The landscape of cognitive function in recovered COVID-19 patients

Hetong Zhou, Shaojia Lu, Jingkai Chen, Ning Wei, Dandan Wang, Hailong Lyu, Chuan Shi, Shaohua Hu, Hetong Zhou, Shaojia Lu, Jingkai Chen, Ning Wei, Dandan Wang, Hailong Lyu, Chuan Shi, Shaohua Hu

Abstract

This study aims to evaluate the impacts of COVID-19 on cognitive functions in recovered patients and its relationship with inflammatory profiles. Twenty-nine patients recovered from COVID-19 as confirmed by negative nucleic tests for two consecutive times were recruited. A total of 29 age-, gender- and education-matched healthy controls were also recruited. The cognitive functions of all subjects were evaluated by the iPad-based online neuropsychological tests, including the Trail Making Test (TMT), Sign Coding Test (SCT), Continuous Performance Test (CPT), and Digital Span Test (DST). Blood samples from all patients were collected for examining inflammatory profiles, including interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and C-reactive protein (CRP). The relationship between cognitive functions and inflammatory profiles were analyzed by Pearson correlation. In results, although no significant differences were found in TMT, SCT, and DST between the two groups, patients with COVID-19 scored lower in the correct number of the second and third parts of CPT, they also scored higher in the missing number of the third part of CPT (all P < 0.05). In patients with COVID-19, there was a trend of significant difference for lower reaction time in the first and second parts of CPT (P = 0.050, and 0.051, respectively), as well as the lower correct number of the second part of CPT (P = 0.050). Correlation analysis showed that the reaction time for the first and second parts of CPT was positively correlated with the CRP levels (r = 0.557 and 0.410, P < 0.05). In conclusion, our findings indicated that cognitive impairments exist even in patients recovered from COVID-19, and might be possibly linked to the underlying inflammatory processes.

Keywords: COVID-19; CRP; Cognitive function; Inflammation.

Conflict of interest statement

All authors declare that they have no conflict of interest.

Copyright © 2020 Elsevier Ltd. All rights reserved.

Figures

Fig. 1
Fig. 1
The correlation analyses revealed that serum CRP level was associated with the reaction time of CPT 1 (A), and CPT 2 (B), respectively.

