Selective visuoconstructional impairment following mild COVID-19 with inflammatory and neuroimaging correlation findings

The study titled “Selective visuoconstructional impairment following mild COVID-19 with inflammatory and neuroimaging correlation findings” provides key insights into the cognitive impacts of COVID-19, particularly in cases classified as mild.

Here’s a detailed summary:

Background: The study addresses the implications of mild COVID-19 cases, which comprise the majority of infections worldwide. While severe cases of COVID-19 have been linked to neurological and psychiatric consequences, the cognitive impact of mild COVID-19 remains under-researched. The study aimed to investigate adults who had recovered from mild COVID-19 by assessing neuropsychological, ocular, neurological tests, immune markers, and neuroimaging. The research found a specific visuoconstructive deficit in approximately a quarter of mild COVID-19 individuals, associated with neuroinflammatory changes and immune markers upregulation​​​​.

Study Participants and Methods: The study involved 192 participants, predominantly female and relatively young, with a high level of education. These participants had mild COVID-19 symptoms such as headache, myalgia, and anosmia, with a small percentage requiring hospitalization. Neuropsychological assessments, along with immune markers assays and neuroimaging (MRI and 18FDG-PET), were conducted to evaluate cognitive impairment and its possible correlates​​.

Key Findings:

  1. Cognitive Impairment: A high rate of impairment was observed in the copy component of the Rey-Osterrieth Complex Figure Test (ROCF), indicating visuoconstructive deficits. This deficit was not explained by socio-demographic, ophthalmologic, or psychiatric factors, suggesting a cognitive deficit secondary to SARS-CoV-2 infection​​.
  2. Immune Markers: Eleven biomarkers were upregulated in individuals with COVID-19 who exhibited visuoconstructive impairment. These included various cytokines and chemokines like LIF, CXCL10, CCL2, and HGF. The results suggest that higher levels of these biomarkers are associated with cognitive impairment, indicating a neuroinflammatory burden​​.
  3. Neuroimaging Results: MRI analysis showed no structural changes such as thromboembolism, atrophy, or acute encephalitis in the patients. This suggests that the cognitive deficits observed are not linked to these types of brain alterations​​.
  4. Constructional Apraxia: The study discusses the concept of constructional apraxia, which is a difficulty in using visual and spatial information to guide complex behaviors like drawing. This condition was observed in the study’s participants, indicating an impact on daily life activities and problem-solving skills. The study highlights the need for comprehensive assessment and rehabilitation of these cognitive impairments​​.

Conclusion: The study concludes that mild COVID-19 can lead to significant cognitive deficits, specifically in visuoconstructional abilities. These deficits are associated with neuroinflammatory markers, suggesting an immune-mediated impact on cognitive functions. The research underscores the importance of a more comprehensive assessment and follow-up of cognitive impairments in mild COVID-19 cases to understand symptom persistence and the need for rehabilitation. It also highlights the need for further research into the long-term effects of COVID-19, particularly in the context of what is now known as long COVID​​.

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