Cognitive decline among individuals with history of mild symptomatic SARS‐CoV‐2 infection: A longitudinal prospective study nested to a population cohort
Background and purpose Neurological complications of SARS‐CoV‐2 infection are noticed among critically ill patients soon after disease onset. Information on delayed neurological sequelae of SARS‐CoV‐2 infection is nil. Following a longitudinal study design, the occurrence of cognitive decline among...
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| Vydáno v: | European journal of neurology Ročník 28; číslo 10; s. 3245 - 3253 |
|---|---|
| Hlavní autoři: | , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
England
John Wiley & Sons, Inc
01.10.2021
John Wiley and Sons Inc |
| Témata: | |
| ISSN: | 1351-5101, 1468-1331, 1468-1331 |
| On-line přístup: | Získat plný text |
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| Abstract | Background and purpose
Neurological complications of SARS‐CoV‐2 infection are noticed among critically ill patients soon after disease onset. Information on delayed neurological sequelae of SARS‐CoV‐2 infection is nil. Following a longitudinal study design, the occurrence of cognitive decline among individuals with a history of mild symptomatic SARS‐CoV‐2 infection was assessed.
Methods
Stroke‐ and seizure‐free Atahualpa residents aged ≥40 years, who had pre‐pandemic cognitive assessments as well as normal brain magnetic resonance imaging and electroencephalogram recordings, underwent repeated evaluations 6 months after a SARS‐CoV‐2 outbreak infection in Atahualpa. Patients requiring oxygen therapy, hospitalization, and those who had initial neurological manifestations were excluded. Cognitive decline was defined as a reduction in the Montreal Cognitive Assessment (MoCA) score between the post‐pandemic and pre‐pandemic assessments that was ≥4 points greater than the reduction observed between two pre‐pandemic MoCAs. The relationship between SARS‐CoV‐2 infection and cognitive decline was assessed by fitting logistic mixed models for longitudinal data as well as exposure‐effect models.
Results
Of 93 included individuals (mean age 62.6 ± 11 years), 52 (56%) had a history of mild symptomatic SARS‐CoV‐2 infection. Post‐pandemic MoCA decay was worse in seropositive individuals. Cognitive decline was recognized in 11/52 (21%) seropositive and 1/41 (2%) seronegative individuals. In multivariate analyses, the odds for developing cognitive decline were 18.1 times higher among SARS‐CoV‐2 seropositive individuals (95% confidence interval 1.75–188; p = 0.015). Exposure‐effect models confirmed this association (β = 0.24; 95% confidence interval 0.07–0.41; p = 0.006).
Conclusions
This study provides evidence of cognitive decline among individuals with mild symptomatic SARS‐CoV‐2 infection. The pathogenesis of this complication remains unknown.
This population‐based longitudinal prospective cohort study, conducted in a selected population of community‐dwelling middle‐aged and older adults living in a rural village severely struck by the SARS‐CoV‐2 pandemic, demonstrates that individuals with a history of mild symptomatic SARS‐CoV‐2 infections have more than 18 times the odds of developing late substantial cognitive decline than those without clinical and serological evidence of the infection. |
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| AbstractList | Neurological complications of SARS-CoV-2 infection are noticed among critically ill patients soon after disease onset. Information on delayed neurological sequelae of SARS-CoV-2 infection is nil. Following a longitudinal study design, the occurrence of cognitive decline among individuals with a history of mild symptomatic SARS-CoV-2 infection was assessed.
Stroke- and seizure-free Atahualpa residents aged ≥40 years, who had pre-pandemic cognitive assessments as well as normal brain magnetic resonance imaging and electroencephalogram recordings, underwent repeated evaluations 6 months after a SARS-CoV-2 outbreak infection in Atahualpa. Patients requiring oxygen therapy, hospitalization, and those who had initial neurological manifestations were excluded. Cognitive decline was defined as a reduction in the Montreal Cognitive Assessment (MoCA) score between the post-pandemic and pre-pandemic assessments that was ≥4 points greater than the reduction observed between two pre-pandemic MoCAs. The relationship between SARS-CoV-2 infection and cognitive decline was assessed by fitting logistic mixed models for longitudinal data as well as exposure-effect models.