References

    1. Brouillette M.J., Fellows L.K., Finch L., Thomas R., Mayo N.E. Properties of a brief assessment tool for longitudinal measurement of cognition in people living with HIV. PloS One. 2019;14
    1. Carlos W.G., Dela Cruz C.S., Cao B., Pasnick S., Jamil S. Novel Wuhan (2019-nCoV) coronavirus. Am. J. Respir. Crit. Care Med. 2020;201:P7–P8.
    1. Chakrabarty T., Torres I.J., Bond D.J., Yatham L.N. Inflammatory cytokines and cognitive functioning in early-stage bipolar I disorder. J. Affect. Disord. 2019;245:679–685.
    1. Chang Lin M., Wei L., Xie L., Zhu G., Dela Cruz C.S. Epidemiologic and clinical characteristics of novel coronavirus infections involving 13 patients outside Wuhan, China. Jama. 2020;323:1092–1093.
    1. Chang L.Y., Huang L.M., Gau S.S., Wu Y.Y., Hsia S.H., Fan T.Y. Neurodevelopment and cognition in children after enterovirus 71 infection. N. Engl. J. Med. 2007;356:1226–1234.
    1. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–513.
    1. Culpepper L., Lam R.W., McIntyre R.S. Cognitive impairment in patients with depression: awareness, assessment, and management. J. Clin. Psychiatr. 2017;78:1383–1394.
    1. Duarte P.O., Duarte M.G.F., Pelichek A., Pfrimer K., Ferriolli E., Moriguti J.C. Cardiovascular risk factors and inflammatory activity among centenarians with and without dementia. Aging Clin. Exp. Res. 2017;29:411–417.
    1. Hafiz P., Miskowiak K.W., Kessing L.V., Elleby Jespersen A., Obenhausen K., Gulyas L. The internet-based cognitive assessment tool: system design and feasibility study. JMIR formative. Res. 2019;3
    1. Han H.B., Lee K.E., Choi J.H. Functional dissociation of theta oscillations in the frontal and visual cortices and their long-range network during sustained attention. eNeuro. 2019;6
    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.
    1. Kanmogne G.D., Fonsah J.Y., Umlauf A., Moul J., Doh R.F., Kengne A.M. Attention/working memory, learning and memory in adult Cameroonians: normative data, effects of HIV infection and viral genotype. J. Int. Neuropsychol. Soc. 2020;26:607–623.
    1. Lai C.C., Shih T.P., Ko W.C., Tang H.J., Hsueh P.R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): the epidemic and the challenges. Int. J. Antimicrob. Agents. 2020;55:105924.
    1. Liu Z., Xiao X., Wei X., Li J., Yang J., Tan H. Composition and divergence of coronavirus spike proteins and host ACE2 receptors predict potential intermediate hosts of SARS-CoV-2. J. Med. Virol. 2020;92:595–601.
    1. Magalhaes R.C., Pimenta L.P., Barbosa I.G., Moreira J.M., de Barros J., Teixeira A.L. Inflammatory molecules and neurotrophic factors as biomarkers of neuropsychomotor development in preterm neonates: a Systematic Review. Int. J. Dev. Neurosci: Offc. J. Int. Soc. Dev. Neurosci. 2018;65:29–37.
    1. Mitko A., Rothlein D., Poole V., Robinson M., McGlinchey R., DeGutis J. Individual differences in sustained attention are associated with cortical thickness. Hum. Brain Mapp. 2019;40:3243–3253.
    1. Peiris J.S., Chu C.M., Cheng V.C., Chan K.S., Hung I.F., Poon L.L. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: a prospective study. Lancet. 2003;361:1767–1772.
    1. Raper J., Kovacs-Balint Z., Mavigner M., Gumber S., Burke M.W., Habib J. Long-term alterations in brain and behavior after postnatal Zika virus infection in infant macaques. Nat. Commun. 2020;11:2534.
    1. Shen X.N., Niu L.D., Wang Y.J., Cao X.P., Liu Q., Tan L. Inflammatory markers in Alzheimer's disease and mild cognitive impairment: a meta-analysis and systematic review of 170 studies. J. Neurol. Neurosurg. Psychiatr. 2019;90:590–598.
    1. Sheng B., Cheng S.K., Lau K.K., Li H.L., Chan E.L. The effects of disease severity, use of corticosteroids and social factors on neuropsychiatric complaints in severe acute respiratory syndrome (SARS) patients at acute and convalescent phases. Eur. Psychiatr. : J. Assoc. Eur. Psychiatr. 2005;20:236–242.
    1. Sheng W.H., Chiang B.L., Chang S.C., Ho H.N., Wang J.T., Chen Y.C. Clinical manifestations and inflammatory cytokine responses in patients with severe acute respiratory syndrome. J. Formosan. Med. Assoc. Taiwan Yi Zhi. 2005;104:715–723.
    1. Shi C., Kang L., Yao S., Ma Y., Li T., Liang Y. The matrics consensus cognitive battery (MCCB): Co-norming and standardization in China. Schizophr. Res. 2015;169:109–115.
    1. Tsang H.W., Scudds R.J., Chan E.Y. Psychosocial impact of SARS. Emerg. Infect. Dis. 2004;10:1326–1327.
    1. Vintimilla R., Hall J., Johnson L., O'Bryant S. The relationship of CRP and cognition in cognitively normal older Mexican Americans: a cross-sectional study of the HABLE cohort. Medicine. 2019;98
    1. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama. 2020;323:1061–1069.
    1. Xu K., Cai H., Shen Y., Ni Q., Chen Y., Hu S. [Management of corona virus disease-19 (COVID-19): the Zhejiang experience] Zhejiang da xue xue bao Yi xue ban = J. Zhejiang. Univ. Med. Sci. 2020;49:147–157.
    1. Xu K., Li X. Risk factors for depression in patients with chronic obstructive pulmonary disease. Med. Sci. Mon. Int. Med. J. Exp. Clin. Res. 2018;24:1417–1423.
    1. Yap Y.Y., Sathar J., Law K.B., Zulkurnain P.A.B., Edmund S.C., Chang K.M. Clinical characteristics and outcomes of thrombotic microangiopathy in Malaysia. Blood. Res. 2018;53:130–137.
    1. Zhang J.J., Dong X., Cao Y.Y., Yuan Y.D., Yang Y.B., Yan Y.Q. Allergy; 2020. Clinical Characteristics of 140 Patients Infected with SARS-CoV-2 in Wuhan, China.
    1. Zheng F., Xie W. High-sensitivity C-reactive protein and cognitive decline: the English longitudinal study of ageing. Psychol. Med. 2018;48:1381–1389.

Source: PubMed

3
S'abonner