Long Neurocognitive and Neuropsychiatric Sequelae in Participants with Post-COVID-19 Infection: A Longitudinal Study
Abstract
:1. Introduction
2. Methods
2.1. Study Design and Participants
2.2. Data Collection and Definitions
2.3. Statistical Analysis
3. Results
3.1. Demographic and Clinical Characteristics
3.2. Neuropsychological Findings
3.2.1. Neuropsychological Results Depending on the Severity of the Disease
3.2.2. Neuropsychological Results Based on Cognitive Complaints
3.2.3. Neuropsychological Results Based on Clinical Symptoms
4. Discussion
4.1. Neuropsychological Outcomes
4.1.1. Illness Severity
4.1.2. Subjective Cognitive Complaints
4.1.3. Persistent Clinical Symptoms on Follow-Up
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Neuropsychological Tests | Basal Mean (SD) | 6 Months Mean (SD) | Sig. (2-Tailed) | d Cohen | Effect (r) |
---|---|---|---|---|---|
TAVEC-1 | 6.38 (1.76) | 7.62 (1.88) | 0.001 * | 0.68 | 0.32 |
TAVECTotal | 53.18 (8.75) | 57.23 (9.54) | 0.001 * | 0.44 | 0.21 |
TAVEC-B | 5.27 (1.62) | 5.50 (1.64) | 0.171 | 0.14 | 0.07 |
TAVEC-IMR | 11.15 (2.60) | 12.26 (2.78) | 0.001 * | 0.41 | 0.20 |
TAVEC-IMRSC | 12.19 (2.46) | 13.30 (2.52) | 0.001 * | 0.44 | 0.21 |
TAVEC-DFR | 11.74 (2.85) | 12.56 (2.94) | 0.001 * | 0.28 | 0.14 |
TAVEC-DFRSC | 12.27 (2.65) | 13.32 (2.53) | 0.001 * | 0.40 | 0.19 |
TAVEC-REC | 14.99 (1.28) | 15.23 (1.33) | 0.126 | 0.18 | 0.09 |
WMS-IMR | 34.74 (5.93) | 36.32 (5.40) | 0.001 * | 0.27 | 0.13 |
WMS-DFR | 28.08 (9.04) | 31.21 (8.18) | 0.001 * | 0.36 | 0.17 |
Digits Forward | 5.81 (1.15) | 5.88 (1.21) | 0.407 | 0.05 | 0.02 |
Digits Backward | 4.31 (1.12) | 4.81 (2.64) | 0.055 | 0.24 | 0.12 |
Letter and Number | 9.62 (2.43) | 9.79 (2.33) | 0.233 | 0.07 | 0.03 |
TMT-A | 36.31 (15.21) | 35.18 (17.13) | 0.281 | 0.06 | 0.03 |
TMT-B | 97.56 (60.48) | 88.66 (49.81) | 0.028 * | 0.16 | 0.08 |
SDMT | 42.63 (11.63) | 44.63 (12.31) | 0.001 * | 0.16 | 0.08 |
Stroop Lecture | 100.66 (18.71) | 97.67 (20.75) | 0.014 * | 0.15 | 0.07 |
Stroop Color | 65.86 (11.51) | 64.83 (12.56) | 0.168 | 0.08 | 0.04 |
Stroop Interference | 38.86 (10.76) | 38.77 (10.92) | 0.882 | 0.00 | 0.00 |
Semantic Fluency | 23.41 (6.14) | 23.99 (6.49) | 0.209 | 0.09 | 0.04 |
Phonetic Fluency | 14.26 (4.69) | 15.15 (4.82) | 0.016 * | 0.18 | 0.09 |
FCRO copy | 33.04 (4.16) | 33.09 (4.05) | 0.907 | 0.01 | 0.00 |
