Researchers from the University of Sao Paulo found that cognitive impairments, such as memory loss and attention deficits, persist in both severe and mild COVID-19 patients long after initial infection, affecting their daily lives. The study of 302 volunteers found that even patients with mild symptoms exhibited significant cognitive impairment, highlighting the great need for cognitive rehabilitation strategies to address these long-term effects. Credit: SciTechDaily.com
According to the study, the most serious impact is SARS-CoV-2 Observed in acutely ill patients COVID-19However, people who had milder symptoms and were not hospitalized reported symptoms of memory loss and attention deficit that continued for more than 18 months after infection.
Memory loss and attention deficits are common symptoms among survivors of severe COVID-19, but a study by researchers at the University of São Paulo (USP) in Brazil found that these and other cognitive impairments have also been observed in patients with milder disease more than 18 months after infection.
An article about the study was published in the journal BMC Psychology. The findings highlight the need for more comprehensive rehabilitation to address the long-term cognitive effects of COVID-19, the authors wrote.
Data collected from 302 volunteers showed that cognitive impairment was present in 11.7% of patients with mild disease, 39.2% of patients with moderate disease, and 48.9% of patients with severe disease.
“The damage caused by the disease, such as memory loss, attention deficits and reduced processing speed, increases in proportion to the severity of the disease, but a not inconsiderable number of people with mild or moderate COVID-19 (around 100 in our study) suffer from the same problems,” said Antonio de Padua Seraphim, lead author of the study and professor at the Institute of Psychology (IP-USP).
The results of this FAPESP-funded study demonstrate the potential impact of neuroinflammation due to SARS-CoV-2 infection.
“Memory loss and attention deficits are known to be associated with post-intensive care syndrome due to intubation under deep anesthesia. However, some of the data analyzed in the study came from patients who presented with memory loss and attention deficits despite not needing intensive care or being sick enough to be hospitalized. The findings therefore open our eyes to the issue of neuroinflammation due to COVID-19,” Seraphim said.
Memory and attention are important cognitive functions that affect people’s daily lives. Reflecting this, study participants who scored poorly on tests of memory and attention reported having difficulty remembering words or carrying out everyday activities such as leaving a pot on the stove or missing to pick up their children from school.
“Hierarchically speaking, attention is a primary function in all mental activities, which explains why attention deficits have such a significant impact on people’s daily lives. Thinking and acting in different ways simultaneously requires high-quality attention. Poor attention, in turn, affects memory. In some cases, attentional activity is so dispersed that new stimuli (or impending activities) get drowned out and you can’t remember what you were doing. This also affects processing activity, which is what allows you to make quick, informed decisions,” he said.
Cognitive rehabilitation
Seraphim said evidence has long shown that SARS-CoV-2 can affect the lungs, kidneys, heart and muscles as well as the central nervous system, but the extent of the damage it can cause is not fully understood. “We don’t know if the cognitive impairment caused by COVID-19 is permanent, and we are currently looking at ways to intervene in this process,” he said.
Seraphim is collaborating with other researchers at USP to develop a program to mitigate the cognitive decline caused by COVID-19 by investigating whether techniques such as neurostimulation and neurofeedback can reduce or prevent memory loss and attention deficits.
“Both are non-invasive techniques that aim to improve brain function through neuromodulation, which stimulates the connections (synapses) between neurons in the brain. So far, we only have case studies. For example, in the case of a doctor who was hospitalized in the intensive care unit for 34 days, we performed a neurofeedback protocol, which is often used to study patients with attention deficit disorder, and he recovered well. But that was an isolated case,” he said.
“Based on what we know so far about cognitive stimulation and rehabilitation techniques, we believe that brain training may be able to improve neural connections and stimulate overall cognitive abilities. The serious phase of the pandemic has passed, but the aftereffects remain. So this is not a solved case. Many people were infected, and many people have these kinds of aftereffects. But we don’t have effective programs to intervene not only on the emotional side, but also on the cognitive impairment caused by COVID-19.”
Reference: “Cognitive performance in post-COVID patients in mild, moderate and severe clinical situations” Antonio de Pádua Serafim, Fabiana Saffi, Amanda Rafaella A. Soares, Alessandra Mara Morita, Mariana Medeiros Assed, Sandro de Toledo, Cristiana CA Rocca, Ricardo SS Durães, 26 April 2024, BMC Psychology.
DOI: 10.1186/s40359-024-01740-7
This study was funded by the São Paulo Research Foundation.
