Cognitive impairment in long-COVID and its association with persistent dysregulation in inflammatory markers

长期 COVID 患者的认知障碍及其与炎症标志物持续失调的关系

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作者:Rodolfo Furlan Damiano, Cristiana Castanho de Almeida Rocca, Antonio de Pádua Serafim, Jennifer M Loftis, Leda Leme Talib, Pedro Mário Pan, Edecio Cunha-Neto, Jorge Kalil, Gabriela Salim de Castro, Marilia Seelaender, Bruno F Guedes, Suely K Nagahashi Marie, Heraldo Possolo de Souza, Ricardo Nitrini

Conclusion

Though we identified several sociodemographic characteristics that might protect against cognitive impairment following SARS-CoV-2 infection, our data do not support a prominent role for clinical status (both during acute and long-stage of COVID-19) or inflammatory background (also during acute and long-stage of COVID-19) to explain the cognitive deficits that can follow COVID-19 infection.

Methods

We assessed 710 adult participants (Mean age = 55 ± 14; 48.3% were female) 6 to 11 months after hospital discharge with a complete cognitive battery, as well as a psychiatric, clinical and laboratory evaluation. A large set of inferential statistical methods was used to predict potential variables associated with any long-term cognitive impairment, with a focus on a panel of 28 cytokines and other blood inflammatory and disease severity markers.

Objective

To analyze the potential impact of sociodemographic, clinical and biological factors on the long-term cognitive outcome of patients who survived moderate and severe forms of COVID-19.

Results

Concerning the subjective assessment of cognitive performance, 36.1% reported a slightly poorer overall cognitive performance, and 14.6% reported being severely impacted, compared to their pre-COVID-19 status. Multivariate analysis found sex, age, ethnicity, education, comorbidity, frailty and physical activity associated with general cognition. A bivariate analysis found that G-CSF, IFN-alfa2, IL13, IL15, IL1.RA, EL1.alfa, IL45, IL5, IL6, IL7, TNF-Beta, VEGF, Follow-up C-Reactive Protein, and Follow-up D-Dimer were significantly (p<.05) associated with general cognition. However, a LASSO regression that included all follow-up variables, inflammatory markers and cytokines did not support these findings.

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