive status was not associated with APOE genotypes. DiscussionHospitalized patients had more severe infection with a greater possibility of systemic complications, greater inflammatory response, and prolonged hospitalization, which could impact cognitive performance. Cognitive impairment in patients with COVID-19 does not necessarily involve specific APOE polymorphisms. However, psychiatric disorders may also be responsible for cognitive complaints. Cognitive complaints are frequent in patients with COVID-19, even after the acute phase of the disease and in mild cases. Hospitalized participants and depressed patients may have a higher risk of cognitive impairment. APOE genotypes or haplotypes may not significantly play a role in COVID-19 cognitive impairment.

4.
Journal of the Formosan Medical Association ; 121(9):1617-1621, 2022.
Article in English | Scopus | ID: covidwho-2015654
5.
Journal of the American Geriatrics Society ; 70(5):1570-1573, 2022.
Article in English | APA PsycInfo | ID: covidwho-2011733

ABSTRACT

Presents a study which aims to examine an innovative post-hospital model of care. The study developed a model of care for those who had delirium in the hospital and then transitioned home, known as DDEFY Delirium. This pilot study aimed to assess the implementation of this novel model of care and determine the ability to recruit patients. This pilot randomized controlled trial was conducted between August 2019 and December 2020. Patients aged >=65 years, treated by inpatient geriatric consultative service for delirium and discharged home, were randomized into control or intervention (and later on a virtual group due to COVID-19). Once determined eligible, the DDEFY Delirium intervention was implemented. DDEFY is used to describe the five pillars that form our conceptual model: (1) Diagnose cognitive disorder;(2) review Drugs;(3) Educate patient and family;(4) assess and treat Function (al) decline;(5) Your (patient's and family's) health goals. For the intervention groups, participants were asked about their caregivers, asked to perform cognitive and functional assessments, and discussed goals of care. Outcomes of interest included recruitment rate, adherence, attrition, and study team participation. Both the in-person and virtual intervention groups had 100% adherence to pillars 2 and 4. Lowest adherence was to pillars 1 (virtual = 75%) and 5 (in-person = 71%;virtual = 75%). For both the in-person and virtual intervention groups, attrition was zero and study team participation was 100%. In this pilot study, we assessed patients in their homes, after experiencing delirium during and after their hospital admission. Even though the recruitment rate was affected by COVID-19, it was higher than anticipated as was the adherence to the intervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

6.
Neurodegener Dis Manag ; 12(4): 171-184, 2022 08.
Article in English | MEDLINE | ID: covidwho-2009821

ABSTRACT

Cognitive impairment related to dementia is under-diagnosed in primary care despite availability of numerous cognitive assessment tools; under-diagnosis is more prevalent for members of racial and ethnic minority groups. Clinical decision-support systems may improve rates of primary care providers responding to positive cognitive assessments with appropriate follow-up. The 5-Cog study is a randomized controlled trial in 1200 predominantly Black and Hispanic older adults from an urban underserved community who are presenting to primary care with cognitive concerns. The study will validate a novel 5-minute cognitive assessment coupled with an electronic medical record-embedded decision tree to overcome the barriers of current cognitive assessment paradigms in primary care and facilitate improved dementia care.


Dementia is common, though under-recognized, in older adults (OAs). Primary care providers (PCPs) miss opportunities to help patients and their families manage the disease because of failure to, or delay to, make an appropriate diagnosis. Black and Hispanic OAs are more likely than White OAs to experience delayed diagnosis. Most available memory tests are too long for practical use by PCPs, and are ill suited to patients of diverse language, cultural and educational backgrounds. Studies have shown that even when patients test positive for dementia in primary care, PCPs often do not take follow-up action. Our improved memory test, the 5-Cog, is brief (5 min), not biased by language issues (uses pictures and symbols instead of words), and simple (doesn't require expensive technology and complex staff training). The 5-Cog is paired with a clinical decision support tool, providing tailored recommendations directly into the patient's medical record, and making it easier for PCPs to take appropriate action. This study will evaluate whether the 5-Cog paradigm results in improved dementia care.


