European Academy of Neurology Presentations Show Cognitive and Behavioral Symptoms After COVID-19
Several studies regarding cognitive and behavioral symptoms after recovery from acute COVID-19 were presented at the 7th Congress of the European Academy of Neurology.
A study from professor Massimo Filippi of the Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy Issues found memory, spatial awareness, and information processing problems were identified in over half of individuals who had follow-up within 8 weeks. Posttraumatic stress disorder symptoms were found in 20% of these individuals and depressive symptoms occurred in 16%.
Similarly, in another study of 53 individuals in Italy, 77.4% had at least 1 neurologic symptom and 46.3% had more than 3 symptoms. Insomnia, daytime sleepiness, and difficulty walking were most common. Less frequent symptoms included headache, hyposmia, and hypogeusia.
In the first study, individuals under age 50 had worse cognitive performance, particularly with executive function deficits. Greater severity of COVID-19 acute respiratory symptoms during hospital admission was associated with lower executive function performance. Longitudinal observation over an additional 8 months, showed a reduction of cognitive disturbances from 53 to 36%, and unchanged levels of PTSD and depressive symptoms.
Professor Filippi noted, “Our study has confirmed significant cognitive and behavioral problems are associated with COVID-19 and persist several months after remission of the disease. A particularly alarming finding is the changes to executive function we found, which can make it difficult for people to concentrate, plan, think flexibly and remember things. These symptoms affected 3 in 4 younger patients who were of a working age.”
In another study, from the Ukraine, 95% of people age 32 to 54 (n=42) who had recovered from acute COVID-19 had neurocognitive symptoms including fatigue and anxiety or depression in all who had post-COVID-19 symptoms. Vestibular (balance) disorders, (59.2%), headaches, (50%) and reduced ability to smell (19%) were also seen, and 5 people in the cohort had ischemic strokes within 2 months of hospitalization with COVID-19.
Participants in this study had neurocognitive tests and MRI scans. No significant relationship was observed between cognitive performance and brain volume within the study.
A study from Dr Tommaso Bocci, a neurologist and neurophysiologist at the University of Milan Department of Neurological Science, provided neuropathologic neurophysiologic, and clinical evidence of brain-stem involvement in COVID-19, particularly at the medullary level. If confirmed, this suggests a mechanism for neurologic involvement in the respiratory failure seen with COVID-19. Postmortem neuropathology showed a high percentage of neuronal damage and a higher number of amyloid bodies. Evidence of SARS-CoV-2 in the brain stem was seen on immunohistochemistry.