Trial Report Examining well-being and cognitive function in people with long Covid and ME/CFS, and age-matched healthy controls, 2024, Sanal-Hayes

[Dolphin]

https://www.sciencedirect.com/science/article/pii/S0002934324002730

The American Journal of Medicine
Available online 13 May 2024
In Press, Journal Pre-proof

Clinical Research Study
Examining well-being and cognitive function in people with long Covid and ME/CFS, and age-matched healthy controls: A Case-Case-Control Study

Nilihan E.M. Sanal-Hayes, PhD 1,2,*, Marie Mclaughlin, PhD2,3, Lawrence D. Hayes, PhD 2,4, Ethan C.J. Berry, BSc (Hons)2, Nicholas F. Sculthorpe, PhD2
1 School of Health and Society, University of Salford, Salford, UK
2 Sport and Physical Activity Research Institute, School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
3 School of Sport, Exercise & Rehabilitation Sciences, University of Hull, Hull, UK
4 Lancaster Medical School, Lancaster University, Lancaster, UK
Received 11 April 2024, Accepted 25 April 2024, Available online 13 May 2024.

https://doi.org/10.1016/j.amjmed.2024.04.041
open access

Abstract
Purpose
Well-being and cognitive function had not previously been compared between people with long COVID and people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Therefore, this study examined well-being and cognitive function in people with long COVID (∼16 months illness duration; n= 17) and ME/CFS (∼16 years illness duration; n=24), versus age-matched healthy controls (n=16).

Methods
Well-being was examined using several questionnaires, namely the Health Visual Analogue Scale (VAS), Fatigue Severity Scale (FSS), Post-exertional malaise (PEM), Pittsburgh Sleep Quality Index (PSQI), European Quality of Life-5 Domains (EQ-5D), MRC Dyspnoea, Self-Efficacy (SELTC), The Edinburgh Neurosymptoms Questionnaire (ENS), General Anxiety Disorder 7 (GAD-7), and Patient Health Questionnaire 9 (PHQ-9). Cognitive function was examined using Single Digit Modalities Test (SDMT), Stroop test, and Trails A and B. These were delivered via a mobile application (app) built specifically for this remote data collection.

Results
The main findings of the present investigation were that people with ME/CFS and people with long COVID were generally comparable on all well-being and cognitive function measures, but self-reported worse values for pain, fatigue, Post-exertional malaise, sleep quality, general well-being in relation to mobility, usual activities, self-care, breathlessness, neurological symptoms, self-efficacy, and other well-being such as anxiety and depression, compared to controls. There was no effect of group for cognitive function measures.

Conclusions
These data suggest that both people with long COVID and people with ME/CFS have similar impairment on well-being measures examined herein. Therefore, interventions that target well-being of people with ME/CFS and long COVID are required.

Keywords
Well-being
Cognitive function
Myalgic Encephalomyelitis
Chronic Fatigue Syndrome
Post-Exertional Malaise
Long COVID

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Clinical significance

Long COVID and ME/CFS cause impaired well-being and cognitive function, putting these groups at greater risk of employment and activities of daily living challenges.

People with Long COVID and ME/CFS have lower well-being but comparable cognitive function when compared to controls, which likely causes greater dysfunction in their daily lives.

As a result, accommodations for activities of daily living should be made available to long COVID and ME/CFS individuals.

https://twitter.com/user/status/1791062601356427366

 

[forestglip]

Our cognitive function findings do not support the existing literature that suggest cognitive impairment, deficits and abnormalities in people with ME/CFS and long COVID. Past research on cognitive function in long COVID and ME/CFS highlight that individuals with long COVID performed worse in cognitive tasks related to attention and working memory, and individuals with ME/CFS exhibited impairments affecting various cognitive processes involved in episodic verbal memory, and visual memory. We assessed cognitive function using following cognitive tasks; SDMT, the Stroop test, and Trails A and B that capture these affected cognitive processes in individuals with long COVID, and ME/CFS. In the present study, we presented these tasks on a mobile device app which involved moving fingers to form trails or clicking on correct answers on a small screen. Therefore, it is possible that the nature of the task in the present study may have been less challenging in terms of dexterity and force application that in a typical experimental setting on a large keyboard. This is an important finding and should be considered going forwards when testing cognitive function in people with impaired dexterity (as in our patient groups), so researchers to not conflate poor dexterity with poorer cognitive function.

That's interesting.

Thirdly, the observed magnitude of the well-being and cognitive function measures in this study likely underestimates the true effects when compared to controls because this paper was a small part of a larger project which involved participants attending the laboratory. As such, we acknowledge the inherent selection bias as only the least ill participants would be able to attend to laboratory for testing.

 

[Trish]

Well, hold the front page, sick people are found to be sick. Who knew?

I wish they wouldn't use the phrase 'well being'. We are sick. It smacks of the whole 'wellness' industry, quackery, Goop etc.

 

[Eleanor]

"Long COVID and ME/CFS cause impaired well-being and cognitive function", but "People with Long COVID and ME/CFS have... comparable cognitive function when compared to controls" and "Our cognitive function findings do not support the existing literature that suggest cognitive impairment, deficits and abnormalities in people with ME/CFS and long COVID"?