Subject(s)
Cognitive Dysfunction , Dementia , Aged , Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/therapy , Dementia/diagnosis , Dementia/therapy , Ethnicity , Humans , Minority Groups , Randomized Controlled Trials as Topic
7.
PLoS One ; 17(8), 2022.
Article in English | ProQuest Central | ID: covidwho-2002330

ABSTRACT

Studies have reported reduced cognitive function following COVID-19 illness, mostly from hospital settings with short follow-up times. This study recruited non-hospitalized COVID-19 patients from a general population to study prevalence of late cognitive impairment and associations with initial symptoms. We invited patients with PCR-confirmed COVID-19. A postal questionnaire addressed basic demographics, initial COVID-19 symptoms and co-morbidity about 4 months after diagnosis. About 7 months later, we conducted cognitive tests using the Cambridge Neuropsychological Test Automated Battery, comprising four tests for short-term memory, attention and executive function. We present descriptive statistics using z-scores relative to UK population norms and defined impairment as z-score <-1.5. We used multivariable logistic regression with impairment as outcome. Continuous domain scores were analysed by multiple linear regression. Of the initial 458 participants;305 were invited, and 234 (77%) completed cognitive testing. At median 11 (range 8–13) months after PCR positivity, cognitive scores for short term memory, visuospatial processing, learning and attention were lower than norms (p≤0.001). In each domain, 4–14% were cognitively impaired;68/232 (29%) were impaired in ≥ 1 of 4 tests. There was no association between initial symptom severity and impairment. Multivariable linear regression showed association between spatial working memory and initial symptom load (6–9 symptoms vs. 0–5, coef. 4.26, 95% CI: 0.65;7.86). No other dimension scores were associated with symptom load. At median 11 months after out-of-hospital SARS-Cov-2 infection, minor cognitive impairment was seen with little association between COVID-19 symptom severity and outcome.

8.
J Clin Nurs ; 2022.
Article in English | PubMed | ID: covidwho-2001697

ABSTRACT

INTRODUCTION: Treatment with modern technology in an intensive care unit has increased critical illness survival. However, many patients are affected by their critical illness for months or years following discharge, as they experience cognitive impairments. Long-term cognitive impairments can severely affect patients' quality of life. Exploring patients' experiences on how and which cognitive impairments affect their everyday lives is important to improve planning of relevant research into interventions that may alleviate the burden of post-intensive cognitive impairments. AIM: To review the literature on patients' experiences of cognitive impairment following critical illness treated in an intensive care unit. METHODS: A systematic search was conducted in PubMed, Cinahl, PsycInfo and Embase in March-May 2021. References and citations in relevant studies were explored. The Covidence tool was used by two independent researchers to identify relevant studies for inclusion. The Mixed Methods Appraisal Tool was used for critical appraisal. The JBI methodology for scoping reviews and the PRISMA-ScR checklist were used (Supporting Information File 1). RESULTS: We identified 11 relevant qualitative and/or quantitative studies. Four themes were found: 'Experiencing poor memory', 'Managing everyday life', 'Unsupported by the healthcare system' and 'Strategies for support in recovery'. Patients used various strategies during their recovery and rehabilitation to regain independence and avoid being a burden. They needed information to support their recovery and rehabilitation;otherwise, they felt unsupported and betrayed by the healthcare system. CONCLUSION: Patients experienced various cognitive impairments following critical illness in the intensive care unit, affecting and challenging their quality of life and adaption to everyday life. RELEVANCE TO CLINICAL PRACTICE: Knowledge gained by exploring patients' experience of cognitive impairments following critical illness in the intensive care unit can contribute to improve clinical practice by targeting and optimising patients' rehabilitation process. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement in this scoping review.

9.
Aging Clin Exp Res ; 34(8): 1873-1883, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1995921

ABSTRACT

AIM: We estimated the proportion and severity of cognitive disorders in an unselected population of patients referred for transcatheter aortic valve implantation (TAVI). Second, we describe clinical and cognitive outcomes at 1 year. METHODS: Eligible patients were aged ≥ 70 years, with symptomatic aortic stenosis and an indication for TAVI. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive dysfunction (CD), defined as no CD if score ≥ 26, mild CD if 18-25; moderate CD if 10-18, and severe CD if < 10. We assessed survival and in-hospital complications at 6 months and 1 year. RESULTS: Between June 2019 and October 2020, 105 patients were included; 21 (20%) did not undergo TAVI, and thus, 84 were analyzed; median age 85 years, 53.6% females, median EuroScore 11.5%. Median MoCA score was 22 (19-25); CD was excluded in 18 (21%), mild in 50 (59.5%), moderate in 15 (19%) and severe in 1. Mean MoCA score at follow-up was 21.9(± 4.69) and did not differ significantly from baseline (21.79 (± 4.61), p = 0.73). There was no difference in success rate, in-hospital complications, or death across CD categories. CONCLUSION: The clinical course of patients with mild or moderate CD is not different at 1 year after TAVI compared to those without cognitive dysfunction.


