Cognitive Functions After COVID-19

Evaluation Of Cognitive Functions In Adult Individuals With COVID-19

This study was aimed to evaluate the post-infection cognitive functions of adult individuals with COVID-19. 50 individuals with COVID-19 and 50 healthy control groups were included in the study. Cognitive functions of individuals with COVID19 compared with healthy individuals.

Study Overview

• Status: Completed
• Conditions: Cognitive Decline; COVID-19 Acute Respiratory Distress Syndrome
• Intervention / Treatment: Behavioral: Neuropsychometric Test

Detailed Description

This study was aimed to evaluate the post-infection cognitive functions of adult individuals with COVID-19. Fifty COVID-19 patients, aged between 18-50 years, who had positive RT-PCR test in the last 60 days and later recovered, were included in the study. The study group was compared with the control group consisting of 50 healthy individuals in whom gender, age and education year has not difference significantly. Participants' global cognitive skills were measured by the Montreal Cognitive Assessment Test (MoCA), the Clock Drawing Test and memory functions, the Öktem Verbal Memory Processes Test (Ö-SBST), the attention functions by the Digit Span Forward and Digit Span Backwards Test, the executive functions by Categorical Fluency, Phonemic Fluency, the Stroop Test, Trail Making Test A and B, visuospatial skills were evaluated with the Rey-Osterrieth Complex Figure Test (ROCF), and behavioral symptoms were evaluated with the Neuropsychiatric Inventory (NPI). The study group was evaluated between 21 and 60 days from the onset of the disease.

• Study Type: Observational
• Enrollment (Actual): 100

Contacts and Locations

Study Locations

• Turkey
  • İstanbul
    • Beykoz, İstanbul, Turkey, 34810
      • Istanbul Medipol University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Community sample

Description

Inclusion Criteria:

• Having positive for the COVID-19 RT-PCR test and turned negative in the last 60 days.
• be 18-50 years old
• 21 days have passed since the onset of the disease

Exclusion Criteria:

