Researchers at the University of São Paulo have found that cognitive impairments such as memory loss and attention deficits persist in both severe and mild cases of COVID-19 long after initial infection, affecting daily functioning. Their study, involving 302 volunteers, reveals a significant need for cognitive rehabilitation strategies to address these long-term effects, as even patients with mild symptoms showed considerable cognitive difficulties. Credit: SciTechDaily.com
Research indicates that although the most serious effects of SARS-CoV-2 have been observed in patients with acute illness COVID 19People who had milder cases and were not hospitalized also reported symptoms of memory loss and attention deficits lasting more than 18 months after infection.
Memory loss and attention deficits are common complaints among survivors of severe COVID-19. However, these and other cognitive impairments have also been observed in patients with mild cases more than 18 months after infection, according to a study by researchers at the University of São Paulo (USP) in Brazil.
An article about the study is published in the journal BMC PsychologyThe findings highlight the need for more comprehensive rehabilitation to address the lasting cognitive impacts of long COVID, the authors write.
Data collected from 302 volunteers indicated cognitive impairment in 11.7% of mild patients, 39.2% of moderate patients, and 48.9% of severe patients.
“Although the damage caused by the disease in terms of memory loss, attention deficit and slowed processing increases proportionally to its severity, the same problems affect a far from negligible number of people – about 100 in our study – who had mild or moderate COVID,” said Antônio de Pádua Serafim, first author of the article and professor at the Institute of Psychology (IP-USP).
The results of the study, funded by FAPESP, demonstrate the potential impact of neuroinflammation due to SARS-CoV-2 infection.
“It is known that memory loss and attention deficit are 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 did not require intensive care or even had symptoms sufficient to be hospitalized and who nevertheless had memory loss and attention deficit. So the results opened our eyes to the issue of neuroinflammation due to COVID-19,” Serafim said.
Memory and attention are important cognitive functions that affect people’s daily lives. Study participants who performed poorly on memory and attention tests reported difficulty remembering words or performing routine activities, such as leaving pots on the stove or not picking up children from school.
“Hierarchically speaking, attention is the main function of all mental activity, which is why attention deficit has such a significant impact on people’s daily lives. High-quality attention is necessary to think and act in different ways at the same time. Attention deficiency in turn affects memory. In some cases, attentional activity is so scattered that each new stimulus [or impending activity] “Brain activity dissolves, so the person can’t remember what they were doing. It also affects processing activity, which involves rapid decision-making based on information,” he said.
Cognitive rehabilitation
According to Serafim, all the evidence has shown for some time that SARS-CoV-2 can affect the central nervous system as well as the lungs, kidneys, heart and muscles, but the extent of the damage it can cause is poorly understood. “We do not know whether cognitive impairment due to COVID-19 is permanent, and we are currently evaluating ways to intervene in this process,” he said.
In partnership with other USP researchers, Serafim is developing programs to try to mitigate cognitive losses caused by COVID-19. The goal is to find out if techniques such as neurostimulation and neurofeedback can mitigate or limit memory loss and attention deficit.
“These are two non-invasive techniques that aim to improve brain function through neuromodulation, which can stimulate connections between neurons in the brain. [synapses]”We only have case studies so far. For example, in the case of a doctor who was in intensive care for 34 days, we conducted a neurofeedback protocol that is often used to study patients with attention disorders, and he recovered well. But that was an isolated case,” he said.
“Based on the knowledge acquired so far on cognitive stimulation and rehabilitation techniques, I believe that it is possible to achieve an improvement in neural connectivity through brain training to stimulate global cognitive abilities. The severe phase of the pandemic is over, but the aftereffects persist. So this is not a closed case. Many people have been infected and many have aftereffects of this type. However, we do not have an effective program to intervene not only on the emotional aspects but also on the cognitive difficulties resulting from COVID-19.”
Reference: “Cognitive performance of post-covid patients in mild, moderate and severe clinical situations” by Antonio de Pádua Serafim, Fabiana Saffi, Amanda Rafaella A. Soares, Alessandra Mara Morita, Mariana Medeiros Assed, Sandro de Toledo, Cristiana CA Rocca and Ricardo SS Durães, April 26, 2024, BMC Psychology.
DOI: 10.1186/s40359-024-01740-7
The study was funded by the São Paulo Research Foundation.
