Features of cognitive functioning in older people with COVID 19

Abstract

The results of studies on elderly patients with COVID-19 indicate presence of serious comorbidities, including cerebrovascular disease, infection of the central nervous system, and cognitive deficits. Impaired cognitive functioning may be due to neurological damage, combined and potentially reversible effects of depression, anxiety and sleep disturbances.The purpose of the study: to identify characteristics of cognitive impairment of elderly patients hospitalized for COVID-19.Material and methods: the study involved 35 patients: 15 men and 20 women (median age 61.0 years, interquartile range (IQR, 25.0-75.0 percentiles) — 50.0-69.0 years, established clinical diagnosis: “New coronavirus infection COVID-19 (PCR+)”. Inclusion criteria were: 1) confirmation of the diagnosis of COVID-19 by clinical and PCR methods, 2) absence of mental disorders, incl. cognitive impairment prior to COVID-19. The exclusion criterion was age under 40 and over 90 years. The severity of COVID-19 was assessed in accordance with the criteria of the Interim Guidelines of the Ministry of Health of the Russian Federation. Clinical and psychopathological method, psychometric testing using the MMSE scale were used. Monitoring of current physical condition was carried out using The National Early Warning Score (NEWS2) for COVID-19. MMSE testing and monitoring of NEWS2 were carried out twice: upon presentation of cognitive complaints in the first days of hospitalization (1st measurement) and at discharge (2nd time point) Statistical processing was carried out using the STATISTICA 12 package. When comparing features, two-tailed Fisher’s test and Wilcoxon’s test were used. Correlation analysis was carried out using Kendall’s test. The level of statistical significance was p<0.05.Results: Comparative analysis between the first and second measurements revealed an improvement in the cognitive performance of elderly patients with COVID-19 by the end of the hospital stay. A significant predominance of median indicators was revealed: orientation (Med 9.0, IQR 8.0-10.0 vs Med 7.0 IQR 6.0-8.0; p=.0000), immediate memory (Med 3.0 IQR 3.0-3.0 vs Med 2.0 IQR 2.0-3.0; p= .0006), attention and counting (Med 2.0 IQR 2.0-4.0 vs Med 2.0 IQR 1.0-3.0; p=.0000). word reproduction (Med 2.0 IQR 2.0-3.0 vs Med 1.0 IQR 1.0-2.0; p=.0000); speech (Med 6.0 IQR 6.0-8.0 vs Med 5.0 IQR 4.0-5.0; p=.0000). final score (Med 24.0 IQR 23.0-27.0 vs Med 17.0 IQR 15.0-20.0; p=.0000). Correlations between the MMSE scores and anamnestic data were analyzed. Significant negative correlations were found with age, disease severity (only at the 2nd time point), diseases of the nervous, cardiovascular and digestive systems. Statistically significant relationships with gender, disease severity at the first measurement, tumors, diseases of the endocrine, respiratory and genitourinary systems were not obtained.Conclusion. Objective neurocognitive measurements can provide important information for neuropsychiatric sorting and should be included as endpoints in clinical trials.