Boston Naming Test | 50.44 (6.59) | 51.65 (6.37) | 0.001 * | 0.18 | 0.09 |
HAD Anxiety | 7.43 (4.19) | 7.43 (4.45) | 1.000 | 0.00 | 0.00 |
HAD Depresion | 5.08 (3.90) | 5.05 (4.28) | 0.909 | 0.00 | 0.00 |
Neuropsychological Tests | Basal Mean (SD) | 6 Months Mean (SD) | Sig. (2-Tailed) | d Cohen | Effect (r) |
---|---|---|---|---|---|
TAVEC-1 | 6.56 (1.59) | 8.00 (1.58) | 0.026 * | 0.90 | 0.41 |
TAVECTotal | 57.44 (6.63) | 60.22 (7.19) | 0.054 | 0.40 | 0.19 |
TAVEC-B | 4.89 (1.05) | 5.44 (1.66) | 0.325 | 0.39 | 0.19 |
TAVEC-IMR | 12.89 (2.14) | 13.33 (1.93) | 0.525 | 0.21 | 0.10 |
TAVEC-IMRSC | 12.78 (2.27) | 14.33 (1.41) | 0.043 * | 0.82 | 0.37 |
TAVEC-DFR | 13.11 (2.14) | 13.33 (1.58) | 0.791 | 0.11 | 0.05 |
TAVEC-DFRSC | 13.22 (1.92) | 14.11 (1.16) | 0.104 | 0.56 | 0.27 |
TAVEC-REC | 14.89 (1.05) | 15.56 (0.72) | 0.022 | 0.74 | 0.34 |
WMS-IMR | 35.78 (4.94) | 37.11 (5.55) | 0.207 | 0.25 | 0.12 |
WMS-DFR | 30.44 (9.48) | 31.56 (10.16) | 0.531 | 0.11 | 0.05 |
Digits Forward | 6.22 (0.83) | 6.22 (1.20) | 1.000 | 0.00 | 0.00 |
Digits Backward | 4.78 (1.20) | 5.11 (1.16) | 0.195 | 0.27 | 0.13 |
Letter and Number | 9.89 (1.83) | 10.22 (1.71) | 0.620 | 0.18 | 0.09 |
TMT-A | 32.44 (10.16) | 28.11 (5.46) | 0.069 | 0.53 | 0.25 |
TMT-B | 73.67 (21.98) | 70.78 (15.97) | 0.758 | 0.15 | 0.07 |
SDMT | 47.67 (8.13) | 49.33 (6.94) | 0.233 | 0.21 | 0.10 |
Stroop Lecture | 100.89 (12.59) | 101.78 (11.30) | 0.634 | 0.07 | 0.03 |
Stroop Color | 65.44 (6.46) | 65.56 (7.19) | 0.958 | 0.01 | 0.00 |
Stroop Interference | 39.33 (8.04) | 38.33 (7.24) | 0.629 | 0.13 | 0.06 |
Semantic Fluency | 24.00 (3.20) | 23.78 (4.08) | 0.900 | 0.06 | 0.02 |
Phonetic Fluency | 15.22 (4.29) | 15.67 (2.55) | 0.762 | 0.12 | 0.06 |
FCRO copy | 34.38 (2.31) | 34.77 (1.48) | 0.301 | 0.20 | 0.10 |
Boston Naming Test | 53.00 (5.85) | 53.56 (5.00) | 0.384 | 0.10 | 0.05 |
HAD Anxiety | 10.33 (3.84) | 7.67 (3.80) | 0.007 * | 0.69 | 0.32 |
HAD Depresion | 7.33 (4.50) | 5.22 (3.89) | 0.106 | 0.50 | 0.24 |
Neuropsychological Tests | Basal Mean (SD) | 6 Months Mean (SD) | Sig. (2-Tailed) | d Cohen | Effect (r) |
---|---|---|---|---|---|
TAVEC-1 | 6.57 (1.43) | 8.05 (1.71) | 0.003 * | 0.93 | 0.42 |
TAVECTotal | 54.33 (6.60) | 69.52 (9.25) | 0.002 * | 1.89 | 0.68 |
TAVEC-B | 6.10 (1.48) | 6.43 (1.53) | 0.391 | 0.21 | 0.10 |
TAVEC-IMR | 11.19 (2.48) | 12.38 (2.67) | 0.033 * | 0.46 | 0.22 |
