Neuropsychological Pattern in a Series of Post-Acute COVID-19 Patients in a Rehabilitation Unit: Retrospective Analysis and Correlation with Functional Outcomes.

ABSTRACT

Intensive Care Unit delirium, insomnia, anxiety, and frontal/dysexecutive disorders have been described following COVID-19 infection. The aim of this case study was to re-evaluate the neuropsychological pattern in a series of patients with COVID-19 outcomes. We retrospectively evaluated 294 patients admitted to the Istituti Clinici Scientifici Maugeri of Lumezzane (Brescia) (May-September 2020). Neuropsychological assessment was available for 12 patients. We extracted clinical, functional data (FIM and Barthel Index score) and neuropsychological tests (MMSE, Trail making a-b, verbal fluency test, digit span, prose memory test, Frontal Assessment Battery, clock drawing test, Rey-Osterrieth complex figure, Tower of London test). The results were analyzed by Spearman (rho) correlation. Six patients presented dysexecutive alterations even in the presence of normal overall cognitive functioning. Forward digit span score was directly correlated to FIM value at admission (p = 0.015) and inversely correlated to delta FIM (p = 0.030) and delta Barthel Index (p = 0.025). In our experience, subclinical cognitive alterations were present in 4% of patients recovering from COVID-19 pneumonia. The possible correlation between verbal memory and frontal functions, and the degree of functional impairment at admission and its subsequent improvement, underscores the importance of an adequate cognitive evaluation and rehabilitation.