PDF(Pubmed)
Abstract：
This study sought to characterize cognitive functioning in patients with neurological post-acute sequelae of SARS-CoV-2 infection (Neuro-PASC) and investigate the association of subjective and objective functioning along with other relevant factors with prior hospitalization for COVID-19. Participants were 106 adult outpatients with Neuro-PASC referred for abbreviated neuropsychological assessment after scoring worse than one standard deviation below the mean on cognitive screening. Of these patients, 23 had been hospitalized and 83 had not been hospitalized for COVID-19. Subjective cognitive impairment was evaluated with the self-report cognition subscale from the Patient-Reported Outcome Measurement Information System. Objective cognitive performance was assessed using a composite score derived from multiple standardized cognitive measures. Other relevant factors, including fatigue and depression/mood symptoms, were assessed via the Patient-Reported Outcome Measurement Information System. Subjective cognitive impairment measures exceeded the minimal difficulties noted on objective tests and were associated with depression/mood symptoms as well as fatigue. However, fatigue independently explained the most variance (17.51%) in patients\' subjective cognitive ratings. When adjusting for fatigue and time since onset of COVID-19 symptoms, neither objective nor subjective impairment were associated with prior hospitalization for COVID-19. Findings suggest that abbreviated neuropsychological assessment may not reveal objective difficulties beyond initial cognitive screening in patients with Neuro-PASC. However, subjective cognitive concerns may persist irrespective of hospitalization status, and are likely influenced by fatigue and depression/mood symptoms. The impact of concomitant management of fatigue and mood in patients with Neuro-PASC who report cognitive concerns deserve further study.
摘要：
这项研究旨在表征SARS-CoV-2感染（Neuro-PASC）的神经系统急性后遗症患者的认知功能，并调查主观和客观功能以及其他相关因素与COVID-19先前住院的关系。参与者是106名成年的Neuro-PASC门诊患者，他们在认知筛查中得分低于平均值一个标准差后，接受了简短的神经心理学评估。在这些病人中,23人因COVID-19住院，83人未住院。使用来自患者报告结果测量信息系统的自我报告认知子量表评估主观认知障碍。使用来自多个标准化认知测量的综合评分来评估客观认知表现。其他相关因素,包括疲劳和抑郁/情绪症状，通过患者报告的结果测量信息系统进行评估。主观认知障碍指标超过了客观测试中指出的最小困难，并且与抑郁/情绪症状以及疲劳有关。然而,疲劳独立解释了患者主观认知评分中最大的差异(17.51%)。当调整疲劳和自COVID-19症状发作以来的时间时，客观或主观损害均与COVID-19之前的住院无关。研究结果表明，简短的神经心理学评估可能无法揭示Neuro-PASC患者的初始认知筛查之外的客观困难。然而,主观认知担忧可能会持续存在，而与住院状态无关，并可能受到疲劳和抑郁/情绪症状的影响。报告认知问题的Neuro-PASC患者伴随的疲劳和情绪管理的影响值得进一步研究。