TAVEC-IMRSC | 12.14 (2.08) | 13.33 (2.03) | 0.009 * | 0.57 | 0.27 |
TAVEC-DFR | 11.76 (2.56) | 12.62 (3.07) | 0.269 | 0.30 | 0.15 |
TAVEC-DFRSC | 12.38 (2.03) | 13.24 (2.44) | 0.143 | 0.38 | 0.18 |
TAVEC-REC | 15.14 (0.96) | 14.62 (1.77) | 0.248 | 0.36 | 0.17 |
WMS-IMR | 35.76 (6.47) | 36.67 (5.73) | 0.247 | 0.14 | 0.07 |
WMS-DFR | 29.29 (9.63) | 32.71 (8.11) | 0.071 | 0.39 | 0.18 |
Digits Forward | 5.90 (1.09) | 6.00 (1.14) | 0.649 | 0.08 | 0.04 |
Digits Backward | 4.43 (1.14) | 4.71 (1.10) | 0.208 | 0.24 | 0.12 |
Letter and Number | 9.86 (2.22) | 9.90 (2.14) | 0.853 | 0.01 | 0.00 |
TMT-A | 34.33 (11.82) | 31.81 (11.78) | 0.185 | 0.21 | 0.10 |
TMT-B | 90.29 (67.31) | 81.67 (55.71) | 0.422 | 0.13 | 0.06 |
SDMT | 46.05 (10.25) | 46.05 (11.01) | 1.000 | 0.00 | 0.00 |
Stroop Lecture | 105.90 (15.81) | 102.10 (21.76) | 0.181 | 0.19 | 0.09 |
Stroop Color | 68.95 (11.93) | 68.29 (12.74) | 0.689 | 0.05 | 0.02 |
Stroop Interference | 43.00 (10.86) | 43.00 (11.91) | 1.000 | 0.00 | 0.00 |
Semantic Fluency | 25.29 (5.33) | 24.29 (5.78) | 0.188 | 0.19 | 0.09 |
Phonetic Fluency | 15.14 (4.99) | 15.86 (5.03) | 0.379 | 0.14 | 0.07 |
FCRO copy | 32.69 (5.74) | 32.92 (5.37) | 0.763 | 0.04 | 0.02 |
Boston Naming Test | 51.05 (6.31) | 51.67 (6.12) | 0.473 | 0.09 | 0.04 |
HAD Anxiety | 7.48 (3.91) | 6.90 (4.41) | 0.463 | 0.13 | 0.06 |
HAD Depresion | 5.19 (4.30) | 4.24 (3.82) | 0.212 | 0.23 | 0.11 |
Neuropsychological Tests | Basal Mean (SD) | 6 Months Mean (SD) | Sig. (2-Tailed) | d Cohen | Effect (r) |
---|---|---|---|---|---|
TAVEC-1 | 6.34 (1.98) | 7.61 (2.01) | 0.001 * | 0.63 | 0.30 |
TAVECTotal | 52.77 (9.72) | 56.39 (10.18) | 0.002 * | 0.36 | 0.17 |
TAVEC-B | 5.20 (1.64) | 5.20 (1.38) | 1.000 | 0.00 | 0.00 |
TAVEC-IMR | 10.88 (2.69) | 11.96 (2.95) | 0.001 * | 0.38 | 0.18 |
TAVEC-IMRSC | 12.04 (2.66) | 12.98 (2.89) | 0.003 * | 0.33 | 0.16 |
TAVEC-DFR | 11.52 (2.98) | 12.41 (3.20) | 0.008 * | 0.28 | 0.14 |
TAVEC-DFRSC | 11.96 (2.82) | 13.14 (2.77) | 0.001 * | 0.42 | 0.20 |
TAVEC-REC | 15.04 (1.25) | 15.36 (1.18) | 0.092 | 0.26 | 0.13 |
WMS-IMR | 34.86 (5.39) | 36.25 (5.23) | 0.003 * | 0.26 | 0.12 |
WMS-DFR | 27.55 (9.27) | 31.31 (8.29) | 0.001 * | 0.42 | 0.20 |
Digits Forward | 5.82 (1.26) | 5.80 (1.28) | 0.878 | 0.01 | 0.00 |
Digits Backward | 4.21 (1.09) | 4.54 (0.97) | 0.038 * | 0.31 | 0.15 |
Letter and Number | 9.86 (2.62) | 9.84 (2.54) | 0.932 | 0.00 | 0.00 |
