TY - JOUR
T1 - Neurological and (neuro)psychological sequelae in intensive care and general ward COVID-19 survivors
AU - Klinkhammer, Simona
AU - Horn, Janneke
AU - Duits, Annelien A.
AU - Visser-Meily, Johanna M.A.
AU - Verwijk, Esmée
AU - Slooter, Arjen J.C.
AU - Postma, Alida A.
AU - van Heugten, Caroline M.
AU - Aries, Marcel J.H.
AU - van Bussel, Bas C.T.
AU - Jansen, Jacobus F.A.
AU - Janssen, Marcus L.F.
AU - van Santen, Susanne
AU - Magdelijns, Fabienne J.H.
AU - Posthuma, Rein
AU - Linden, David E.J.
AU - van der Woude, Margaretha C.E.
AU - Dormans, Tom
AU - Otten, Amy
AU - Karakus, Attila
AU - Bronsveld, Inez
AU - Kaasjager, Karin A.H.
AU - Galenkamp, Niek
AU - Geurtsen, Gert J.
AU - Brouwer, Matthijs C.
AU - Brinkman, Kees
AU - Kylstra, Wytske A.
AU - Koch, Dook W.
AU - Beudel, Martijn
N1 - Funding Information:
This study was funded by the Brain Foundation Netherlands (Hersenstichting) grant number DR‐2020‐00377.
Publisher Copyright:
© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
PY - 2023/7
Y1 - 2023/7
N2 - Background and purpose: Coronavirus disease 2019 (COVID-19) affects the brain, leading to long-term complaints. Studies combining brain abnormalities with objective and subjective consequences are lacking. Long-term structural brain abnormalities, neurological and (neuro)psychological consequences in COVID-19 patients admitted to the intensive care unit (ICU) or general ward were investigated. The aim was to create a multidisciplinary view on the impact of severe COVID-19 on functioning and to compare long-term consequences between ICU and general ward patients. Methods: This multicentre prospective cohort study assessed brain abnormalities (3 T magnetic resonance imaging), cognitive dysfunction (neuropsychological test battery), neurological symptoms, cognitive complaints, emotional distress and wellbeing (self-report questionnaires) in ICU and general ward (non-ICU) survivors. Results: In al, 101 ICU and 104 non-ICU patients participated 8–10 months post-hospital discharge. Significantly more ICU patients exhibited cerebral microbleeds (61% vs. 32%, p < 0.001) and had higher numbers of microbleeds (p < 0.001). No group differences were found in cognitive dysfunction, neurological symptoms, cognitive complaints, emotional distress or wellbeing. The number of microbleeds did not predict cognitive dysfunction. In the complete sample, cognitive screening suggested cognitive dysfunction in 41%, and standard neuropsychological testing showed cognitive dysfunction in 12%; 62% reported ≥3 cognitive complaints. Clinically relevant scores of depression, anxiety and post-traumatic stress were found in 15%, 19% and 12%, respectively; 28% experienced insomnia and 51% severe fatigue. Conclusion: Coronavirus disease 2019 ICU survivors had a higher prevalence for microbleeds but not for cognitive dysfunction compared to general ward survivors. Self-reported symptoms exceeded cognitive dysfunction. Cognitive complaints, neurological symptoms and severe fatigue were frequently reported in both groups, fitting the post-COVID-19 syndrome.
AB - Background and purpose: Coronavirus disease 2019 (COVID-19) affects the brain, leading to long-term complaints. Studies combining brain abnormalities with objective and subjective consequences are lacking. Long-term structural brain abnormalities, neurological and (neuro)psychological consequences in COVID-19 patients admitted to the intensive care unit (ICU) or general ward were investigated. The aim was to create a multidisciplinary view on the impact of severe COVID-19 on functioning and to compare long-term consequences between ICU and general ward patients. Methods: This multicentre prospective cohort study assessed brain abnormalities (3 T magnetic resonance imaging), cognitive dysfunction (neuropsychological test battery), neurological symptoms, cognitive complaints, emotional distress and wellbeing (self-report questionnaires) in ICU and general ward (non-ICU) survivors. Results: In al, 101 ICU and 104 non-ICU patients participated 8–10 months post-hospital discharge. Significantly more ICU patients exhibited cerebral microbleeds (61% vs. 32%, p < 0.001) and had higher numbers of microbleeds (p < 0.001). No group differences were found in cognitive dysfunction, neurological symptoms, cognitive complaints, emotional distress or wellbeing. The number of microbleeds did not predict cognitive dysfunction. In the complete sample, cognitive screening suggested cognitive dysfunction in 41%, and standard neuropsychological testing showed cognitive dysfunction in 12%; 62% reported ≥3 cognitive complaints. Clinically relevant scores of depression, anxiety and post-traumatic stress were found in 15%, 19% and 12%, respectively; 28% experienced insomnia and 51% severe fatigue. Conclusion: Coronavirus disease 2019 ICU survivors had a higher prevalence for microbleeds but not for cognitive dysfunction compared to general ward survivors. Self-reported symptoms exceeded cognitive dysfunction. Cognitive complaints, neurological symptoms and severe fatigue were frequently reported in both groups, fitting the post-COVID-19 syndrome.
KW - affective
KW - brain damage
KW - cognitive
KW - COVID-19
KW - ICU
KW - neurological
KW - neuropsychological
KW - SARS-CoV-2
UR - http://www.scopus.com/inward/record.url?scp=85153773216&partnerID=8YFLogxK
U2 - 10.1111/ene.15812
DO - 10.1111/ene.15812
M3 - Article
C2 - 37010152
SN - 1351-5101
VL - 30
SP - 1880
EP - 1890
JO - European Journal of Neurology
JF - European Journal of Neurology
IS - 7
ER -