RESUMO
INTRODUCTION: COVID-19 has a wide range of clinical manifestations. Neurological manifestations in COVID-19 patients were demonstrated during the pandemic, including cognitive impairment. This study aimed to determine any relationship between COVID-19 and cognitive complaints, such as dementia, mild cognitive impairment (MCI), or subjective cognitive decline (SCD). METHODS: We performed a systematic review of MEDLINE via Ebsco, Cochrane EMBASE, SCOPUS, and LILACS electronic databases of observational studies with COVID-19 patients confirmed by serology or PCR who developed new cognitive impairment or deteriorated from previous cognitive impairment after infection. This review protocol was recorded on PROSPERO with registration number CRD 42021241590. RESULTS: A total of 3.520 articles were retrieved and read. Twenty-two studies were selected for our review. A wide range of cognitive assessment tools (n = 25) was used. The most described affected domains in these studies were executive functions, attention, and episodic memory. Thirteen studies showed a pattern of cognitive impairment in processing speed, inattention, or executive dysfunction assessed through working memory. CONCLUSION: This review highlights the high frequency of cognitive impairment after COVID-19 infection. However, we were unable to differentiate whether the cognitive impairment found corresponded to mild cognitive impairment or dementia through data from selected studies, and this issue serves as one objective of future studies to be addressed on this topic.
Assuntos
COVID-19 , Disfunção Cognitiva , Demência , COVID-19/complicações , Cognição , Função Executiva , HumanosRESUMO
BACKGROUND: The aim of the present study was to determine the validity of the Brazilian version of the Geriatric Depression Scale (GDS) with 30 (GDS-30), 15 (GDS-15), 10 (GDS-10), 4 (GDS-4) and 1 (GDS-1) items and to calculate the optimum cutoff points for identifying depression among elderly primary care subjects. METHODS: A cross-sectional study was carried out involving 220 elderly patients recruited from four primary care clinics in northeastern Brazil. The following measurements were obtained: sociodemographic variables, Katz scale of independence in activities of daily living, and the GDS with 30, 15, 10, 4 and 1 item(s). A psychiatrist blinded to the results of the GDS applied the mood module of the Structured Clinical Interview for the DSM-IV for the diagnosis of major depressive episodes as the "gold standard." RESULTS: The use of the cut-off point of 10/11 for the GDS-30 produced sensitivity and specificity rates of 92.0% (95% CI: 70-98) and 79% (95% CI: 73-85), respectively. The positive predictive value (PPV) and the negative predictive value (NPV) were 49% and 98%, respectively. The optimum cut-off point for the GDS-15 was 4/5, at which sensitivity was 87% (95% CI: 71-95) and specificity was 82% (95% CI: 76-91), PPV was 51% and NPV was 97%. At the cut-off point of 3/4 the sensitivity, specificity, PPV and NPV for the GDS-10 were 76% (95% CI: 60-89), 81% (95% CI: 75-87), 46% (95% CI: 33-59%), and 94% (95% CI 89-97%), respectively. The optimum cut-off point for the GDS-4 was 0/1, at which sensitivity was 84% (95% CI: 68-93%); specificity was 75% (95% CI; 68-91%); PPV was 41% and NPV was 96%. For the GDS-1, sensitivity was 47%, specificity was 96%; PPV was 69% and NPV was 90%. CONCLUSIONS: The GDS-30, GDS-15, GDS-10 and GDS-4 proved to be good screening instruments for depression in primary care clinics in Brazil, whereas the GDS-1 failed to perform adequately.
