10/18/2023 0 Comments Moca score interpretation malingeringThe clinic serves about 1,000,000 citizens residing in north Israel and is affiliated with a 450-bed tertiary care hospital. This observational study was completed at a post-COVID community clinic in Haifa, Northern Israel. We sought to improve the characterization of cognitive impairment of patients recovering from COVID-19 infection. In the present study, we report the cognitive manifestation of 46 post-COVID patients referred to a community neurology clinic in Northern Israel several months after the diagnosis of COVID-19. Risk was greatest in, but not limited to, patients who had severe COVID-19 or were hospitalized (Groves and Riley 1988 Hopkins et al. The most frequent manifestations were vascular complications (e.g., intracranial hemorrhage and ischemic stroke), dementia and psychiatric manifestations (e.g., mood disorders and anxiety). According to a meta-analysis that used the TriNetX electronic data and evaluated 6-month neurological and psychiatric outcomes among 236,379 patients diagnosed with COVID-19 excluding patients with previous diagnosis of dementia, found that the estimated incidence of a neurological or psychiatric diagnosis 6 months following the infection was 34%, with 13% receiving their first such diagnosis. Long-term cognitive complaints are associated with anxiety and depression (Almeria et al. Previous studies suggest that the presence of anosmia, dysgeusia, diarrhea and the need for oxygen therapy during the acute phase of COVID-19 are risk factors for subsequent cognitive impairment (Almeria et al. One-third of patients upon discharge have evidenced cognitive impairment characterized by a dysexecutive syndrome as well as inattention, disorientation, and poorly organized movements in response to commands (Helms et al. Furthermore, the exact mechanism by which SARS-CoV-2 affects the central nervous system (CNS) remains unclear.ĭuring the acute illness, regardless of disease severity, neurologic symptoms have been reported in many COVID-19 patients, including headache, anosmia, ageusia, confusion, encephalopathy, impairment of consciousness, stroke, cerebral venous sinus thrombosis, intracerebral hemorrhage, coma, and seizures (Lau et al. Despite emerging evidence that COVID-19 has neurologic consequences, it is yet unclear whether SARS-CoV-2 is neurotropic in humans. More than 1 year following the acute stages of infection, many patients report persistent physical and neuropsychiatric symptoms in the aftermath of SARS-CoV-2 infection (WHO 2022 Zubair et al. According to the World Health Organization (WHO), the COVID-19 pandemic has infected more than 298 million people leading to approximately 5.4 million deaths as of late January 2022 (WHO 2022), and it still threatens public health systems worldwide.Įarly in the pandemic, attention was focused on acute morbidity and mortality however, long-term symptoms following infection were reported soon after and these included neuropsychiatric manifestations as well as cognitive issues (Carfi et al. Consequently, the full impact of this infectious disease is not likely to be fully appreciated for years. These findings occurred despite normal laboratory tests and imaging findings.Ĭoronavirus (COVID-19) disease, often characterized by a severe acute respiratory syndrome following infection with SARS-CoV-2, continues to evolve rapidly. Our examination identified abnormalities in executive function, attention, and phonemic fluency. Disease severity, premorbid condition, pulmonary function tests and hypoxia did not contribute to cognitive performance. Cognitive decline may affect otherwise healthy patients post-COVID, independent of disease severity. In contrast, the total MoCA score, and memory and orientation subscores did not differ from expected ranges. On the MoCA test, executive functions, particularly phonemic fluency, and attention, were impaired. The neurologic work-up included detailed medical history, symptom inventory, neurological examination, the Montreal Cognitive Assessment (MoCA), laboratory tests and brain CT or MRI. Between December 2020 and June 2021, 46 patients were referred for neurological consultation (65% female), mean age 49.5 (19–72 years). The present study aims to characterize cognitive performance in patients experiencing cognitive symptoms post-COVID infection. Patients evaluated at a post COVID clinic in Northern Israel who endorsed cognitive symptoms were referred for neurologic consultation. The long-term sequelae of COVID-19 and neurologic syndromes post COVID remain poorly understood. The coronavirus (COVID-19) pandemic is still evolving, causing hundreds of millions of infections around the world.
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