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Jaywant A, Gunning FM, Oberlin LE, Santillana M, Ognyanova K, Druckman JN, Baum MA, Lazer D, Perlis RH. Cognitive Symptoms of Post-COVID-19 Condition and Daily Functioning. JAMA Netw Open 2024; 7:e2356098. [PMID: 38353947 PMCID: PMC10867690 DOI: 10.1001/jamanetworkopen.2023.56098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/20/2023] [Indexed: 02/16/2024] Open
Abstract
Importance The frequent occurrence of cognitive symptoms in post-COVID-19 condition has been described, but the nature of these symptoms and their demographic and functional factors are not well characterized in generalizable populations. Objective To investigate the prevalence of self-reported cognitive symptoms in post-COVID-19 condition, in comparison with individuals with prior acute SARS-CoV-2 infection who did not develop post-COVID-19 condition, and their association with other individual features, including depressive symptoms and functional status. Design, Setting, and Participants Two waves of a 50-state nonprobability population-based internet survey conducted between December 22, 2022, and May 5, 2023. Participants included survey respondents aged 18 years and older. Exposure Post-COVID-19 condition, defined as self-report of symptoms attributed to COVID-19 beyond 2 months after the initial month of illness. Main Outcomes and Measures Seven items from the Neuro-QoL cognition battery assessing the frequency of cognitive symptoms in the past week and patient Health Questionnaire-9. Results The 14 767 individuals reporting test-confirmed COVID-19 illness at least 2 months before the survey had a mean (SD) age of 44.6 (16.3) years; 568 (3.8%) were Asian, 1484 (10.0%) were Black, 1408 (9.5%) were Hispanic, and 10 811 (73.2%) were White. A total of 10 037 respondents (68.0%) were women and 4730 (32.0%) were men. Of the 1683 individuals reporting post-COVID-19 condition, 955 (56.7%) reported at least 1 cognitive symptom experienced daily, compared with 3552 of 13 084 (27.1%) of those who did not report post-COVID-19 condition. More daily cognitive symptoms were associated with a greater likelihood of reporting at least moderate interference with functioning (unadjusted odds ratio [OR], 1.31 [95% CI, 1.25-1.36]; adjusted [AOR], 1.30 [95% CI, 1.25-1.36]), lesser likelihood of full-time employment (unadjusted OR, 0.95 [95% CI, 0.91-0.99]; AOR, 0.92 [95% CI, 0.88-0.96]) and greater severity of depressive symptoms (unadjusted coefficient, 1.40 [95% CI, 1.29-1.51]; adjusted coefficient 1.27 [95% CI, 1.17-1.38). After including depressive symptoms in regression models, associations were also found between cognitive symptoms and at least moderate interference with everyday functioning (AOR, 1.27 [95% CI, 1.21-1.33]) and between cognitive symptoms and lower odds of full-time employment (AOR, 0.92 [95% CI, 0.88-0.97]). Conclusions and Relevance The findings of this survey study of US adults suggest that cognitive symptoms are common among individuals with post-COVID-19 condition and associated with greater self-reported functional impairment, lesser likelihood of full-time employment, and greater depressive symptom severity. Screening for and addressing cognitive symptoms is an important component of the public health response to post-COVID-19 condition.
