Abstract：
BACKGROUND: Cognitive impairment can be caused by infections with various pathogens, including SARS-CoV-2. Research has yet to determine the true incidence and course of cognitive impairment in older adults following COVID-19. Furthermore, research has theorised that COVID-19 is associated with dementia progression and diagnosis but this association has yet to be fully described.
METHODS: A systematic review was registered in Prospero and conducted on the databases PubMed, Embase, Ovid, CENTRAL and Cochrane Library. Studies reporting cognitive impairment and dementia outcomes in post-acute and post-COVID-19 patients aged ≥65 years, and which included control data, were included in this review.
RESULTS: 15,124 articles were identified by the search strategy. After eliminating duplicate titles and completing title, abstracts and full-text review, 18 studies were included comprising of 412,957 patients with COVID-19 (46.63% male) and 411,929 patients without COVID-19 (46.59% male). The overall mean Montreal Cognitive Assessment (MoCA) score in COVID-19 patients was 23.34 out of 30 (95% CI [22.24, 24.43]). indicating cognitive impairment. The overall proportion of patients identified as having new onset cognitive impairment was 65% (95% CI [44, 81]). Subgroup analyses indicated that time since infection significantly improves overall MoCA score and reduces proportion of patients with cognitive impairment.
CONCLUSIONS: This study indicates that cognitive impairment may be an important sequela of COVID-19. Further research with adequate sample sizes is warranted regarding COVID-19\'s association with new-onset dementia and dementia progression, and the effect of repeat infections. There is a need for development of diagnostic and management protocols for COVID-19 patients with cognitive impairment.
METHODS: A systematic review was registered in Prospero and conducted on the databases PubMed, Embase, Ovid, CENTRAL and Cochrane Library. Studies reporting cognitive impairment and dementia outcomes in post-acute and post-COVID-19 patients aged ≥65 years, and which included control data, were included in this review.
RESULTS: 15,124 articles were identified by the search strategy. After eliminating duplicate titles and completing title, abstracts and full-text review, 18 studies were included comprising of 412,957 patients with COVID-19 (46.63% male) and 411,929 patients without COVID-19 (46.59% male). The overall mean Montreal Cognitive Assessment (MoCA) score in COVID-19 patients was 23.34 out of 30 (95% CI [22.24, 24.43]). indicating cognitive impairment. The overall proportion of patients identified as having new onset cognitive impairment was 65% (95% CI [44, 81]). Subgroup analyses indicated that time since infection significantly improves overall MoCA score and reduces proportion of patients with cognitive impairment.
CONCLUSIONS: This study indicates that cognitive impairment may be an important sequela of COVID-19. Further research with adequate sample sizes is warranted regarding COVID-19\'s association with new-onset dementia and dementia progression, and the effect of repeat infections. There is a need for development of diagnostic and management protocols for COVID-19 patients with cognitive impairment.
摘要：
背景：认知障碍可由各种病原体感染引起，包括SARS-CoV-2.研究尚未确定COVID-19后老年人认知障碍的真实发生率和过程。此外，研究推测COVID-19与痴呆的进展和诊断相关，但这种关联尚未得到充分描述。
方法：在Prospero注册并在PubMed数据库上进行了系统评价，Embase,奥维德,CENTRAL和Cochrane图书馆。研究报告年龄≥65岁的急性后和COVID-19后患者的认知障碍和痴呆结局，其中包括控制数据，包括在这次审查中。
结果：通过搜索策略确定了15,124篇文章。消除重复的标题并完成标题后，摘要和全文回顾，纳入18项研究，包括412,957例COVID-19患者（男性占46.63%）和411,929例无COVID-19患者（男性占46.59%）。COVID-19患者的总体平均蒙特利尔认知评估（MoCA）评分为23.34分（95%CI[22.24,24.43]）。提示认知障碍。确定为新发认知障碍患者的总比例为65%(95%CI[44,81])。亚组分析表明，感染后的时间显着改善了总体MoCA评分，并降低了认知障碍患者的比例。
结论：本研究提示认知障碍可能是COVID-19的重要后遗症。关于COVID-19与新发痴呆和痴呆进展的关系，有必要进行足够样本量的进一步研究，以及重复感染的影响。有必要制定COVID-19认知障碍患者的诊断和管理方案。
方法：在Prospero注册并在PubMed数据库上进行了系统评价，Embase,奥维德,CENTRAL和Cochrane图书馆。研究报告年龄≥65岁的急性后和COVID-19后患者的认知障碍和痴呆结局，其中包括控制数据，包括在这次审查中。
结果：通过搜索策略确定了15,124篇文章。消除重复的标题并完成标题后，摘要和全文回顾，纳入18项研究，包括412,957例COVID-19患者（男性占46.63%）和411,929例无COVID-19患者（男性占46.59%）。COVID-19患者的总体平均蒙特利尔认知评估（MoCA）评分为23.34分（95%CI[22.24,24.43]）。提示认知障碍。确定为新发认知障碍患者的总比例为65%(95%CI[44,81])。亚组分析表明，感染后的时间显着改善了总体MoCA评分，并降低了认知障碍患者的比例。
结论：本研究提示认知障碍可能是COVID-19的重要后遗症。关于COVID-19与新发痴呆和痴呆进展的关系，有必要进行足够样本量的进一步研究，以及重复感染的影响。有必要制定COVID-19认知障碍患者的诊断和管理方案。
