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

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Damiano, Rodolfo Furlan ; Rocca, Cristiana Castanho de Almeida ; Serafim, Antonio de Padua M. ; Loftis, Jennifer ; Talib, Leda Leme ; Pan, Pedro Mario ; Cunha-Neto, Edecio ; Kalil, Jorge ; de Castro, Gabriela Salim ; Seelaender, Marilia F. ; Guedes, Bruno K. ; Marie, Suely K. Nagahashi ; de Souza, Heraldo Possolo ; Nitrini, Ricardo ; Miguel, Euripedes Constantino ; Busatto, Geraldo ; Forlenza, Orestes, V ; HCFMUSP COVID 19 Study Grp

• Document type: Journal article
• Source: FRONTIERS IN IMMUNOLOGY; v. 14, p. 13-pg., 2023-05-23.

Abstract

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. (AU)

• FAPESP's process: 22/01769-5 - Late assessment of physical, psychological and cognitive effects in a cohort of patients surviving COVID-19 hospitalization at a tertiary university hospital: a multidisciplinary approach
• Grantee: Carlos Roberto Ribeiro de Carvalho
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 21/14379-8 - Psychiatric and cognitive manifestations associated with SARS-CoV-2 virus infection
• Grantee: Rodolfo Furlan Damiano
• Support Opportunities: Scholarships in Brazil - Doctorate (Direct)
• FAPESP's process: 20/02988-7 - Decoding the impact of microenvironment and signaling pathways in health and disease in brain, adrenal gland and kidney
• Grantee: Suely Kazue Nagahashi Marie
• Support Opportunities: Research Projects - Thematic Grants