Neurocognitive screening in patients following SARS-CoV-2 infection: tools for triage, 2022, Blackmon et al

Abstract
Background
Cognitive complaints are common in patients recovering from Coronavirus Disease 2019 (COVID-19), yet their etiology is often unclear. We assess factors that contribute to cognitive impairment in ambulatory versus hospitalized patients during the sub-acute stage of recovery.

Methods
In this cross-sectional study, participants were prospectively recruited from a hospital-wide registry. All patients tested positive for SARS-CoV-2 infection using a real-time reverse transcriptase polymerase-chain-reaction assay. Patients ≤ 18 years-of-age and those with a pre-existing major neurocognitive disorder were excluded. Participants completed an extensive neuropsychological questionnaire and a computerized cognitive screen via remote telemedicine platform. Rates of subjective and objective neuropsychological impairment were compared between the ambulatory and hospitalized groups. Factors associated with impairment were explored separately within each group.

Results
A total of 102 patients (76 ambulatory, 26 hospitalized) completed the symptom inventory and neurocognitive tests 24 ± 22 days following laboratory confirmation of SARS-CoV-2 infection. Hospitalized and ambulatory patients self-reported high rates of cognitive impairment (27–40%), without differences between the groups. However, hospitalized patients showed higher rates of objective impairment in visual memory (30% vs. 4%; p = 0.001) and psychomotor speed (41% vs. 15%; p = 0.008). Objective cognitive test performance was associated with anxiety, depression, fatigue, and pain in the ambulatory but not the hospitalized group.

Conclusions
Focal cognitive deficits are more common in hospitalized than ambulatory patients. Cognitive performance is associated with neuropsychiatric symptoms in ambulatory but not hospitalized patients. Objective neurocognitive measures can provide essential information to inform neurologic triage and should be included as endpoints in clinical trials.

Open access, https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-022-02817-9

 

"Asymptomatic or mild ambulatory patients performed, on average, within the normal range on objective cognitive measures. This is consistent with a prior study of ambulatory patients who presented to a Neuro-COVID-19 care clinic [3], which found no difference in cognitive test performance between patients who tested positive and negative for SARS-COV-2. Although the SARS-COV-2-positive patients scored lower than a demographic-matched US normative population on measures of attention and working memory, their mean scores were still within the average range [3]. Similar to our findings, they identified a moderate relationship between fatigue and cognitive performance [3]. This suggests that direct referral to behavioral programs designed to address chronic fatigue may offer the most efficient and cost-effective treatment approach for patients complaining of fatigue and ‘brain fog’ [37]."

Link is to
Intensive Multicomponent Fibromyalgia Treatment: A Translational Study to Evaluate Effectiveness in Routine Care Delivery, 2021, Bruce et al
Paywall, https://journals.lww.com/jclinrheum...ticomponent_Fibromyalgia_Treatment__A.39.aspx

 

"Some people are saying this, everyone is saying it, it's the talk of the town, everyone around me is saying it!"

None of this suggests this, obviously. The authors are suggesting it, and passing their own suggestion as being validated by an external source. The snake oil must sell, they have warehouses of it and bet the future of the profession on it. Just zero idea what the words even mean, not even bothered by their ignorance, they freely share their opinion as if they are fact. They don't need evidence, after all this is evidence-based medicine.