Neurological and (neuro)psychological sequelae in intensive care and general ward COVID‐19 survivors

Author:

Klinkhammer Simona12ORCID,Horn Janneke34,Duits Annelien A.156,Visser‐Meily Johanna M. A.789,Verwijk Esmée41011,Slooter Arjen J. C.81213,Postma Alida A.1415,van Heugten Caroline M.1216,

Affiliation:

1. Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience Maastricht University Maastricht The Netherlands

2. Limburg Brain Injury Center Maastricht University Maastricht The Netherlands

3. Department of Intensive Care, Amsterdam University Medical Center University of Amsterdam Amsterdam The Netherlands

4. Amsterdam Neuroscience, Amsterdam University Medical Center University of Amsterdam Amsterdam The Netherlands

5. Department of Medical Psychology Maastricht University Medical Center Maastricht The Netherlands

6. Department of Medical Psychology Radboud University Medical Center Nijmegen The Netherlands

7. Department of Rehabilitation, Physical Therapy Science and Sports University Medical Center Utrecht Utrecht The Netherlands

8. UMC Utrecht Brain Center University Medical Center Utrecht Utrecht The Netherlands

9. Center of Excellence for Rehabilitation Medicine Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation Utrecht The Netherlands

10. Department of Medical Psychology Amsterdam University Medical Center Amsterdam The Netherlands

11. Department of Psychology, Brain and Cognition University of Amsterdam Amsterdam The Netherlands

12. Department of Psychiatry and Intensive Care Medicine University Medical Center Utrecht Utrecht The Netherlands

13. Department of Neurology UZ Brussel and Vrije Universiteit Brussel Jette Brussels Health Campus Belgium

14. Department of Radiology and Nuclear Medicine Maastricht University Medical Center Maastricht The Netherlands

15. Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience Maastricht University Maastricht The Netherlands

16. Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience Maastricht University Maastricht The Netherlands

Abstract

AbstractBackground and purposeCoronavirus disease 2019 (COVID‐19) affects the brain, leading to long‐term complaints. Studies combining brain abnormalities with objective and subjective consequences are lacking. Long‐term structural brain abnormalities, neurological and (neuro)psychological consequences in COVID‐19 patients admitted to the intensive care unit (ICU) or general ward were investigated. The aim was to create a multidisciplinary view on the impact of severe COVID‐19 on functioning and to compare long‐term consequences between ICU and general ward patients.MethodsThis multicentre prospective cohort study assessed brain abnormalities (3 T magnetic resonance imaging), cognitive dysfunction (neuropsychological test battery), neurological symptoms, cognitive complaints, emotional distress and wellbeing (self‐report questionnaires) in ICU and general ward (non‐ICU) survivors.ResultsIn al, 101 ICU and 104 non‐ICU patients participated 8–10 months post‐hospital discharge. Significantly more ICU patients exhibited cerebral microbleeds (61% vs. 32%, p < 0.001) and had higher numbers of microbleeds (p < 0.001). No group differences were found in cognitive dysfunction, neurological symptoms, cognitive complaints, emotional distress or wellbeing. The number of microbleeds did not predict cognitive dysfunction. In the complete sample, cognitive screening suggested cognitive dysfunction in 41%, and standard neuropsychological testing showed cognitive dysfunction in 12%; 62% reported ≥3 cognitive complaints. Clinically relevant scores of depression, anxiety and post‐traumatic stress were found in 15%, 19% and 12%, respectively; 28% experienced insomnia and 51% severe fatigue.ConclusionCoronavirus disease 2019 ICU survivors had a higher prevalence for microbleeds but not for cognitive dysfunction compared to general ward survivors. Self‐reported symptoms exceeded cognitive dysfunction. Cognitive complaints, neurological symptoms and severe fatigue were frequently reported in both groups, fitting the post‐COVID‐19 syndrome.

Funder

Hersenstichting

Publisher

Wiley

Subject

Neurology (clinical),Neurology

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