Older patients who survive severe COVID-19 have a much higher risk of cognitive decline compared with their peers who do not get COVID-19, a study in JAMA Neurology has found. Overall, 21% of patients in the study who survived severe COVID-19 experienced progressive cognitive decline, which suggests that the virus may cause long-lasting damage to cognition.
“These findings imply that the pandemic may substantially contribute to the world dementia burden in the future,” wrote Yu-Hui Liu, M.D., Ph.D., of Daping Hospital in Chongqing, China, and colleagues.
The researchers analyzed data from 1,438 COVID-19 survivors older than 60 years who were discharged from three COVID-19–designated hospitals in Wuhan, China, from February 10 to April 10, 2020, including 260 who had severe illness and 1,178 who had nonsevere illness. The researchers also recruited 438 uninfected spouses of infected patients for a control group for the study. The main outcome was change in cognition one year after patient discharge. The researchers assessed all study participants for cognitive changes during the first and second six-month follow-up periods via the Informant Questionnaire on Cognitive Decline in the Elderly and the Telephone Interview of Cognitive Status-40, respectively.
The incidence of cognitive impairment in survivors 12 months after discharge was 12.45%. The researchers categorized participants as having early onset cognitive decline if the changes occurred in the first six months only; late-onset cognitive decline, if they occurred in the second six months.
Patients who had severe COVID-19 had lower Telephone Interview of Cognitive Status-40 scores than patients who had nonsevere cases and the control group at 12 months. Compared with the control group, patients who had severe COVID-19 had 4.87 times the odds of early onset cognitive decline, 7.58 times the odds of late-onset cognitive decline, and 19.00 times the odds of progressive cognitive decline. Patients who had nonsevere COVID-19 had 1.71 times the odds of early onset cognitive decline compared with the control group.
The researchers noted several potential explanations for the increased risk, including long-lasting infection-related hypoxia (inadequate oxygen delivery to tissue) and lingering inflammation, both of which can damage neurons. They added that it is possible that the virus can directly invade the brain and damage neurons.
For related information, see the Psychiatric News article “Cognitive Impact of COVID-19 Lasts Months.”
(Image: iStock/Willowpix)
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