Subject(s)
Aortic Valve Stenosis , Cognitive Dysfunction , Heart Valve Prosthesis Implantation , Transcatheter Aortic Valve Replacement , Aged, 80 and over , Aortic Valve/surgery , Aortic Valve Stenosis/surgery , Cognition , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/etiology , Female , Humans , Male , Prevalence , Risk Assessment , Risk Factors , Severity of Illness Index , Time Factors , Transcatheter Aortic Valve Replacement/adverse effects , Treatment Outcome
10.
Siberian Medical Review ; 2022(2):40-48, 2022.
Article in Russian | Scopus | ID: covidwho-1988761

ABSTRACT

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”. © 2022, Krasnoyarsk State Medical University. All rights reserved.

11.
Perioper Med (Lond) ; 11(1): 26, 2022 Jul 05.
Article in English | MEDLINE | ID: covidwho-1986911

ABSTRACT

BACKGROUND: In 2010, a national enquiry into elderly patient outcomes after surgery identified that only 36% received 'good' care. Guidance was subsequently published by the Association of Anaesthetists of Great Britain and Ireland regarding perioperative care of the elderly and those with dementia; this study aims to assess current adherence to these guidelines in anaesthetic departments across Scotland. METHODS: A web-based survey was sent to all Scottish departments. The questions assessed department patient demographic, access to specialist pre-assessment services, availability of multidisciplinary input, perioperative care of patients with cognitive impairment and departmental training on geriatric perioperative care. RESULTS: Responses were collected from November-December 2020 with a 92.6% response rate. A total of 64% of departments stated that > 50% of their workload involved patients over 75. One department had a lead clinician for geriatric anaesthesia, whilst 20% could access a geriatric specialist when coordinating perioperative care. Specialist geriatric pre-assessment services operate in 20% of centres. A total of 60% of respondents used a clinical frailty score when pre-assessing patients over 75, with 48% specifically screening for cognitive impairment. The vast majority of centres, 76%, did not routinely provide information regarding post-operative delirium and 24% 'never or very rarely' invite caregivers to accompany patients with dementia into the department. Education sessions regarding perioperative elderly care had occurred in 56% of departments. CONCLUSIONS: Elderly patients represent a significant proportion of anaesthetic workload in Scotland. Despite this, adherence to recommended practice is low. The vast majority of centres lack access to specialist multidisciplinary input or specialist pre-assessment services which are essential to providing good care. Reported screening for frailty and cognitive impairment is variable, with opportunities for improvement in communication and education (patient and clinician) surrounding these conditions.

12.
Joint International Conference on Digital Inclusion, Assistive Technology, and Accessibility, ICCHP-AAATE 2022 ; 13342 LNCS:51-63, 2022.
Article in English | Scopus | ID: covidwho-1971445

ABSTRACT

The increasing availability of online video content, partially fueled by the Covid-19 pandemic and the growing presence of social media, adds to the importance of providing audio descriptions as a media alternative to video content for blind and visually impaired persons. To address concerns as to what can be sufficiently described, we developed a concept providing audio descriptions in three levels of detail. We included an additional feature for providing optional explanations to terms and abbreviations, helping users without specific knowledge or persons with neurodiversity in comprehending complex video content. We implemented these features in a prototype based on the open-source Able Player, using an XML-based data structure to store information for all layers of audio descriptions. A qualitative user test focused on the benefits of multi-layered audio descriptions and optional explanatory content. Findings suggest that the choice on several levels of detail is received positively by users. They also appreciated the concept of optional explanations and came up with further use cases for such a practice. Participants preferred a higher level of detail for a high-paced action video and a lower level for informative content. © 2022, Springer Nature Switzerland AG.

