Neurological and cognitive sequelae of Covid-19: a four month follow-up

Introduction: Self-reported affective and cognitive sequelae are frequently reported in cardiac arrest survivors; however, little is known about the risk factors. Hypothesis: We assessed the hypothesis that self-reported (subjective) affective and cognitive outcomes six months after OHCA may be associated with demography, acute care and cerebral outcome. Methods: This is a sub study of the multicenter “Target Temperature Management for 48 vs. 24 hours and Neurologic Outcome after Out-of-Hospital Cardiac Arrest: A Randomized Clinical Trial” (the TTH48 trial) investigating the effect of prolonged TTM (24h vs 48h) at 33±1°C. Patients with good outcome on the Cerebral Performances Categories (CPC score≤2) were invited to answer questionnaires on anxiety, depression, emotional distress, perceived stress and cognitive failures six months after OHCA. Multivariate regression analyses were used to test the possible predictors of self-reported outcomes six months follow-up added successively in three blocks: [1] demography (age and gender), [2] acute care (time to ROSC and allocated treatment (24h vs 48h TTM)) and [3] cerebral outcome (objective cognitive impairment and CPC score). Results: A total of 79 out of 107 eligible patients were included in the analysis. There were no significant differences in baseline characteristics between the included group and the group lost to follow-up. [1] Younger age was a significant predictor across all self-reported outcomes, even when controlling for gender, ROSC time, treatment allocation, cognitive impairment and global outcome (CPC). Female gender was a predictor of anxiety, though this should be interpreted cautiously as only eight women participated. [2] ROSC time predicted self-reported cognitive failures, when not controlling for block 3. Treatment allocation had no predictive value. [3] Objective cognitive impairment was not a predictor of self-reported affective or cognitive sequelae. The CPC score was a significant predictor of self-reported affective outcomes, albeit not for self-reported cognitive failures. Conclusion: Younger age was a significant risk factor for self-reported affective and cognitive sequelae six months post OHCA. The CPC score may be a proxy for self-reported affective outcomes.

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Monthlong Intubated Patient with Life-Threatening COVID-19 and Cerebral Microbleeds Suffers Only Mild Cognitive Sequelae at 8-Month Follow-up: A Case Report

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab075 ◽

2021 ◽

Author(s):

Linda Backman ◽

Marika C Möller ◽

Eric P Thelin ◽

Daniel Dahlgren ◽

Catharina Deboussard ◽

...

Keyword(s):

Processing Speed ◽

Psychiatric Symptoms ◽

Cerebral Microbleeds ◽

Word Fluency ◽

Memory And Attention ◽

Cognitive Sequelae ◽

Life Threatening ◽

Part Time ◽

Long Term Prognosis

Abstract Objective To elaborate on possible cognitive sequelae related to COVID-19, associated cerebrovascular injuries as well as the general consequences from intensive care. COVID-19 is known to have several, serious CNS-related consequences, but neuropsychological studies of severe COVID-19 are still rare. Methods M., a 45-year-old man, who survived a severe COVID-19 disease course including Acute Respiratory Distress Syndrome (ARDS), cerebral microbleeds, and 35 days of mechanical ventilation, is described. We elaborate on M’s recovery and rehabilitation process from onset to the 8-month follow-up. The cognitive functions were evaluated with a comprehensive screening battery at 4 weeks after extubation and at the 8-month follow-up. Results Following extubation, M. was delirious, reported visual hallucinations, and had severe sleeping difficulties. At about 3 months after COVID-19 onset, M. showed mild to moderate deficits on tests measuring processing speed, working memory, and attention. At assessments at 8 months, M. performed better, with results above average on tests measuring learning, memory, word fluency, and visuospatial functions. Minor deficits were still found regarding logical reasoning, attention, executive functioning, and processing speed. There were no lingering psychiatric symptoms. While M. had returned to a part-time job, he was not able to resume previous work-tasks. Conclusion This case-study demonstrates possible cognitive deficits after severe COVID-19 and emphasizes the need of a neuropsychological follow-up, with tests sensitive to minor deficits. The main findings of this report provide some support that the long-term prognosis for cognition in severe COVID-19 may be hopeful.

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Cognitive Impairment in Moderate Degree Diffuse Axonal Head Injuries: Analysis of 84 Cases Using MMSE

Indian Journal of Neurotrauma ◽

10.1055/s-0039-1700365 ◽

2020 ◽

Vol 17 (01) ◽

pp. 06-10

Author(s):

Momin Abdul Jaleel ◽

Shighakolli Ramesh ◽

Subodh Raju ◽

Renuka Sharma ◽

Shailendra Anjankar ◽

...