Make it make sense to my cognitively impaired brain

(not that this tiny study of a few dozen people in total is going to provide any game-changing evidence for anything anyway, but still...)

 

[rvallee]

Our cognitive function findings do not support the existing literature that suggest cognitive impairment, deficits and abnormalities in people with ME/CFS and long COVID.

It's one of the most widely reported problem, and one of the most disabling. People are literally losing the ability to read and communicate, to do basic activities of daily living, and they can't find anything at all?! Any serious scientist should be able to question their own results, that if their methods are unable to find one of the most common problems reported in this population, then it's their methods that are wrong, not the reports.

Oddly enough, what this has shown is that medicine literally doesn't have a single valid method to measure cognitive impairment that doesn't involve nerve connections being cut. Not a single one, the results are all over the place.

But this really continues the systemic confusion caused by "there is nothing wrong with them". It makes otherwise smart people think, say and do foolish things that make no sense, because they reject what reality is and substitute it with some other version. It makes no sense to speak of well-being given this level of impairment, given how much we have lost. But it makes sense to them because they think we're not ill, that we're something else in between, or around, or whatever.

Frankly all this type of research makes as much sense as selective recording of people stampeding away from a threat, and arguing they must be mad because there is no visible threat on screen. It's like they can't imagine that anything can exist beyond the boundaries of the screen, they have ideological blinkers.

 

[Yann04]

"People with Long COVID and ME/CFS have... comparable cognitive function when compared to controls" and "Our cognitive function findings do not support the existing literature that suggest cognitive impairment, deficits and abnormalities in people with ME/CFS and long COVID"?

I didn’t read the study but this sounds like they just tested it one-off on mild and moderate people who might have been experiencing adrenaline which helps cognitive function.

No accounting for PEM or for home/bedbound severe patients would be a likely explainer to why cognitive impairment is not found.

 

[Eleanor]

Oddly enough, what this has shown is that medicine literally doesn't have a single valid method to measure cognitive impairment that doesn't involve nerve connections being cut. Not a single one, the results are all over the place.

The Cognitron/GBIT study found measurable, significant post-Covid cognitive impairment with more than 100,000 participants (and that didn't even include a more severe cohort). These researchers trying to say they've disproved that on the basis of 50 people doing a Stroop test is just sad.

 

[rvallee]

The Cognitron/GBIT study found measurable, significant post-Covid cognitive impairment with more than 100,000 participants (and that didn't even include a more severe cohort). These researchers trying to say they've disproved that on the basis of 50 people doing a Stroop test is just sad.

Those tests don't seem to be standardized enough to matter, though. If it were a validated test, I can't see how it would be disputed, but it hasn't made a dent for the most part. They have a lot of interpretation behind them, are not anywhere near as valid as basically anything done in engineering fields, with repeatable experiments.

The biggest factor is still probably the whole "yeah, sure cognitive impairment, but it could be anxiety/depression/stress/aliens". It's hard to see how any progress can be made out of ambiguous results when there's always this easy excuse to dismiss anything anyone doesn't feel like it's true. Psychosomatic ideology is seriously acting as a capstone on medical progress, way too much like the sophons in the 3 body problem (an imaginary technology capable of blocking all experiments in physics, essentially blocking humanity from progressing further).

 

[Andy]

The Spectrum of Long-COVID Symptoms Should Be Assessed Through On-Site Examinations Rather Than Electronic Questionnaires, Josef Finsterer, MD, PhD

To the Editor:

The interesting article by Sanal-Hayes et al on well-being and cognitive functions in 17 patients with long-COVID syndrome, 24 patients with myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS), and 16 age-matched healthy controls1 raises concerns.

...

Before symptoms following SARS-CoV-2 infection can be attributed to long-COVID syndrome, alternative causes, including co-medications and comorbidities, must be thoroughly ruled out. The spectrum of long-COVID syndrome symptoms should be assessed through on-site examinations rather than electronic questionnaires.

Open access

 

[Utsikt]

The second point is that the clinical manifestations of acute SARS-CoV-2 infection have not been reported. How many of the patients had central nervous system or muscle involvement during SARS-CoV-2 infection? The central nervous system involvement in SARS-CoV-2 infection is diverse and includes ischemic stroke, bleeding, venous sinus thrombosis, meningitis, encephalitis, acute disseminated encephalomyelitis, headache, insomnia, and several others. Muscle involvement includes myositis, rhabdomyolysis, dermatomyositis, myasthenia, and myalgia. In patients who did not experience central nervous system or muscle impairment during SARS-CoV-2 infection, it is quite unlikely that the reported symptoms are causally related to SARS-CoV-2 infection.

I don’t understand the last sentence. They seem to believe that ME/CFS has to be caused by damage during the acute infection?

The third point is that the vaccination status of the patients was not reported. Since SARS-CoV-2 vaccinations are not free of side effects, it is important to know how many of the clinical manifestations were actually due to SARS-CoV-2 vaccination and not to SARS-CoV-2 infection.

And then they completely ignore that line of reasoning, because apparently vaccines can cause all kinds of delayed symptoms regardless of the acute effect.