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Comprehensive clinical assessment identifies specific neurocognitive deficits in working-age patients with long-COVID.
Holdsworth, David A; Chamley, Rebecca; Barker-Davies, Rob; O'Sullivan, Oliver; Ladlow, Peter; Mitchell, James L; Dewson, Dominic; Mills, Daniel; May, Samantha L J; Cranley, Mark; Xie, Cheng; Sellon, Edward; Mulae, Joseph; Naylor, Jon; Raman, Betty; Talbot, Nick P; Rider, Oliver J; Bennett, Alexander N; Nicol, Edward D.
  • Holdsworth DA; Royal Centre for Defence Medicine Birmingham, Birmingham, United Kingdom.
  • Chamley R; Academic Department of Military Medicine, Birmingham, United Kingdom.
  • Barker-Davies R; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • O'Sullivan O; Academic Department of Military Medicine, Birmingham, United Kingdom.
  • Ladlow P; University of Oxford, OCMR, Division of Cardiovascular Medicine, Oxford, United Kingdom.
  • Mitchell JL; Defence Medical Rehabilitation Centre, Academic Department of Military Rehabilitation, Stanford Hall, United Kingdom.
  • Dewson D; Loughborough University, School of Sport, Exercise and Health Sciences, Loughborough, United Kingdom.
  • Mills D; Defence Medical Rehabilitation Centre, Academic Department of Military Rehabilitation, Stanford Hall, United Kingdom.
  • May SLJ; Defence Medical Rehabilitation Centre, Academic Department of Military Rehabilitation, Stanford Hall, United Kingdom.
  • Cranley M; Department for Health, University of Bath, Bath, United Kingdom.
  • Xie C; Defence Medical Rehabilitation Centre, Academic Department of Military Rehabilitation, Stanford Hall, United Kingdom.
  • Sellon E; University of Birmingham, Metabolic Neurology, Institute of Metabolism and Systems Research, Birmingham, United Kingdom.
  • Mulae J; Defence Medical Rehabilitation Centre, Academic Department of Military Rehabilitation, Stanford Hall, United Kingdom.
  • Naylor J; Defence Medical Rehabilitation Centre, Academic Department of Military Rehabilitation, Stanford Hall, United Kingdom.
  • Raman B; Defence Medical Rehabilitation Centre, Academic Department of Military Rehabilitation, Stanford Hall, United Kingdom.
  • Talbot NP; Defence Medical Rehabilitation Centre, Stanford Hall, United Kingdom.
  • Rider OJ; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • Bennett AN; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • Nicol ED; Defence Medical Rehabilitation Centre, Stanford Hall, United Kingdom.
PLoS One ; 17(6): e0267392, 2022.
Article in English | MEDLINE | ID: covidwho-2021694
ABSTRACT

INTRODUCTION:

There have been more than 425 million COVID-19 infections worldwide. Post-COVID illness has become a common, disabling complication of this infection. Therefore, it presents a significant challenge to global public health and economic activity.

METHODS:

Comprehensive clinical assessment (symptoms, WHO performance status, cognitive testing, CPET, lung function, high-resolution CT chest, CT pulmonary angiogram and cardiac MRI) of previously well, working-age adults in full-time employment was conducted to identify physical and neurocognitive deficits in those with severe or prolonged COVID-19 illness.

RESULTS:

205 consecutive patients, age 39 (IQR30.0-46.7) years, 84% male, were assessed 24 (IQR17.1-34.0) weeks after acute illness. 69% reported ≥3 ongoing symptoms. Shortness of breath (61%), fatigue (54%) and cognitive problems (47%) were the most frequent symptoms, 17% met criteria for anxiety and 24% depression. 67% remained below pre-COVID performance status at 24 weeks. One third of lung function tests were abnormal, (reduced lung volume and transfer factor, and obstructive spirometry). HRCT lung was clinically indicated in <50% of patients, with COVID-associated pathology found in 25% of these. In all but three HRCTs, changes were graded 'mild'. There was an extremely low incidence of pulmonary thromboembolic disease or significant cardiac pathology. A specific, focal cognitive deficit was identified in those with ongoing symptoms of fatigue, poor concentration, poor memory, low mood, and anxiety. This was notably more common in patients managed in the community during their acute illness.

CONCLUSION:

Despite low rates of residual cardiopulmonary pathology, in this cohort, with low rates of premorbid illness, there is a high burden of symptoms and failure to regain pre-COVID performance 6-months after acute illness. Cognitive assessment identified a specific deficit of the same magnitude as intoxication at the UK drink driving limit or the deterioration expected with 10 years ageing, which appears to contribute significantly to the symptomatology of long-COVID.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0267392

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Female / Humans / Male Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0267392