Keyword(s):

Cognitive Impairment ◽

Brain Injuries ◽

Head Injuries ◽

Cognitive Outcome ◽

Moderate Degree ◽

Associated Injuries ◽

Cognitive Sequelae ◽

Mini Mental Status Examination ◽

Routine Assessment

Abstract Background Cognitive impairment is commonly seen in traumatic brain injury survivors. Posttraumatic cognitive sequelae may be more devastating than focal motor and focal sensory deficits, and are usually left unattended. Aim and Objective Aim of this study was to assess cognitive impairment in patients who had sustained moderate degree diffuse axonal injuries and having good outcome (Glasgow Outcome Score of 5). Methods and Materials Prospective observational study was done from 2011 to 2015 on the patients who had sustained moderated degree diffuse brain injuries. Eighty-four cases fulfilling the inclusion criteria were studied. Patients were assessed with Mini-Mental Status Examination at discharge, end of 1 month, and at 3 months. Result Seventy-six were males and 8 were females. Age ranged from 16 to 49 years. Note that 4.76% (4) patients had hypotension at presentation, 32.14% (27) patients had associated injuries, and 19.04% (16) patients had hyponatremia at presentation. Diabetes mellitus was seen in 34.52% (29) patients, while hypertension was seen in 14.28% (12). At 3 months’ follow-up, 19.06% (16) patients had cognitive impairment. The present study revealed that hypotension and presence of associated injuries at presentation raises the odds of having cognitive impairment by 8 and 5 times, respectively. Conclusion Routine assessment of cognitive impairment in head injury survivors is essential as it may help in identifying cognitive deficits. Early intervention of neurorehabilitation to such patients results in better neurocognitive outcome. Hypotension and associated injuries are associated with poor cognitive outcome.

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Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800105x ◽

2019 ◽

Vol 42 ◽

Cited By ~ 2

Author(s):

John P. A. Ioannidis

Keyword(s):

Mental Health ◽

Mental Disease ◽

Brain Disorders ◽

Social Stressors ◽

Labor Education ◽

Mental Diseases ◽

Long Term Follow Up ◽

Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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Brief summary of Kleť photographic search programme for minor planets

International Astronomical Union Colloquium ◽

10.1017/s0252921100031419 ◽

1999 ◽

Vol 173 ◽

pp. 189-192

Author(s):

J. Tichá ◽

M. Tichý ◽

Z. Moravec

Keyword(s):

Ccd Camera ◽

Minor Planet ◽

Minor Planets ◽

Main Belt

AbstractA long-term photographic search programme for minor planets was begun at the Kleť Observatory at the end of seventies using a 0.63-m Maksutov telescope, but with insufficient respect for long-arc follow-up astrometry. More than two thousand provisional designations were given to new Kleť discoveries. Since 1993 targeted follow-up astrometry of Kleť candidates has been performed with a 0.57-m reflector equipped with a CCD camera, and reliable orbits for many previous Kleť discoveries have been determined. The photographic programme results in more than 350 numbered minor planets credited to Kleť, one of the world's most prolific discovery sites. Nearly 50 per cent of them were numbered as a consequence of CCD follow-up observations since 1994.This brief summary describes the results of this Kleť photographic minor planet survey between 1977 and 1996. The majority of the Kleť photographic discoveries are main belt asteroids, but two Amor type asteroids and one Trojan have been found.

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Intranuclear Crystals in Regenerating Canine Kidneys

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100072502 ◽

1973 ◽

Vol 31 ◽

pp. 412-413

Author(s):

D.G. Osborne ◽

L.J. McCormack ◽

M.O. Magnusson ◽

W.S. Kiser

Keyword(s):

Epithelial Cell ◽

Epithelial Cells ◽

Tubular Epithelial Cell ◽

Tubular Epithelial Cells ◽

Cell Nuclei ◽

Crystalline Structures ◽

Small Crystals ◽

Membrane Bound

During a project in which regenerative changes were studied in autotransplanted canine kidneys, intranuclear crystals were seen in a small number of tubular epithelial cells. These crystalline structures were seen in the control specimens and also in regenerating specimens; the main differences being in size and number of them. The control specimens showed a few tubular epithelial cell nuclei almost completely occupied by large crystals that were not membrane bound. Subsequent follow-up biopsies of the same kidneys contained similar intranuclear crystals but of a much smaller size. Some of these nuclei contained several small crystals. The small crystals occurred at one week following transplantation and were seen even four weeks following transplantation. As time passed, the small crystals appeared to fuse to form larger crystals.

