Cognitive domains affected post-COVID-19; a systematic review and meta-analysis.

Autor: Fanshawe JB; Department of Psychiatry, University of Oxford, Oxford, UK.; Oxford Health NHS Foundation Trust, Oxford, UK., Sargent BF; Department of Psychiatry, University of Oxford, Oxford, UK.; Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK., Badenoch JB; Barts Health NHS Trust, London, UK.; Preventive Neurology Unit, Queen Mary University of London, London, UK., Saini A; School of Life and Medical Sciences, University College London, London, UK., Watson CJ; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.; South London and Maudsley NHS Foundation Trust, London, UK., Pokrovskaya A; Department of Brain Sciences, Imperial College London, London, UK., Aniwattanapong D; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.; Department of Psychiatry, King Chulalongkorn Memorial Hospital, Bangkok, Thailand., Conti I; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK., Nye C; Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK., Burchill E; Division of Psychiatry, University College London, London, UK., Hussain ZU; NHS Greater Glasgow and Clyde, Glasgow, UK.; Edinburgh Medical School, University of Edinburgh, Edinburgh, UK., Said K; Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania., Kuhoga E; Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania., Tharmaratnam K; Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK., Pendered S; Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK., Mbwele B; Mbeya College of Health and Allied Sciences, University of Dar es Salaam, Mbeya, Tanzania., Taquet M; Department of Psychiatry, University of Oxford, Oxford, UK.; Oxford Health NHS Foundation Trust, Oxford, UK., Wood GK; Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK., Rogers JP; Division of Psychiatry, University College London, London, UK., Hampshire A; Department of Brain Sciences, Imperial College London, London, UK., Carson A; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK., David AS; Division of Psychiatry, University College London, London, UK., Michael BD; Department of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections at University of Liverpool, Liverpool, UK.; Walton Centre NHS Foundation Trust, Liverpool, UK., Nicholson TR; Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK., Paddick SM; Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.; Gateshead Health NHS Foundation Trust, Gateshead, UK., Leek CE; Department of Psychology, University of Liverpool, Liverpool, UK.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2024 Feb 20, pp. e16181. Date of Electronic Publication: 2024 Feb 20.
DOI: 10.1111/ene.16181
Abstrakt: Background and Purpose: This review aims to characterize the pattern of post-COVID-19 cognitive impairment, allowing better prediction of impact on daily function to inform clinical management and rehabilitation.
Methods: A systematic review and meta-analysis of neurocognitive sequelae following COVID-19 was conducted, following PRISMA-S guidelines. Studies were included if they reported domain-specific cognitive assessment in patients with COVID-19 at >4 weeks post-infection. Studies were deemed high-quality if they had >40 participants, utilized healthy controls, had low attrition rates and mitigated for confounders.
Results: Five of the seven primary Diagnostic and Statistical Manual of Mental Disorders (DSM-5) cognitive domains were assessed by enough high-quality studies to facilitate meta-analysis. Medium effect sizes indicating impairment in patients post-COVID-19 versus controls were seen across executive function (standardised mean difference (SMD) -0.45), learning and memory (SMD -0.55), complex attention (SMD -0.54) and language (SMD -0.54), with perceptual motor function appearing to be impacted to a greater degree (SMD -0.70). A narrative synthesis of the 56 low-quality studies also suggested no obvious pattern of impairment.
Conclusions: This review found moderate impairments across multiple domains of cognition in patients post-COVID-19, with no specific pattern. The reported literature was significantly heterogeneous, with a wide variety of cognitive tasks, small sample sizes and disparate initial disease severities limiting interpretability. The finding of consistent impairment across a range of cognitive tasks suggests broad, as opposed to domain-specific, brain dysfunction. Future studies should utilize a harmonized test battery to facilitate inter-study comparisons, whilst also accounting for the interactions between COVID-19, neurological sequelae and mental health, the interplay between which might explain cognitive impairment.
(© 2024 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
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