Cognitive impairment in long-COVID and its association with persistent dysregulation in inflammatory markers

Frontiers in Immunology

Immunology

Marilia Seelaender¹  Gabriela Salim de Castro¹  Jorge Kalil²  Edecio Cunha-Neto²  Heraldo Possolo de Souza³  Suely K. Nagahashi Marie⁴  Bruno F. Guedes⁴  Ricardo Nitrini⁴  Pedro Mário Pan⁵  Leda Leme Talib⁶  Euripedes Constantino Miguel⁶  Orestes V. Forlenza⁶  Geraldo Busatto⁶  Cristiana Castanho de Almeida Rocca⁶  Rodolfo Furlan Damiano⁶  Antonio de Pádua Serafim⁷  Jennifer M. Loftis⁸ 

[1] Cancer Metabolism Research Group, Department of Surgery and LIM 26, Hospital das Clínicas, University of São Paulo, São Paulo, SP, Brazil;Departamento de Cínica Médica, Universidade de São Paulo FMUSP, São Paulo, SP, Brazil;Institute for Investigation in Immunology/National Institutes for Science and Technology (iii/INCT), São Paulo, Brazil;Departamento de Emergências Médicas, Universidade de São Paulo FMUSP, São Paulo, SP, Brazil;Departamento de Neurologia, Universidade de São Paulo FMUSP, São Paulo, Brazil;Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil;Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil;Instituto de Psicologia, Universidade de São Paulo, São Paulo, SP, Brazil;Research & Development Service, VA Portland Health Care System, Portland, OR, United States;Departments of Psychiatry and Behavioral Neuroscience, Oregon Health and Science University, Portland, OR, United States;

关键词: COVID-19;    SARS- CoV-2;    cognition;    inflammation;    cohort study (or longitudinal study);   

DOI  :  10.3389/fimmu.2023.1174020

 received in 2023-02-25, accepted in 2023-05-10,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveTo analyze the potential impact of sociodemographic, clinical and biological factors on the long-term cognitive outcome of patients who survived moderate and severe forms of COVID-19.MethodsWe assessed 710 adult participants (Mean age = 55 ± 14; 48.3% were female) 6 to 11 months after hospital discharge with a complete cognitive battery, as well as a psychiatric, clinical and laboratory evaluation. A large set of inferential statistical methods was used to predict potential variables associated with any long-term cognitive impairment, with a focus on a panel of 28 cytokines and other blood inflammatory and disease severity markers.ResultsConcerning the subjective assessment of cognitive performance, 36.1% reported a slightly poorer overall cognitive performance, and 14.6% reported being severely impacted, compared to their pre-COVID-19 status. Multivariate analysis found sex, age, ethnicity, education, comorbidity, frailty and physical activity associated with general cognition. A bivariate analysis found that G-CSF, IFN-alfa2, IL13, IL15, IL1.RA, EL1.alfa, IL45, IL5, IL6, IL7, TNF-Beta, VEGF, Follow-up C-Reactive Protein, and Follow-up D-Dimer were significantly (p<.05) associated with general cognition. However, a LASSO regression that included all follow-up variables, inflammatory markers and cytokines did not support these findings.ConclusionThough we identified several sociodemographic characteristics that might protect against cognitive impairment following SARS-CoV-2 infection, our data do not support a prominent role for clinical status (both during acute and long-stage of COVID-19) or inflammatory background (also during acute and long-stage of COVID-19) to explain the cognitive deficits that can follow COVID-19 infection.

【 授权许可】

Unknown   
Copyright © 2023 Damiano, Rocca, Serafim, Loftis, Talib, Pan, Cunha-Neto, Kalil, de Castro, Seelaender, Guedes, Nagahashi Marie, de Souza, Nitrini, Miguel, Busatto, Forlenza and HCFMUSP COVID-19 Study Group