COVID-19 causes cognitive, behavioral changes, especially among younger adults

COVID-19 infection correlated with cognitive and behavioral changes within 2 months of hospital discharge, according to findings from a small study presented during the 7th Congress of the European Academy of Neurology.

Study results showed that patients aged less than 50 years, which the researchers identified as the youngest patients, experienced the most severe changes.

“Our study has confirmed significant cognitive and behavioral problems are associated with COVID-19 and persist several months after remission of the disease,” lead study author Massimo Filippi, MD, professor of neurology, director of the residency school in neurology and president of the bachelor’s degree in physiotherapy at Università Vita-Salute San Raffaele in Milan, said in a press release. “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.”

Filippi and colleagues aimed to determine cognitive and behavioral characteristics among 49 patients with confirmed COVID-19 infection. The researchers performed a neuropsychological evaluation and a brain MRI within 2 months of hospital discharge. They recorded the rates of cognitive and behavioral changes, as observed in the normative data, and collected data on total brain volumes for these patients. They also drew correlations between neuropsychological performance, brain volume and severity of acute-phase respiratory symptoms at the time of hospital admission.

The researchers found that 16% of patients presented with depressive symptoms and 18% reported PTSD. Nearly half of the study population (45%) demonstrated executive dysfunctions, while 30% had visuospatial issues and 25% had long-term problems with verbal and nonverbal memory.

Filippi and colleagues reported that the youngest patients, or those aged less than 50 years, had the “most severe” profile, where 75% of those patients demonstrated executive dysfunctions. Half of the patients in this group (50%) also had pure visuospatial dysfunctions and 40% had primary long-term memory problems.

The researchers observed a negative relationship in all patients between frontal executive performance and the severity of acute-phase respiratory symptoms at the time of hospital admission (r = –0.347; P < .01). However, they reported no significant relationship between cognitive performance and brain volume, according to the study results.

Changes in cognition and behavior occurred independent of brain structural integrity, Filippi and colleagues found. According to the researchers, “it is still to be determined” whether these changes directly correlate with COVID-19 infection or with its “related consequences,” in addition to whether they are reversible or part of a neurodegenerative process.

“Larger studies and longer-term follow up are both needed, but this study suggests that COVID-19 is associated with significant cognitive and psychopathological problems,” Elisa Canu, PhD, a researcher at the San Raffaele Hospital in Milan and first author of the study, said in the press release. “Appropriate follow-up and treatments are crucial to ensure these previously hospitalized patients are given adequate support to help to alleviate these symptoms.”

Reference:

European Academy of Neurology. COVID-19 leads to significant cognitive and behavioral problems in patients, new study reveals. Available at: https://www.ean.org/congress2021. Accessed June 21, 2021.