TMT-A | 36.20 (14.21) | 36.20 (19.17) | 1.000 | 0.00 | 0.00 |
TMT-B | 98.64 (59.20) | 93.64 (53.54) | 0.353 | 0.08 | 0.04 |
SDMT | 41.63 (12.21) | 44.21 (12.56) | 0.001 * | 0.20 | 0.10 |
Stroop Lecture | 100.89 (19.03) | 97.69 (21.25) | 0.084 | 0.15 | 0.07 |
Stroop Color | 66.38 (10.40) | 64.47 (13.25) | 0.068 | 0.16 | 0.07 |
Stroop Interference | 38.87 (10.71) | 38.51 (11.10) | 0.612 | 0.03 | 0.01 |
Semantic Fluency | 23.16 (5.99) | 24.61 (6.86) | 0.035 * | 0.22 | 0.11 |
Phonetic Fluency | 13.86 (4.27) | 15.07 (4.72) | 0.022 * | 0.26 | 0.13 |
FCRO copy | 33.13 (3.24) | 32.75 (3.79) | 0.332 | 0.10 | 0.05 |
Boston Naming Test | 50.38 (6.71) | 51.61 (6.72) | 0.001 * | 0.18 | 0.09 |
HAD Anxiety | 7.30 (4.43) | 7.80 (4.79) | 0.272 | 0.10 | 0.05 |
HAD Depresion | 5.00 (3.81) | 5.39 (4.69) | 0.371 | 0.09 | 0.04 |
Neuropsychological Tests | Basal Mean (SD) | 6 Months Mean (SD) | Sig. (2-Tailed) | d Cohen | Effect (r) |
---|---|---|---|---|---|
TAVEC-1 | 6.19 (1.63) | 7.00 (1.76) | 0.015 * | 0.47 | 0.23 |
TAVECTotal | 51.10 (8.55) | 55.52 (8.84) | 0.002 * | 0.50 | 0.24 |
TAVEC-B | 4.86 (1.71) | 5.33 (2.10) | 0.329 | 0.24 | 0.12 |
TAVEC-IMR | 10.95 (2.53) | 12.29 (2.70) | 0.002 * | 0.51 | 0.24 |
TAVEC-IMRSC | 12.29 (2.47) | 13.52 (2.25) | 0.002 * | 0.52 | 0.25 |
TAVEC-DFR | 11.57 (3.02) | 12.43 (2.61) | 0.064 | 0.30 | 0.15 |
TAVEC-DFRSC | 12.43 (2.97) | 13.43 (2.39) | 0.105 | 0.37 | 0.18 |
TAVEC-REC | 14.71 (1.73) | 15.33 (1.31) | 0.148 | 0.40 | 0.19 |
WMS-IMR | 32.86 (7.14) | 35.86 (5.92) | 0.032 * | 0.45 | 0.22 |
WMS-DFR | 26.95 (7.96) | 29.10 (7.34) | 0.202 | 0.28 | 0.13 |
Digits Forward | 5.52 (1.03) | 5.76 (1.17) | 0.261 | 0.21 | 0.10 |
Digits Backward | 4.24 (1.09) | 5.52 (5.68) | 0.316 | 0.31 | 0.15 |
Letter and Number | 8.57 (2.22) | 9.29 (2.61) | 0.008 * | 0.29 | 0.14 |
TMT-A | 41.05 (21.30) | 39.48 (18.50) | 0.392 | 0.07 | 0.03 |
TMT-B | 114.65 (67.63) | 92.05 (43.75) | 0.027 * | 0.39 | 0.19 |
SDMT | 39.43 (11.96) | 42.24 (14.75) | 0.052 | 0.20 | 0.10 |
Stroop Lecture | 93.90 (21.75) | 90.38 (20.74) | 0.181 | 0.16 | 0.08 |
Stroop Color | 61.30 (14.97) | 61.55 (12.39) | 0.899 | 0.01 | 0.00 |
Stroop Interference | 34.25 (10.98) | 34.90 (9.92) | 0.670 | 0.06 | 0.03 |
Semantic Fluency | 20.90 (6.06) | 21.38 (5.90) | 0.671 | 0.08 | 0.04 |
Phonetic Fluency | 13.29 (4.49) | 13.71 (4.60) | 0.602 | 0.09 | 0.04 |