• Having any neurological or psychiatric illness

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Study Group; The study group consists of 50 individuals aged 18-50 years who have received a positive COVID-19 RT-PCR test in the past 60 days.	Behavioral: Neuropsychometric Test; Participants' global cognitive skills were measured by the Montreal Cognitive Assessment Test (MoCA), the Clock Drawing Test and memory functions, the Öktem Verbal Memory Processes Test (Ö-SBST), the attention functions by the Digit Span Forward and Digit Span Backwards Test, the executive functions by Categorical Fluency, Phonemic Fluency, the Stroop Test, Trail Making Test A and B, visuospatial skills were evaluated with the Rey-Osterrieth Complex Figure Test (ROCF), and behavioral symptoms were evaluated with the Neuropsychiatric Inventory (NPI).; Other Names: Stroop Test; Montreal Cognitive Assessment Test (MoCA); Clock Drawing Test; Öktem Verbal Memory Processes Test (Ö-SBST); Digit Span Forward Test; Digit Span Backwards Test; Categorical Fluency; Phonemic Fluency; Trail Making Test A; Trail Making Test B; Rey-Osterrieth Complex Figure Test (ROCF); Neuropsychiatric Inventory (NPI)
Control Group; The control group consists of 50 healthy individuals aged 18-50 years who have not had COVID-19.	Behavioral: Neuropsychometric Test; Participants' global cognitive skills were measured by the Montreal Cognitive Assessment Test (MoCA), the Clock Drawing Test and memory functions, the Öktem Verbal Memory Processes Test (Ö-SBST), the attention functions by the Digit Span Forward and Digit Span Backwards Test, the executive functions by Categorical Fluency, Phonemic Fluency, the Stroop Test, Trail Making Test A and B, visuospatial skills were evaluated with the Rey-Osterrieth Complex Figure Test (ROCF), and behavioral symptoms were evaluated with the Neuropsychiatric Inventory (NPI).; Other Names: Stroop Test; Montreal Cognitive Assessment Test (MoCA); Clock Drawing Test; Öktem Verbal Memory Processes Test (Ö-SBST); Digit Span Forward Test; Digit Span Backwards Test; Categorical Fluency; Phonemic Fluency; Trail Making Test A; Trail Making Test B; Rey-Osterrieth Complex Figure Test (ROCF); Neuropsychiatric Inventory (NPI)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Montreal Cognitive Assessment Test (MoCA)	It is a test that measures attention and concentration, executive functions, memory, language, visuospatial skills, abstract thinking, calculation and orientation skills in order to distinguish individuals with mild cognitive impairment from healthy individuals.	Any day between 21-60 days from the date of COVID-10 RT-PCR test positive.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clock Drawing Test	The person is asked to draw a clock circle and place numbers in it. After succeeding, they are asked to show 11 by 10 crossing. This test can test comprehension, memory, visuospatial functions and executive functions.	Any day between 21-60 days from the date of COVID-10 RT-PCR test positive.
Öktem Verbal Memory Processes Test (Ö-SBST)	The test consists of fifteen unrelated words. Fifteen words are read to the subject at one-second intervals and then asked to say the ones that come to mind. In this process, information is collected about the subject's ability to maintain instant memory and attention. The number of correct answers of the subject is recorded as Instant Memory Score. After the first attempt, the same list is read to the subject nine more times, and each time he is asked to say all he remembers. This gives information about the subject's learning ability.	Any day between 21-60 days from the date of COVID-10 RT-PCR test positive.
Digit Span	The test consists of two parts as forward and backward span. In the forward digit span, the numbers are read at one second intervals and the patient is asked to repeat the randomly read numbers in the same order. It assesses attention and short-term memory. In the back digit span, it is requested to repeat the numbers read from the end to the beginning. Working memory is evaluated in the back count range. As the person succeeds in the trials, the test is continued by increasing one step. If the patient fails twice in a row for both sections, the test is discontinued.	Any day between 21-60 days from the date of COVID-10 RT-PCR test positive.
Verbal Fluency Test	Verbal fluency tests aim to evaluate the executive aspects of verbal behavior by using language capacity as a fluent speech. Verbal fluency tests are applied in two ways: phonemic fluency and semantic fluency. In the semantic fluency test, the person is asked to count animal names in one minute, and in the phonemic fluency test, the person is asked to produce words that start with a certain letter (K-A-S) and are not proper nouns.	Any day between 21-60 days from the date of COVID-10 RT-PCR test positive.
Stroop Test	The Stroop test evaluates focused attention, the ability to change attention in line with changing demands and under a distraction, the ability to suppress a habitual behavior pattern and perform an unusual behavior.	Any day between 21-60 days from the date of COVID-10 RT-PCR test positive.
Trail Making Test	The trail making test consists of two parts, A and B. In part A, the participants are asked to combine the circles with the numbers in the correct order and following each other (1-2-3-4-5...). In section B, there are letters and numbers placed in circles. Participants are asked to combine letters and numbers in the correct sequence (1-A-2-B-3-C-4-D...). The times of both sections are recorded. The A part of the IST evaluates the processing speed based on visual scanning ability, and the B part evaluates the complex attention, planning, set changing, blocking ability and following the sequentiality.	Any day between 21-60 days from the date of COVID-10 RT-PCR test positive.
Rey-Osterrieth Complex Figure Test (ROCF)	The purpose of the test is to evaluate visuospatial structuring skills and visual memory. The test material consists of a complex shape printed on a card, a registration form, an identification form with 24 details, three blank sheets of paper, a pencil and an eraser. The subject is first asked to copy the complex shape and the copying time is noted. During copying, the subject is not informed that he will draw the shape again. In the next step, the complex shape is removed and the person is asked to draw the shape again as far as he can remember, and the drawing time is noted. This is instant recall application. After the instant recall, the subject is not informed that he will draw the shape again, and the subject's mind is occupied by introducing different tests. After 30 minutes, he is asked to draw again. This is the delayed recall phase.	Any day between 21-60 days from the date of COVID-10 RT-PCR test positive.
Neuropsychiatric Inventory (NPI)	The scale is scored by interview with the patient's relative. A total of 12 behavioral domains (delusions, hallucinations, agitation/aggression, depression/dysphoria, anxiety, elation/euphoria, apathy, disinhibition, irritability/lability, abnormal motor behavior, sleep/night behaviors, appetite and eating changes) are questioned.	Any day between 21-60 days from the date of COVID-10 RT-PCR test positive.

Collaborators and Investigators

• Sponsor: Medipol University
• Investigators: Principal Investigator: Büşra Tüfekçi, MD, Medipol University

Publications and helpful links

General Publications

• Zhou H, Lu S, Chen J, Wei N, Wang D, Lyu H, Shi C, Hu S. The landscape of cognitive function in recovered COVID-19 patients. J Psychiatr Res. 2020 Oct;129:98-102. doi: 10.1016/j.jpsychires.2020.06.022. Epub 2020 Jun 30.

Study record dates

Study Major Dates

• Study Start (Actual): December 15, 2020
• Primary Completion (Actual): January 10, 2021
• Study Completion (Actual): July 30, 2021

Study Registration Dates

• First Submitted: July 18, 2021
• First Submitted That Met QC Criteria: July 22, 2021
• First Posted (Actual): July 27, 2021

Study Record Updates

• Last Update Posted (Actual): August 5, 2022
• Last Update Submitted That Met QC Criteria: August 3, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Keywords: COVID-19; Attention; Memory; Neurophysiology; Cognitive Functions; Executive Functions
• Additional Relevant MeSH Terms: Mental Disorders; Coronavirus Infections; Coronaviridae Infections; Nidovirales Infections; RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Respiration Disorders; Pneumonia, Viral; Pneumonia; Lung Diseases; Neurocognitive Disorders; Infant, Newborn, Diseases; Cognition Disorders; Lung Injury; Infant, Premature, Diseases; COVID-19; Cognitive Dysfunction; Respiratory Distress Syndrome; Respiratory Distress Syndrome, Newborn; Acute Lung Injury
• Other Study ID Numbers: Medipol Mega3

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No