Evaluation of cognitive impairment in long-severe COVID patients
Bibliographic record
Abstract
Background: “Long Covid” is an expression for describing the syndrome with signs and symptoms that emerge or continue after a Covid-19 acute infection. These symptoms must persist for over 12 weeks and are not explained by an alternative diagnosis. Persistent symptoms include breathing difficulty, fatigue, mental health disorders and cognitive impairment. Objective: To measure and characterize the cognitive impairment and psychiatric disorders related to Covid-19 infection. Methods: This is a cross-sectional study, approved by our institution’s ethics committee (CEP:6.123.125), in a population-based cohort. Two hundred patients admitted to the ICU of a hospital in Porto Alegre due to severe Covid-19 infection and who were discharged from 01/15/2021 to 03/30/2021 were assessed for eligibility. Data regarding cognitive function (Montreal Cognitive Assessment [MoCA] and Addenbrooke’s Cognitive Examination [ACE-III]), psychiatric comorbidities (Hamilton scales) and quality of life (Short Form Health Survey [SF-36]) were collected. Results: A total of 46 patients were enrolled, regardless of their cognitive status, with an average age of 52.2 years (DP 12.1). Twenty-four (54,3%) were male. The vast majority (95.6%) was not experiencing social isolation and had at least eleven years of education (91.3%). We found that many patients suffered from executive and visuospatial dysfunction, performing similarly in MoCA and ACE-III, with a median score of 3.87 (maximum score of 5; DP 1.29; P=0.099) and 14 (maximum score of 16; DP 1.08), respectively. Language was also impaired in our patients, with average scores of 2.52 (maximum score of 3; DP 0.72; P=0.380) and 24.82 (maximum score of 26; DP 1.82) in MoCa and ACE-III, respectively. Regarding memory, MoCA had an average score of 2.7 (maximum score of 5; DP 1.48), while ACE-III showed a score of 18.7 (maximum score of 26; DP 1.5). Unexpectedly, memory performance in both tests was significantly worse even in patients with more than 14 years of formal education. Of all patients, 30,5% (n=14) had normal cognition, 13.04% (n=6) had physical deficit without cognitive impairment, 34.78% (n=16) had mild cognitive impairment (MCI) and 21.73% (n=10) had dementia. The median scores in MoCA were 27.36 (DP±1,216), 27.67 (DP±0,816), 22.75 (DP±2,543) and 22.30 (DP±3,129) in each group, respectively. The median scores in ACE-III were 87.79 (DP±5,820), 92.33 (DP±5,502), 83.81 (DP±8,101) and 80.2 (DP±7,642), respectively. Conclusion: This study provides evidence for a protracted cognitive impairment years after severe Covid-19 infection, showing a combination of executive, visuospatial, language and memory impairments. Although other factors, such as prolonged ICU stay, may have had a role, our findings support that even relatively heathy patients suffer from Covid-19 cognitive dysfunction, which was displayed even more prominently in highly educated patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".