13.
Meditsinskiy Sovet ; 2022(11):102-107, 2022.
Article in Russian | Scopus | ID: covidwho-1964927

ABSTRACT

Post-Cognitive Impairment, including in the young population, is an urgent medical and social problem. It is known that COVID-19, even in the absence of direct brain damage associated with covid-associated stroke or encephalitis, regardless of the severity of the infection during the acute period and the age of patients, can cause long-term and maladaptive cognitive impairment. The pathogenesis of these disorders is complex, and it is not completely clear today and continues to be actively studied. There is also no standardized diagnostic and therapeutic approach in the management of patients with post-COVID cognitive impairment. The presented clinical observation demonstrates the experience of treating cognitive impairment after COVID-19 in a young patient using the available knowledge of pathogenesis. A review of modern publications on the problem of post-COVID cognitive impairment was carried out. Based on the available literature data, the role of various pathogenetic factors in the development of post-covid cognitive impairment in the presented patient is discussed. Based on a specific clinical example, the rationale for the choice of treatment strategies and the need to further increase knowledge about the post-COVID syndrome, conduct future research in the field of pathogenesis, diagnosis and treatment of post-COVID cognitive impairment, which will create an evidence base for the development of clinical recommendations, is given. © 2022, Remedium Group Ltd. All rights reserved.

14.
The Open Journal of Occupational Therapy ; 10(3):1-12, 2022.
Article in English | ProQuest Central | ID: covidwho-1964781

ABSTRACT

Background: This case report details occupational therapy (OT) for a woman with breast cancer experiencing cancer-related cognitive impairment (CRCI), referred to OT for memory strategies. Method: Preliminary subjective and cognitive screenings were completed with further/finer assessment diarized. Results: While the cognitive aspect of CRCI is often addressed via OT, in this case, stress was the most prevalent barrier to function reported. Stress was identified as: impacting occupational engagement, CRCI presentation, interfering with return-to-work goals, and accentuated given the COVID-19 pandemic. A common cancer-specific stress screening tool appeared inadequate in identifying the impact and interplay of stress on function, necessitating a more narrative exploration around these themes. Intervention details, clinical reasoning, and outcomes are profiled in this case report. Conclusion: Current published literature showcases the multi-factorial nature of CRCI, highlighting stress as an important, though often overlooked, factor, and thus an area for OT practice growth. Developing the OT approach to functional management of CRCI involves further exploration and appreciation of the relationship between stress and function. Clinical case studies offer a foundation and serve as a first step for expanding the value of OT in approaching CRCI and stress from a functional perspective, particularly considering the stressors of the current pandemic.

15.
Deterioro cognitivo en personas con COVID-19 con síntomas leves-moderados en Ecuador. ; 23(4):126-129, 2022.
Article in English | Academic Search Complete | ID: covidwho-1955374

ABSTRACT

Background: Complications of COVID-19 can include neurological, psychiatric, psychological, and psychosocial sequelae. Little is known about the consequences of COVID-19 on the cognitive functions of patients in the subacute phase of the disease. Objective: The objective of the study was to determine if there is an incidence of cognitive impairment in patients with COVID-19 with mild to moderate symptoms in the remission phase. Method: This is a cross-sectional study conducted between April 2021 and August 2021 at the Eugenio Espejo Hospital in Quito, Ecuador. The Montreal Cognitive Assessment test was applied to COVID-19 patients with mild to moderate symptoms. Results: A total of 50 subjects were recruited, 88% (n = 44) presented cognitive deterioration and only 12% (n = 6) showed a normal score. Conclusions: In our cohort study, patients with COVID-19 with mild-moderate symptoms are at high risk of cognitive impairment. (English) [ FROM AUTHOR] Antecedentes: Las complicaciones de COVID-19 pueden incluir secuelas neurológicas, psiquiátricas, psicológicas y psicosociales. Se sabe poco sobre las consecuencias del COVID-19 en las funciones cognitivas de los pacientes en la fase subaguda de la enfermedad. Objetivo: Determinar si existe incidencia de deterioro cognitivo en pacientes con COVID-19 con síntomas leves a moderados en la fase de remisión. Método: Se trata de un estudio de tipo transversal realizado entre abril de 2021 y agosto de 2021 en el Hospital Eugenio Espejo de Quito, Ecuador. Se aplicó el MoCA test a los pacientes con COVID-19 con síntomas de leve a moderado. Resultados: Un total de 50 sujetos fueron reclutados, el 88% (n = 44) presentó deterioro cognitivo y apenas el 12% (n = 6) evidenció una puntuación normal. Conclusiones: En nuestro estudio de cohorte los pacientes con COVID-19 con sintomatología leve-moderada tienen un alto riesgo de presentar deterioro cognitivo. (Spanish) [ FROM AUTHOR] Copyright of Revista Mexicana de Neurociencia is the property of Academia Mexicana de Neurologia 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.)

