| Cross-sectional case-control studies  

Neurological and (neuro)psychological sequelae in intensive care and general ward COVID-19 survivors

COVID-19 affects the brain, leading to long-term complaints. Studies combining brain abnormalities with objective and subjective consequences are lacking. In this multicentre prospective cohort study the authors investigated long-term structural brain abnormalities, neurological-, and (neuro)psychological consequences in COVID-19 patients admitted to the intensive care unit (ICU) or general ward. They aimed 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. Brain abnormalities (3T MRI), cognitive dysfunction (neuropsychological test battery), neurological symptoms, cognitive complaints, emotional distress, and wellbeing (self-report questionnaires) in ICU and general ward (non-ICU) survivors were assessed.

101 ICU and 104 non-ICU patients participated 8-10 months post-hospital discharge. Significantly more ICU patients exhibited cerebral microbleeds (61% versus 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%, standard neuropsychological testing showed cognitive dysfunction in 12%. Sixty-two% reported ≥3 cognitive complaints. Clinically relevant scores of depression, anxiety, and post-traumatic stress were found in 15%, 19%, and 12%, respectively. Twenty-eight% experienced insomnia and 51% severe fatigue. The authors concluded that COVID-19 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.

Klinkhammer S, Horn J, Duits AA, Visser-Meily JMA, Verwijk E, Slooter AJC, Postma AA, van Heugten CM; NeNeSCo study group. Neurological and (neuro)psychological sequelae in intensive care and general ward COVID-19 survivors. Eur J Neurol. 2023 Apr 3.

doi: 10.1111/ene.15812