Of 93 included individuals (mean age 62.6 ± 11 years), 52 (56%) had a history of mild symptomatic SARS-CoV-2 infection. Post-pandemic MoCA decay was worse in seropositive individuals. Cognitive decline was recognized in 11/52 (21%) seropositive and 1/41 (2%) seronegative individuals. In multivariate analyses, the odds for developing cognitive decline were 18.1 times higher among SARS-CoV-2 seropositive individuals (95% confidence interval 1.75-188; p = 0.015). Exposure-effect models confirmed this association (β = 0.24; 95% confidence interval 0.07-0.41; p = 0.006).
This study provides evidence of cognitive decline among individuals with mild symptomatic SARS-CoV-2 infection. The pathogenesis of this complication remains unknown. This population‐based longitudinal prospective cohort study, conducted in a selected population of community‐dwelling middle‐aged and older adults living in a rural village severely struck by the SARS‐CoV‐2 pandemic, demonstrates that individuals with a history of mild symptomatic SARS‐CoV‐2 infections have more than 18 times the odds of developing late substantial cognitive decline than those without clinical and serological evidence of the infection. Neurological complications of SARS-CoV-2 infection are noticed among critically ill patients soon after disease onset. Information on delayed neurological sequelae of SARS-CoV-2 infection is nil. Following a longitudinal study design, the occurrence of cognitive decline among individuals with a history of mild symptomatic SARS-CoV-2 infection was assessed.BACKGROUND AND PURPOSENeurological complications of SARS-CoV-2 infection are noticed among critically ill patients soon after disease onset. Information on delayed neurological sequelae of SARS-CoV-2 infection is nil. Following a longitudinal study design, the occurrence of cognitive decline among individuals with a history of mild symptomatic SARS-CoV-2 infection was assessed.Stroke- and seizure-free Atahualpa residents aged ≥40 years, who had pre-pandemic cognitive assessments as well as normal brain magnetic resonance imaging and electroencephalogram recordings, underwent repeated evaluations 6 months after a SARS-CoV-2 outbreak infection in Atahualpa. Patients requiring oxygen therapy, hospitalization, and those who had initial neurological manifestations were excluded. Cognitive decline was defined as a reduction in the Montreal Cognitive Assessment (MoCA) score between the post-pandemic and pre-pandemic assessments that was ≥4 points greater than the reduction observed between two pre-pandemic MoCAs. The relationship between SARS-CoV-2 infection and cognitive decline was assessed by fitting logistic mixed models for longitudinal data as well as exposure-effect models.METHODSStroke- and seizure-free Atahualpa residents aged ≥40 years, who had pre-pandemic cognitive assessments as well as normal brain magnetic resonance imaging and electroencephalogram recordings, underwent repeated evaluations 6 months after a SARS-CoV-2 outbreak infection in Atahualpa. Patients requiring oxygen therapy, hospitalization, and those who had initial neurological manifestations were excluded. Cognitive decline was defined as a reduction in the Montreal Cognitive Assessment (MoCA) score between the post-pandemic and pre-pandemic assessments that was ≥4 points greater than the reduction observed between two pre-pandemic MoCAs. The relationship between SARS-CoV-2 infection and cognitive decline was assessed by fitting logistic mixed models for longitudinal data as well as exposure-effect models.Of 93 included individuals (mean age 62.6 ± 11 years), 52 (56%) had a history of mild symptomatic SARS-CoV-2 infection. Post-pandemic MoCA decay was worse in seropositive individuals. Cognitive decline was recognized in 11/52 (21%) seropositive and 1/41 (2%) seronegative individuals. In multivariate analyses, the odds for developing cognitive decline were 18.1 times higher among SARS-CoV-2 seropositive individuals (95% confidence interval 1.75-188; p = 0.015). Exposure-effect models confirmed this association (β = 0.24; 95% confidence interval 0.07-0.41; p = 0.006).RESULTSOf 93 included individuals (mean age 62.6 ± 11 years), 52 (56%) had a history of mild symptomatic SARS-CoV-2 infection. Post-pandemic MoCA decay was worse in seropositive individuals. Cognitive decline was recognized in 11/52 (21%) seropositive and 1/41 (2%) seronegative individuals. In multivariate analyses, the odds for developing cognitive decline were 18.1 times higher among SARS-CoV-2 seropositive individuals (95% confidence interval 1.75-188; p = 0.015). Exposure-effect models confirmed this association (β = 0.24; 95% confidence interval 0.07-0.41; p = 0.006).This study provides evidence of cognitive decline among individuals with mild symptomatic SARS-CoV-2 infection. The pathogenesis of this complication remains unknown.CONCLUSIONSThis study provides evidence of cognitive decline among individuals with mild symptomatic SARS-CoV-2 infection. The pathogenesis of this complication remains unknown. Background and purposeNeurological complications of SARS‐CoV‐2 infection are noticed among critically ill patients soon after disease onset. Information on delayed neurological sequelae of SARS‐CoV‐2 infection is nil. Following a longitudinal study design, the occurrence of cognitive decline among individuals with a history of mild symptomatic SARS‐CoV‐2 infection was assessed.MethodsStroke‐ and seizure‐free Atahualpa residents aged ≥40 years, who had pre‐pandemic cognitive assessments as well as normal brain magnetic resonance imaging and electroencephalogram recordings, underwent repeated evaluations 6 months after a SARS‐CoV‐2 outbreak infection in Atahualpa. Patients requiring oxygen therapy, hospitalization, and those who had initial neurological manifestations were excluded. Cognitive decline was defined as a reduction in the Montreal Cognitive Assessment (MoCA) score between the post‐pandemic and pre‐pandemic assessments that was ≥4 points greater than the reduction observed between two pre‐pandemic MoCAs. The relationship between SARS‐CoV‐2 infection and cognitive decline was assessed by fitting logistic mixed models for longitudinal data as well as exposure‐effect models.ResultsOf 93 included individuals (mean age 62.6 ± 11 years), 52 (56%) had a history of mild symptomatic SARS‐CoV‐2 infection. Post‐pandemic MoCA decay was worse in seropositive individuals. Cognitive decline was recognized in 11/52 (21%) seropositive and 1/41 (2%) seronegative individuals. In multivariate analyses, the odds for developing cognitive decline were 18.1 times higher among SARS‐CoV‐2 seropositive individuals (95% confidence interval 1.75–188; p = 0.015). Exposure‐effect models confirmed this association (β = 0.24; 95% confidence interval 0.07–0.41; p = 0.006).ConclusionsThis study provides evidence of cognitive decline among individuals with mild symptomatic SARS‐CoV‐2 infection. The pathogenesis of this complication remains unknown. Background and purpose Neurological complications of SARS‐CoV‐2 infection are noticed among critically ill patients soon after disease onset. Information on delayed neurological sequelae of SARS‐CoV‐2 infection is nil. Following a longitudinal study design, the occurrence of cognitive decline among individuals with a history of mild symptomatic SARS‐CoV‐2 infection was assessed. Methods Stroke‐ and seizure‐free Atahualpa residents aged ≥40 years, who had pre‐pandemic cognitive assessments as well as normal brain magnetic resonance imaging and electroencephalogram recordings, underwent repeated evaluations 6 months after a SARS‐CoV‐2 outbreak infection in Atahualpa. Patients requiring oxygen therapy, hospitalization, and those who had initial neurological manifestations were excluded. Cognitive decline was defined as a reduction in the Montreal Cognitive Assessment (MoCA) score between the post‐pandemic and pre‐pandemic assessments that was ≥4 points greater than the reduction observed between two pre‐pandemic MoCAs. The relationship between SARS‐CoV‐2 infection and cognitive decline was assessed by fitting logistic mixed models for longitudinal data as well as exposure‐effect models. Results Of 93 included individuals (mean age 62.6 ± 11 years), 52 (56%) had a history of mild symptomatic SARS‐CoV‐2 infection. Post‐pandemic MoCA decay was worse in seropositive