16.
Crit Care ; 26(1): 223, 2022 07 20.
Article in English | MEDLINE | ID: covidwho-1938338

ABSTRACT

BACKGROUND: Cognitive impairment has emerged as a common post-acute sequela of coronavirus disease 2019 (COVID-19). We hypothesised that cognitive impairment exists in patients after COVID-19 and that it is most severe in patients admitted to the intensive care unit (ICU). METHODS: This prospective controlled cohort study of 213 participants performed at the Helsinki University Hospital and the University of Helsinki, Finland, comprised three groups of patients-ICU-treated (n = 72), ward-treated (n = 49), and home-isolated (n = 44)-with confirmed COVID-19 between March 13 and December 31, 2020, participating in a comprehensive neuropsychological evaluation six months after the acute phase. Our study included a control group with no history of COVID-19 (n = 48). Medical and demographic data were collected from electronic patient records and interviews carried out four months after the acute phase. Questionnaires filled six months after the acute phase provided information about change in cognitive functioning observed by a close informant, as well as the presence of self-reported depressive and post-traumatic symptoms. RESULTS: The groups differed (effect size η2p = 0.065, p = 0.004) in the total cognitive score, calculated from neuropsychological measures in three domains (attention, executive functions, and memory). Both ICU-treated (p = 0.011) and ward-treated patients (p = 0.005) performed worse than home-isolated patients. Among those with more than 12 years of education, ICU-treated patients performed worse in the attention domain than ward-treated patients (p = 0.021) or non-COVID controls (p = 0.045); ICU-treated male patients, in particular, were impaired in executive functions (p = 0.037). CONCLUSIONS: ICU-treated COVID-19 patients, compared to patients with less severe acute COVID-19 or non-COVID controls, showed more severe long-term cognitive impairment. Among those with more than 12 years of education, impairment existed particularly in the domains of attention and for men, of executive functions. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT04864938, retrospectively registered February 9, 2021.


Subject(s)
COVID-19 , Cognitive Dysfunction , Cognition , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/etiology , Cohort Studies , Humans , Intensive Care Units , Male , Prospective Studies
17.
BMC Med Ethics ; 23(1): 75, 2022 07 18.
Article in English | MEDLINE | ID: covidwho-1938311

ABSTRACT

People who are unable to make decisions about participating in research rely on proxies to make a decision based on their wishes and preferences. However, patients rarely discuss their preferences about research and proxies find it challenging to determine what their wishes would be. While the process of informed consent has traditionally been the focus of research to improve consent decisions, the more conceptually complex area of what constitutes 'good' proxy decision-making for research has remained unexplored. Interventions are needed to improve and support proxy decision-making for research but are hampered by a lack of understanding about what constitutes decision quality in this context. A global increase in conditions associated with cognitive impairment such as dementia has led to an urgent need for more research into these conditions. The COVID-19 pandemic and subsequent necessity to conduct research with large numbers of critically ill patients has made this need even more pressing. Much of the empirical research centres on the desire to improve decision accuracy, despite growing evidence that authenticity is more reflective of the aim of proxy decisions and concerns about the methodological flaws in authenticity-focused studies. Such studies also fail to take account of the impact of decision-making on proxies, or the considerable body of research on improving the quality of healthcare decisions. This paper reports a concept synthesis of the literature that was conducted to develop the first conceptualisation of 'good' proxy decisions about research participation. Elements of decision quality were identified across three stages of decision-making: proxy preparedness for decision-making which includes knowledge and understanding, and values clarification and preference elicitation; the role of uncertainty, decisional conflict, satisfaction and regret in the decision-making process; and preference linked outcomes and their effect. This conceptualisation provides an essential first step towards the future development of interventions to enhance the quality of proxy decision-making and ensure proxy decisions represent patients' values and preferences.