FCRO copy | 32.42 (5.18) | 32.92 (4.09) | 0.368 | 0.10 | 0.05 |
Boston Naming Test | 48.62 (6.80) | 50.67 (6.46) | 0.001 * | 0.30 | 0.15 |
HAD Anxiety | 6.67 (3.66) | 7.05 (3.95) | 0.662 | 0.09 | 0.04 |
HAD Depresion | 4.43 (3.55) | 5.10 (3.82) | 0.379 | 0.18 | 0.09 |
Neuropsychological Tests | Subjects without SCC (n = 70) Basal (SD)/6 Months (SD) | Sig. (2-Tailed) | d Cohen | Effect (r) | |
---|---|---|---|---|---|
TAVEC-1 | 6.47 (1.85) | 7.43 (1.85) | 0.001 * | 0.51 | 0.25 |
TAVECTotal | 52.83 (9.37) | 56.59 (10.12) | 0.001 * | 0.38 | 0.18 |
TAVEC-B | 4.99 (1.48) | 5.11 (1.69) | 0.554 | 0.07 | 0.03 |
TAVEC-IMR | 11.03 (2.66) | 12.03 (2.89) | 0.001 * | 0.36 | 0.17 |
TAVEC-IMRSC | 12.09 (2.64) | 13.14 (2.69) | 0.001 * | 0.39 | 0.19 |
TAVEC-DFR | 11.74 (3.03) | 12.41 (3.19) | 0.060 | 0.21 | 0.10 |
TAVEC-DFRSC | 12.16 (2.83) | 13.17 (2.74) | 0.002 * | 0.36 | 0.17 |
TAVEC-REC | 14.97 (1.32) | 15.26 (1.51) | 0.204 | 0.20 | 0.10 |
WMS-IMR | 35.33 (5.96) | 37.11 (4.81) | 0.001 * | 0.32 | 0.16 |
WMS-DFR | 29.38 (8.92) | 31.59 (8.43) | 0.006 * | 0.25 | 0.12 |
Digits Forward | 5.93 (1.22) | 6.01 (1.25) | 0.443 | 0.06 | 0.03 |
Digits Backward | 4.40 (1.16) | 4.60 (1.05) | 0.118 | 0.18 | 0.09 |
Letter and Number | 9.81 (2.51) | 9.89 (2.36) | 0.679 | 0.03 | 0.01 |
TMT-A | 36.53 (16.92) | 34.30 (18.23) | 0.061 | 0.12 | 0.06 |
TMT-B | 94.68 (54.06) | 89.87 (53.84) | 0.291 | 0.08 | 0.04 |
SDMT | 43.31 (12.05) | 44.54 (13.04) | 0.076 | 0.09 | 0.04 |
Stroop Lecture | 101.51 (18.98) | 97.03 (21.43) | 0.012 * | 0.22 | 0.10 |
Stroop Color | 66.28 (12.94) | 64.50 (14.01) | 0.090 | 0.13 | 0.06 |
Stroop Interference | 39.54 (11.54) | 38.53 (11.92) | 0.155 | 0.08 | 0.04 |
Semantic Fluency | 23.67 (5.88) | 24.61 (6.48) | 0.099 | 0.15 | 0.07 |
Phonetic Fluency | 14.63 (4.65) | 15.14 (4.98) | 0.262 | 0.10 | 0.05 |
FCRO copy | 33.13 (4.46) | 33.35 (3.62) | 0.537 | 0.05 | 0.02 |
Boston Naming Test | 51.30 (6.51) | 52.21 (6.21) | 0.005 * | 0.14 | 0.07 |
HAD Anxiety | 5.89 (3.54) | 6.26 (4.32) | 0.307 | 0.09 | 0.04 |
HAD Depresion | 3.59 (3.08) | 4.10 (3.97) | 0.178 | 0.14 | 0.07 |
Neuropsychological Tests | Subjects with SCC (n = 38) Basal (SD)/6 Mesos (SD) | Sig. (2-Tailed) | d Cohen | Effect (r) | |
---|---|---|---|---|---|
TAVEC-1 | 6.27 (1.62) | 7.95 (1.92) | 0.001 * | 0.94 | 0.42 |
TAVECTotal | 53.73 (7.64) | 58.24 (8.41) | 0.001 * | 0.56 | 0.27 |
