COVID-19: Effects of cognitive impairment and its impacts on society

This article was exclusively written for The European Sting by Ms. Daniella Thomé Campagnolli, a 22 year old medical student was born in Campinas, Brazil. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

COVID-19 is an infectious disease caused by the Sars-Cov-2 virus, which is responsible for the current pandemic, infecting millions of people around the world. Although its main manifestations are respiratory, many patients report neurological symptoms, mostly cognitive, that are more prevalent in the late phase of the disease.

The Post-Acute COVID-19 Syndrome (PACS), also known as long-covid, affects from 10% to 25% of the patients and is defined by the persistence or development of symptoms after 4 weeks of infection, which can last for several months. One of the most common symptoms of this syndrome is cognitive impairment.

Some studies monitored patients in the acute phase of COVID-19 and reported that cognitive deficits increased up to the 10th day of infection, after which they returned to normal. However, there are divergences, because these symptoms can last or even appear for weeks after the first day of infection, since after the first 30 days the risk of neurological disorders increases, as shown by other studies.

Thereby, the most common cognitive symptoms in the long-covid are: inattention, disorientation, lack of concentration, word search problems, lower processing speed and issues in executive functions. This constellation of cognitive symptoms is known as the “brain fog”. There are hypotheses for such events as neuroinflammation and neurodegeneration, which may be caused by the cytokine storm or due to hypoxia, or even because of secondary events such as sleep and psychiatric disorders caused by the long-covid. Nevertheless, no pathophysiology is totally clear at the time.

This cognitive impairment apparently affects patients regardless of previous health issues, hospitalization or infection severity. As a result of these deficiencies, patients feel insecure and lose their independence in daily activities. Furthermore, when put along with other symptoms of long-covid, such as fatigue, the consequences are absence from work, unemployment, financial difficulties and withdrawal from social life. All those factors contribute to the economic and social deterioration that are already compromised by the pandemic.

Therefore, the cognitive after-effects caused by COVID-19 have a huge impact on people’s lives, directly interfering in society. Thus, more studies are necessary in order to clarify why and how the pathophysiology, the influence of patient-related factors, as well as the evolution of the disease, affects cognition. As a result, the next steps can be taken to prevent and treat the cognitive impairment caused by COVID-19, in addition to stopping the effect on the quality of life of the population, which is already quite vulnerable.

References:

1. COVCOG 1: Factors Predicting Physical, Neurological and Cognitive Symptoms in Long COVID in a Community Sample. A First Publication From the COVID and Cognition Study.
2. Post-acute COVID-19 Syndrome Negatively Impacts Physical Function, Cognitive Function, Health-Related Quality of Life, and Participation.
3. Long-term neurologic outcomes of COVID-19. 
4. Cognitive dysfunction following COVID-19 infection. 
5. Long COVID-19: Objectifying most self-reported neurological symptoms. 
6. Multidisciplinary Approach to Brain Fog and Related Persisting Symptoms Post COVID-19. 
7. COVID-19 associated cognitive impairment: A systematic review
8. About the author
9. Daniella Thomé Campagnolli is 22 years old and was born in Campinas, Brazil. Fascinated by medical sciences and dedicated to helping people, she is currently in her 4th year of medical school graduation at the Pontifical Catholic University Of Campinas. Furthermore, Daniella is regional coordinator at IFMSA Brazil, and she is passionate about scientific writing. Daniella also believes that the future has already begun and that medical research will continue to innovate and improve people’s lives.