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.
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。