TAVEC-B | 5.84 (1.74) | 6.19 (1.30) | 0.186 | 0.22 | 0.11 |
TAVEC-IMR | 11.30 (2.51) | 12.59 (2.51) | 0.001 * | 0.51 | 0.24 |
TAVEC-IMRSC | 12.32 (2.13) | 13.51 (2.19) | 0.001 * | 0.55 | 0.26 |
TAVEC-DFR | 11.65 (2.50) | 12.76 (2.42) | 0.001 * | 0.45 | 0.22 |
TAVEC-DFRSC | 12.41 (2.29) | 13.54 (2.07) | 0.001 * | 0.51 | 0.25 |
TAVEC-REC | 15.00 (1.22) | 15.16 (0.92) | 0.362 | 0.14 | 0.07 |
WMS-IMR | 33.57 (5.85) | 34.84 (6.23) | 0.054 | 0.21 | 0.10 |
WMS-DFR | 25.49 (8.87) | 30.38 (7.82) | 0.001 * | 0.58 | 0.28 |
Digits Forward | 5.59 (1.01) | 5.59 (1.11) | 1.000 | 0.00 | 0.00 |
Digits Backward | 4.14 (1.05) | 5.22 (4.29) | 0.136 | 0.34 | 0.17 |
Letter and Number | 9.22 (2.28) | 9.57 (2.31) | 0.156 | 0.15 | 0.07 |
TMT-A | 36.35 (11.45) | 37.19 (14.97) | 0.693 | 0.06 | 0.03 |
TMT-B | 104.06 (72.35) | 87.00 (42.22) | 0.036 * | 0.28 | 0.14 |
SDMT | 41.16 (10.94) | 44.78 (11.14) | 0.001 * | 0.32 | 0.16 |
Stroop Lecture | 98.62 (18.34) | 98.27 (19.64) | 0.743 | 0.01 | 0.00 |
Stroop Color | 65.05 (8.60) | 65.27 (9.66) | 0.814 | 0.02 | 0.01 |
Stroop Interference | 37.59 (9.34) | 39.03 (9.02) | 0.137 | 0.15 | 0.07 |
Semantic Fluency | 22.32 (5.62) | 22.38 (5.85) | 0.947 | 0.01 | 0.00 |
Phonetic Fluency | 13.14 (3.93) | 14.76 (3.88) | 0.011 * | 0.41 | 0.20 |
FCRO copy | 32.78 (3.60) | 32.31 (4.78) | 0.318 | 0.11 | 0.05 |
Boston Naming Test | 48.65 (6.48) | 50.43 (6.64) | 0.001 * | 0.27 | 0.13 |
HAD Anxiety | 10.46 (3.69) | 9.76 (3.78) | 0.322 | 0.18 | 0.09 |
HAD Depresion | 8.03 (3.65) | 6.97 (4.25) | 0.084 | 0.26 | 0.13 |
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Almeria, M.; Cejudo, J.C.; Deus, J.; Krupinski, J. Long Neurocognitive and Neuropsychiatric Sequelae in Participants with Post-COVID-19 Infection: A Longitudinal Study. Neurol. Int. 2024, 16, 853-868. https://doi.org/10.3390/neurolint16040064
Almeria M, Cejudo JC, Deus J, Krupinski J. Long Neurocognitive and Neuropsychiatric Sequelae in Participants with Post-COVID-19 Infection: A Longitudinal Study. Neurology International. 2024; 16(4):853-868. https://doi.org/10.3390/neurolint16040064
Chicago/Turabian StyleAlmeria, Marta, Juan Carlos Cejudo, Joan Deus, and Jerzy Krupinski. 2024. "Long Neurocognitive and Neuropsychiatric Sequelae in Participants with Post-COVID-19 Infection: A Longitudinal Study" Neurology International 16, no. 4: 853-868. https://doi.org/10.3390/neurolint16040064