Outcome of severe COVID-19: spotlight on fatigue, fatigability, multidomain complaints and pattern of cognitive deficits in a case series without prior brain dysfunction and without COVID-19-related stroke and/or cardiac arrest.

Cognitive impairment Everyday living impact Fatigability Fatigue Mental effort Multidomain complaints Severe COVID-19

Journal

Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382

Informations de publication

Date de publication:
02 Feb 2024
Historique:
received: 02 09 2022
accepted: 02 12 2023
medline: 2 2 2024
pubmed: 2 2 2024
entrez: 2 2 2024
Statut: epublish

Résumé

Population-wide surveys and large-scale investigations highlighted the presence of cognitive deficits in the acute and postacute stages of severe COVID-19; a few studies documented their occurrence in cases without prior or COVID-19-related brain damage. The evolution of cognitive deficits in the latter population and their relationship to the post-COVID-19 fatigue syndrome are poorly understood. We report the outcome at 12 months after severe COVID-19 involving an intensive care unit stay and mechanical ventilation in six (five Caucasian and one Asian) patients (age range: 53-71 years, mean age 61.7 ± 6.5 years) without history of prior brain dysfunction and without stroke and/or cardiac arrest during or after COVID-19. All patients reported pervading mental and physical fatigue as well as numerous multidomain complaints, which impacted everyday life. Individual patients described mental fatigability, apathy, and/or anxiety. Standardized neuropsychological tests revealed isolated symptoms of cognitive dysfunction or performance at the lower limit of the norm in the attentional, executive, and/or working memory domains in four of the six patients. Somatic scales documented dyspnoea, muscle weakness, olfactory disorder, and/or minor sleep problems in some, but not all, patients. Fatigue, fatigability, multidomain complaints, cognitive difficulties, or dysfunction, as well as isolated neurobehavioral and/or psychiatric and/or somatic symptoms, tend to occur in the aftermath of severe COVID-19 and persist at 12 months, even in the absence of prior and/or COVID-19-related brain damage. This clinical situation, which impacts everyday life, calls for a detailed investigation of patients' complaints, its neural underpinning, and an elaboration of specific rehabilitation programs.

Sections du résumé

BACKGROUND BACKGROUND
Population-wide surveys and large-scale investigations highlighted the presence of cognitive deficits in the acute and postacute stages of severe COVID-19; a few studies documented their occurrence in cases without prior or COVID-19-related brain damage. The evolution of cognitive deficits in the latter population and their relationship to the post-COVID-19 fatigue syndrome are poorly understood.
CASE PRESENTATION METHODS
We report the outcome at 12 months after severe COVID-19 involving an intensive care unit stay and mechanical ventilation in six (five Caucasian and one Asian) patients (age range: 53-71 years, mean age 61.7 ± 6.5 years) without history of prior brain dysfunction and without stroke and/or cardiac arrest during or after COVID-19. All patients reported pervading mental and physical fatigue as well as numerous multidomain complaints, which impacted everyday life. Individual patients described mental fatigability, apathy, and/or anxiety. Standardized neuropsychological tests revealed isolated symptoms of cognitive dysfunction or performance at the lower limit of the norm in the attentional, executive, and/or working memory domains in four of the six patients. Somatic scales documented dyspnoea, muscle weakness, olfactory disorder, and/or minor sleep problems in some, but not all, patients.
CONCLUSION CONCLUSIONS
Fatigue, fatigability, multidomain complaints, cognitive difficulties, or dysfunction, as well as isolated neurobehavioral and/or psychiatric and/or somatic symptoms, tend to occur in the aftermath of severe COVID-19 and persist at 12 months, even in the absence of prior and/or COVID-19-related brain damage. This clinical situation, which impacts everyday life, calls for a detailed investigation of patients' complaints, its neural underpinning, and an elaboration of specific rehabilitation programs.

Identifiants

pubmed: 38303088
doi: 10.1186/s13256-023-04300-6
pii: 10.1186/s13256-023-04300-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

64

Informations de copyright

© 2024. The Author(s).

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Auteurs

Valérie Beaud (V)

Service of Neuropsychology and Neurorehabilitation, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 5, 1011, Lausanne, Switzerland. valerie.beaud@psychologie.ch.

Sonia Crottaz-Herbette (S)

Service of Neuropsychology and Neurorehabilitation, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 5, 1011, Lausanne, Switzerland.

Vincent Dunet (V)

Service of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland.

Jean-François Knebel (JF)

Service of Neuropsychology and Neurorehabilitation, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 5, 1011, Lausanne, Switzerland.

Pierre-Alexandre Bart (PA)

Service of Internal Medicine, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland.

Stephanie Clarke (S)

Service of Neuropsychology and Neurorehabilitation, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 5, 1011, Lausanne, Switzerland.

Classifications MeSH