Subject(s)
COVID-19 , Pandemics , Advance Directives , Decision Making , Humans , Informed Consent/psychology , Proxy/psychology
18.
Int J Environ Res Public Health ; 19(13)2022 Jun 22.
Article in English | MEDLINE | ID: covidwho-1934029

ABSTRACT

Background: Person-centered care (PCC) requires knowledge about patient preferences. This formative qualitative study aimed to identify (sub)criteria of PCC for the design of a quantitative, choice-based instrument to elicit patient preferences for person-centered dementia care. Method: Interviews were conducted with n = 2 dementia care managers, n = 10 People living with Dementia (PlwD), and n = 3 caregivers (CGs), which followed a semi-structured interview guide including a card game with PCC criteria identified from the literature. Criteria cards were shown to explore the PlwD's conception. PlwD were asked to rank the cards to identify patient-relevant criteria of PCC. Audios were verbatim-transcribed and analyzed with qualitative content analysis. Card game results were coded on a 10-point-scale, and sums and means for criteria were calculated. Results: Six criteria with two sub-criteria emerged from the analysis; social relationships (indirect contact, direct contact), cognitive training (passive, active), organization of care (decentralized structures and no shared decision making, centralized structures and shared decision making), assistance with daily activities (professional, family member), characteristics of care professionals (empathy, education and work experience) and physical activities (alone, group). Dementia-sensitive wording and balance between comprehensibility vs. completeness of the (sub)criteria emerged as additional themes. Conclusions: Our formative study provides initial data about patient-relevant criteria of PCC to design a quantitative patient preference instrument. Future research may want to consider the balance between (sub)criteria comprehensibility vs. completeness.


Subject(s)
Dementia , Patient Preference , Analytic Hierarchy Process , Caregivers/psychology , Dementia/psychology , Dementia/therapy , Humans , Patient-Centered Care/methods , Qualitative Research , Research Design
19.
Meditsinskiy Sovet ; 2022(6):60-67, 2022.
Article in Russian | Scopus | ID: covidwho-1934849

ABSTRACT

Introduction. Neurological pathologies are typical not only for adults, but are also widespread in childhood. These are disorders of speech and language functions, autism spectrum disorders, attention deficit hyperactivity disorder, emotional disorders. Also, many cognitive impairments affect patients who have had acute viral diseases, especially the coronavirus infection. Purpose-to evaluate the effectiveness and safety of a specialized dietary therapeutic food product and dietary preventive nutrition-jelly "Good Memory" and the phytocomplex included in it at various neurological symptoms. Materials and methods. In a 30-day study with 68 individuals (34 adults and 34 children, ages 1 to 21), the effect of a monthly intake of a phytotherapeutic complex on memory parameters was tudied,attention, intellectual performance of volunteers included in  the study according to Bourbon tests, methodology «Kraepelin score», Eysenck subtests, graphical test and IQ indicators according to the Denver test. Results. A 30-day intake of a specialized food product jelly «Good memory» contributed to improving the performance of  various types of memory and attention, reducing fatigue, increasing efficiency. The survey showed that the intellectual performance of the comparison group decreased by 59% for all three indicators of mental activity. So, in terms of mathematical abilities, the improvement was 47.1%, for linguistic-34.7% and for the total indicator-52.2%. At the same time, the main indicators stabilized intellectual performance. Conclusion. The results of the study allow us to recommend a specialized nutrition jelly «Good Memory» children over 1 year old  and adults to maintain the integrative functions of the brain and other parts of the mental process, as well as for the prevention and rehabilitation of post-covid cognitive impairment, recovery of mental, intellectual performance. © 2022, Remedium Group Ltd. All rights reserved.

20.
Exp Ther Med ; 24(2): 497, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1928720

ABSTRACT

The complex manifestations of COVID-19 include psychiatric symptoms, having multifaceted profiles with varying severity during the acute phase and further during the recovery period. Limited data exist which have analyzed whether there are any age-related differences. A study lot of 89 COVID-19 patients with mild-to-moderate SARS-CoV-2 infection requiring hospitalization for mental issues provided comparative data from two age groups below and above 60 years. The majority of patients had new onset of a mental issue during COVID-19, 24.7% of the total lot being diagnosed with depressive disorder. The senior patient set had a significantly higher prevalence of sleep disorder vs. the younger study group (53.3 vs. 28.8%), depression (33.3 vs. 10.2%) and cognitive impairment (26.7 vs. 8.5%), while patients <60 years of age had a higher prevalence of hallucinations, delirium and bizarre behavior. Psychiatric manifestations are an important part of the symptomatology of COVID-19, sometimes requiring hospitalization. Age-related neuropsychiatric substrate could explain some of these differences between the two study subgroups. Further data are needed to complete the acute and long-term distinctive profiles of COVID-19-related mental illness in older and younger patients.

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