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Affiliation(s)
- Abhishek Jaywant
- Department of Psychiatry, Weill Cornell Medicine, New York, New York
| | - Faith M. Gunning
- Department of Psychiatry, Weill Cornell Medicine, New York, New York
| | - Lauren E. Oberlin
- Department of Psychiatry, Weill Cornell Medicine, New York, New York
| | - Mauricio Santillana
- Machine Intelligence Group for the Betterment of Health and the Environment, Northeastern University, Boston, Massachusetts
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Katherine Ognyanova
- Department of Communication, School of Communication and Information, Rutgers University, New Brunswick, New Jersey
| | - James N. Druckman
- Department of Political Science, University of Rochester, Rochester, New York
| | - Matthew A. Baum
- John F. Kennedy School of Government and Department of Government, Harvard University, Cambridge, Massachusetts
| | - David Lazer
- Network Science Institute, Northeastern University, Boston, Massachusetts
- Department of Political Science, Northeastern University, Boston, Massachusetts
- Khoury College of Computer Sciences, Northeastern University, Boston, Massachusetts
- Institute for Quantitative Social Science, Harvard University, Cambridge, Massachusetts
| | - Roy H. Perlis
- Center for Quantitative Health, Massachusetts General Hospital, Boston
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Vélez-Santamaría R, Fernández-Solana J, Méndez-López F, Domínguez-García M, González-Bernal JJ, Magallón-Botaya R, Oliván-Blázquez B, González-Santos J, Santamaría-Peláez M. Functionality, physical activity, fatigue and quality of life in patients with acute COVID-19 and Long COVID infection. Sci Rep 2023; 13:19907. [PMID: 37963962 PMCID: PMC10645778 DOI: 10.1038/s41598-023-47218-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 11/10/2023] [Indexed: 11/16/2023] Open
Abstract
A prominent feature of COVID-19, both in the short and long term, is the reduction in quality of life (QoL) due to low functionality scores and the presence of fatigue, which can hinder daily activities. The main objective of this study is to compare the functional status, level of physical activity, fatigue, and QoL of patients with Long COVID to other COVID-19 patients who did not develop persistent illness, and to determine whether there is a relationship between these variables and QoL. A cross-sectional study was conducted with 170 participants who had been infected with COVID-19 or had developed Long COVID. The main variables studied were functionality, physical activity, QoL and fatigue, measured using the PostCOVID-19 Functional Status Scale (PCFS), International Physical Activity Questionnaire (IPAQ), Short Form 12 (SF-12), and Fatigue Severity Scale (FSS). The main findings show a significant relationship (p < 0.001) between reduced functionality, lower physical activity levels, increased fatigue severity, and poorer QoL in Long COVID patients. Furthermore, these variables are also related to worse QoL, but only functional status predicts it. In conclusion, our results have shown highly significant correlations between the group with COVID-19 and Long COVID regarding functional status, level of physical activity, QoL, and fatigue.
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Affiliation(s)
| | | | - Fátima Méndez-López
- Primary Care Research Group, Aragon Health Research Institute (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
| | - Marta Domínguez-García
- Primary Care Research Group, Aragon Health Research Institute (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Aragonese Healthcare Service (SALUD), Zaragoza, Spain
| | | | - Rosa Magallón-Botaya
- Primary Care Research Group, Aragon Health Research Institute (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Department of Medicine, Psychiatry and Dermatology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Primary Care Research Group, Aragon Health Research Institute (IISA), Zaragoza, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
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Romero-Rodriguez E, Perula-de Torres LA, Monserrat-Villatoro J, Gonzalez-Lama J, Carmona-Casado AB, Ranchal-Sanchez A. Sociodemographic and Clinical Profile of Long COVID-19 Patients, and Its Correlation with Medical Leave: A Comprehensive Descriptive and Multicenter Study. Healthcare (Basel) 2023; 11:2632. [PMID: 37830667 PMCID: PMC10572288 DOI: 10.3390/healthcare11192632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/19/2023] [Accepted: 09/25/2023] [Indexed: 10/14/2023] Open
Abstract
The persistent condition of COVID-19 is characterized by a wide range of symptoms that have had a significant impact on both the health status and occupational life of the population. In this observational and multicenter study, the relationship between the sociodemographic and clinical profile of Spanish patients diagnosed with long COVID, and the work-related disability resulting from this pathology was analyzed. The analysis included 689 responses. A descriptive analysis of the variables recorded was performed, together with a bivariate analysis to determine associations between work-related disability and variables such as gender, age, health status, disabling symptoms or comorbidities. The results obtained highlight fatigue and lack of concentration (brain fog) as the most incapacitating symptoms among patients diagnosed with long COVID. Multivariate analysis revealed that time since diagnosis (OR: 0.57, CI95%: 0.36-0.89, p: 0.013), concomitant renal insufficiency (OR: 4.04, CI95%: 1.42-11.4, p: 0.008), and symptoms like fatigue (OR: 0.56, CI95%: 0.33-0.99) and tremors (OR: 2.0, CI95%: 1.06-3.69, p: 0.029), were associated with work-related disability. These findings highlight the need to improve the health and work-related management of this condition in the healthcare system. Besides risk factor control, it is suggested to pay special attention to determining the appropriate timing of medical leave work reintegration, along with coordination between primary care and occupational health services to ensure the gradual and tailored return of patients with long COVID to the workforce.
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Affiliation(s)
- Esperanza Romero-Rodriguez
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba University, 14004 Córdoba, Spain; (E.R.-R.); (L.A.P.-d.T.); (J.M.-V.); (A.B.C.-C.)