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Electron Microscopy of Human Gallstones

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100065523 ◽

1971 ◽

Vol 29 ◽

pp. 296-297

Author(s):

C. Wolpers ◽

R. Blaschke

Keyword(s):

Electron Microscopy ◽

Room Temperature ◽

Bile Pigment ◽

X Ray Diffraction ◽

Triclinic Crystal System ◽

X Ray ◽

Follow Up Study ◽

Infra Red ◽

Main Components

Scanning microscopy was used to study the surface of human gallstones and the surface of fractures. The specimens were obtained by operation, washed with water, dried at room temperature and shadowcasted with carbon and aluminum. Most of the specimens belong to patients from a series of X-ray follow-up study, examined during the last twenty years. So it was possible to evaluate approximately the age of these gallstones and to get information on the intensity of growing and solving.Cholesterol, a group of bile pigment substances and different salts of calcium, are the main components of human gallstones. By X-ray diffraction technique, infra-red spectroscopy and by chemical analysis it was demonstrated that all three components can be found in any gallstone. In the presence of water cholesterol crystallizes in pane-like plates of the triclinic crystal system.

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Articulatory Intervention for the Visually Impaired

Language Speech and Hearing Services in Schools ◽

10.1044/0161-1461.1003.139 ◽

1979 ◽

Vol 10 (3) ◽

pp. 139-144

Author(s):

Cheri L. Florance ◽

Judith O’Keefe

Keyword(s):

High School ◽

High School Students ◽

Behavior Change ◽

Visually Impaired ◽

School Students ◽

Handicapped Children ◽

Paired Stimuli ◽

Visually Handicapped ◽

Parent Program

A modification of the Paired-Stimuli Parent Program (Florance, 1977) was adapted for the treatment of articulatory errors of visually handicapped children. Blind high school students served as clinical aides. A discussion of treatment methodology, and the results of administrating the program to 32 children, including a two-year follow-up evaluation to measure permanence of behavior change, is presented.

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What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-19-00171 ◽

2020 ◽

Vol 29 (2) ◽

pp. 688-704

Author(s):

Katrina Fulcher-Rood ◽

Anny Castilla-Earls ◽

Jeff Higginbotham

Keyword(s):

Clinical Practice ◽

Research Evidence ◽

Evidence Based Practice ◽

Evidence Based ◽

Clinical Expertise ◽

Speech Language Pathologists ◽

School Based ◽

Research Findings ◽

Ebp Implementation

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

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The Link Between Verbal Short-Term Memory and Anomia Treatment Gains

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-18-0176 ◽

2019 ◽

Vol 28 (3) ◽

pp. 1039-1052

Author(s):

Reva M. Zimmerman ◽

JoAnn P. Silkes ◽

Diane L. Kendall ◽

Irene Minkina

Keyword(s):

Short Term Memory ◽

Controlled Trial ◽

Treatment Success ◽

Linear Regression Models ◽

Language Performance ◽

Short Term ◽

Term Memory ◽

Treatment Gains ◽

Post Hoc

Purpose A significant relationship between verbal short-term memory (STM) and language performance in people with aphasia has been found across studies. However, very few studies have examined the predictive value of verbal STM in treatment outcomes. This study aims to determine if verbal STM can be used as a predictor of treatment success. Method Retrospective data from 25 people with aphasia in a larger randomized controlled trial of phonomotor treatment were analyzed. Digit and word spans from immediately pretreatment were run in multiple linear regression models to determine whether they predict magnitude of change from pre- to posttreatment and follow-up naming accuracy. Pretreatment, immediately posttreatment, and 3 months posttreatment digit and word span scores were compared to determine if they changed following a novel treatment approach. Results Verbal STM, as measured by digit and word spans, did not predict magnitude of change in naming accuracy from pre- to posttreatment nor from pretreatment to 3 months posttreatment. Furthermore, digit and word spans did not change from pre- to posttreatment or from pretreatment to 3 months posttreatment in the overall analysis. A post hoc analysis revealed that only the less impaired group showed significant changes in word span scores from pretreatment to 3 months posttreatment. Discussion The results suggest that digit and word spans do not predict treatment gains. In a less severe subsample of participants, digit and word span scores can change following phonomotor treatment; however, the overall results suggest that span scores may not change significantly. The implications of these findings are discussed within the broader purview of theoretical and empirical associations between aphasic language and verbal STM processing.

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