individuals. Cognitive decline was recognized in 11/52 (21%) seropositive and 1/41 (2%) seronegative individuals. In multivariate analyses, the odds for developing cognitive decline were 18.1 times higher among SARS‐CoV‐2 seropositive individuals (95% confidence interval 1.75–188; p = 0.015). Exposure‐effect models confirmed this association (β = 0.24; 95% confidence interval 0.07–0.41; p = 0.006). Conclusions This study provides evidence of cognitive decline among individuals with mild symptomatic SARS‐CoV‐2 infection. The pathogenesis of this complication remains unknown. This population‐based longitudinal prospective cohort study, conducted in a selected population of community‐dwelling middle‐aged and older adults living in a rural village severely struck by the SARS‐CoV‐2 pandemic, demonstrates that individuals with a history of mild symptomatic SARS‐CoV‐2 infections have more than 18 times the odds of developing late substantial cognitive decline than those without clinical and serological evidence of the infection. |
| Author | Costa, Aldo F. Wu, Shasha Del Brutto, Oscar H. Mera, Robertino M. Recalde, Bettsy Y. Issa, Naoum P. |
| AuthorAffiliation | 2 Department of Neurology University of Chicago Chicago IL USA 3 Department of Epidemiology Gilead Sciences, Inc Foster City CA USA 5 Community Center the Atahualpa Project Atahualpa Ecuador 1 School of Medicine Universidad Espíritu Santo—Ecuador Samborondón Ecuador 4 Department of Neurology Hospital Universitario Reina Sofía Cordoba Spain |
| AuthorAffiliation_xml | – name: 3 Department of Epidemiology Gilead Sciences, Inc Foster City CA USA – name: 2 Department of Neurology University of Chicago Chicago IL USA – name: 4 Department of Neurology Hospital Universitario Reina Sofía Cordoba Spain – name: 1 School of Medicine Universidad Espíritu Santo—Ecuador Samborondón Ecuador – name: 5 Community Center the Atahualpa Project Atahualpa Ecuador |
| Author_xml | – sequence: 1 givenname: Oscar H. orcidid: 0000-0003-1917-8805 surname: Del Brutto fullname: Del Brutto, Oscar H. email: oscardelbrutto@hotmail.com organization: Universidad Espíritu Santo—Ecuador – sequence: 2 givenname: Shasha surname: Wu fullname: Wu, Shasha organization: University of Chicago – sequence: 3 givenname: Robertino M. surname: Mera fullname: Mera, Robertino M. organization: Gilead Sciences, Inc – sequence: 4 givenname: Aldo F. surname: Costa fullname: Costa, Aldo F. organization: Hospital Universitario Reina Sofía – sequence: 5 givenname: Bettsy Y. surname: Recalde fullname: Recalde, Bettsy Y. organization: the Atahualpa Project – sequence: 6 givenname: Naoum P. surname: Issa fullname: Issa, Naoum P. organization: University of Chicago |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33576150$$D View this record in MEDLINE/PubMed |
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Neurological complications of SARS‐CoV‐2 infection are noticed among critically ill patients soon after disease onset. Information on... Neurological complications of SARS-CoV-2 infection are noticed among critically ill patients soon after disease onset. Information on delayed neurological... Background and purposeNeurological complications of SARS‐CoV‐2 infection are noticed among critically ill patients soon after disease onset. Information on... This population‐based longitudinal prospective cohort study, conducted in a selected population of community‐dwelling middle‐aged and older adults living in a... |
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| SubjectTerms | Assessments Cognitive ability cognitive decline Complications Confidence intervals coronavirus‐19 COVID‐19 Dementia and Cognitive Disorders EEG Exposure Infections Magnetic resonance imaging Montreal Cognitive Assessment Neuroimaging Neurological complications Original Pandemics Pathogenesis Population studies Reduction SARS‐CoV‐2 Seizures Severe acute respiratory syndrome Severe acute respiratory syndrome coronavirus 2 Viral diseases |
| Title | Cognitive decline among individuals with history of mild symptomatic SARS‐CoV‐2 infection: A longitudinal prospective study nested to a population cohort |
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