- Córdoba and Guadalquivir Health District, 14011 Córdoba, Spain
| | - Luis Angel Perula-de Torres
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba University, 14004 Córdoba, Spain; (E.R.-R.); (L.A.P.-d.T.); (J.M.-V.); (A.B.C.-C.)
| | - Jaime Monserrat-Villatoro
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba University, 14004 Córdoba, Spain; (E.R.-R.); (L.A.P.-d.T.); (J.M.-V.); (A.B.C.-C.)
- Córdoba and Guadalquivir Health District, 14011 Córdoba, Spain
| | - Jesus Gonzalez-Lama
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba University, 14004 Córdoba, Spain; (E.R.-R.); (L.A.P.-d.T.); (J.M.-V.); (A.B.C.-C.)
- “Matrona Antonia Mesa Fernández” Health Center, Cabra Clinical Management Unit, AGS South of Córdoba, 14940 Córdoba, Spain
| | - Ana Belen Carmona-Casado
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba University, 14004 Córdoba, Spain; (E.R.-R.); (L.A.P.-d.T.); (J.M.-V.); (A.B.C.-C.)
| | - Antonio Ranchal-Sanchez
- Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), Reina Sofía University Hospital, Córdoba University, 14004 Córdoba, Spain; (E.R.-R.); (L.A.P.-d.T.); (J.M.-V.); (A.B.C.-C.)
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14004 Córdoba, Spain
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Ranucci M, Baryshnikova E, Anguissola M, Pugliese S, Ranucci L, Falco M, Menicanti L. The Very Long COVID: Persistence of Symptoms after 12-18 Months from the Onset of Infection and Hospitalization. J Clin Med 2023; 12:jcm12051915. [PMID: 36902702 PMCID: PMC10003916 DOI: 10.3390/jcm12051915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
According to the World Health Organization's definition, long COVID is the persistence or development of new symptoms 3 months after the initial infection. Various conditions have been explored in studies with up to one-year follow-up but very few looked further. This prospective cohort study addresses the presence of a wide spectrum of symptoms in 121 patients hospitalized during the acute phase of COVID-19 infection, and the association between factors related to the acute phase of the disease and the presence of residual symptoms after one year or longer from hospitalization. The main results are as follows: (i) post-COVID symptoms persist in up to 60% of the patient population at a mean follow-up of 17 months; (ii) the most frequent symptoms are fatigue and dyspnea, but neuropsychological disturbances persist in about 30% of the patients (iii) when corrected for the duration of follow-up with a freedom-from-event analysis; only complete (2 doses) vaccination at the time of hospital admission remained independently associated with persistence of the major physical symptoms, while vaccination and previous neuropsychological symptoms remained independently associated with persistence of major neuropsychological symptoms.
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Affiliation(s)
- Marco Ranucci
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
- Correspondence: ; Tel.: +39-(02)-5277-4754
| | - Ekaterina Baryshnikova
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Martina Anguissola
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Sara Pugliese
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Luca Ranucci
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, 20097 Milan, Italy
| | - Mara Falco
- Department of Radiology, Koelliker Hospital, 10134 Turin, Italy
| | - Lorenzo Menicanti
- Scientific Directorate, IRCCS Policlinico San Donato, 20097 Milan, Italy
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Taube M. Depression and brain fog as long-COVID mental health consequences: Difficult, complex and partially successful treatment of a 72-year-old patient-A case report. Front Psychiatry 2023; 14:1153512. [PMID: 37032935 PMCID: PMC10079873 DOI: 10.3389/fpsyt.2023.1153512] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
SARS-CoV-2 (COVID-19) infection can result in long-term health consequences i.e., long COVID. The clinical manifestations of long COVID include depression, anxiety, brain fog with cognitive dysfunction, memory issues, and fatigue. These delayed effects of COVID-19 occur in up to 30% of people who have had an acute case of COVID-19. In this case report, a 72-year-old, fully vaccinated patient without pre-existing somatic or mental illnesses, or other relevant risk factors was diagnosed with long COVID. Nine months following an acute COVID-19 infection, the patient's depressive symptoms improved, but memory and concentration difficulties persisted, and the patient remains unable to resume work. These long-term symptoms are possibly linked to micro-hemorrhages detected during examinations of the patient's brain following COVID-19 infection. Patient treatment was complex, and positive results were attained via antidepressants and non-drug therapies e.g., art, music, drama, dance and movement therapy, physiotherapy, occupational therapy, and psychotherapy.
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Affiliation(s)
- Maris Taube
- Department of Psychiatry and Narcology, Riga Stradinš University, Riga, Latvia
- Department for Depression and Crisis, Riga Center of Psychiatry and Narcology, Riga, Latvia
- *Correspondence: Maris Taube
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