Cognitive impairment associated with COVID-19: a literature review

Background: SARS-CoV-2 is capable of causing neurological symptoms of the CNS in addition to respiratory and gastrointestinal symptoms. Early knowledge of the possible cognitive functions compromised by the infection will allow the health system to anticipate and create measures to minimize irreversible damage. Objectives: to analyze the cognitive impairment associated with COVID-19, taking into account its pathophysiological mechanisms and their short and long-term consequences. Methods: Narrative review of 62 articles, based on an active search on the PubMed, Google Scholar, Jama and American Academy of Neurology research platforms. Results: Cognitive impairment can be present both during and after infection. The main risk factors for cognitive impairments in the short term are: other neurological symptoms (headache, anosmia, dysgeusia); diarrhea and oxygen therapy. The main cognitive functions affected were memory, attention, executive functions (mental flexibility) and language (semantic and phonetic fluency) associated with anxiety and depression. The factors that contribute to long-term cognitive decline are: previous cognitive weakness (comorbidities); the inflammatory process of COVID-19 with pulmonary (hypoxia), vascular (ischemia), neurological (neuronal damage) and hospitalization (sedation, isolation, delirium). The hippocampus appears to be particularly vulnerable to coronavirus infections. Conclusion: Short-term and long-term cognitive impairment associated with COVID-19 may be related to the increased likelihood of cognitive impairment, as well as the acceleration of neurodegenerative diseases, such as Alzheimer’s disease. Follow-up with neuropsychological assessments of these patients and epidemiological studies are necessary to analyze this impact and to create prevention and treatment programs.

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Depletion of acetate-producing bacteria from the gut microbiota facilitates cognitive impairment through the gut-brain neural mechanism in diabetic mice

Microbiome ◽

10.1186/s40168-021-01088-9 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Hong Zheng ◽

Pengtao Xu ◽

Qiaoying Jiang ◽

Qingqing Xu ◽

Yafei Zheng ◽

...

Keyword(s):

Cognitive Impairment ◽

Gut Microbiota ◽

Cognitive Functions ◽

Neural Mechanism ◽

Fecal Microbiota ◽

Protective Role ◽

Fecal Microbiota Transplant ◽

Memory Impairments ◽

The Impact

Abstract Background Modification of the gut microbiota has been reported to reduce the incidence of type 1 diabetes mellitus (T1D). We hypothesized that the gut microbiota shifts might also have an effect on cognitive functions in T1D. Herein we used a non-absorbable antibiotic vancomycin to modify the gut microbiota in streptozotocin (STZ)-induced T1D mice and studied the impact of microbial changes on cognitive performances in T1D mice and its potential gut-brain neural mechanism. Results We found that vancomycin exposure disrupted the gut microbiome, altered host metabolic phenotypes, and facilitated cognitive impairment in T1D mice. Long-term acetate deficiency due to depletion of acetate-producing bacteria resulted in the reduction of synaptophysin (SYP) in the hippocampus as well as learning and memory impairments. Exogenous acetate supplement or fecal microbiota transplant recovered hippocampal SYP level in vancomycin-treated T1D mice, and this effect was attenuated by vagal inhibition or vagotomy. Conclusions Our results demonstrate the protective role of microbiota metabolite acetate in cognitive functions and suggest long-term acetate deficiency as a risk factor of cognitive decline.

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A Comparison of Long-Term and Short-Term Residential Treatment Programs for Dual Diagnosis Patients

Psychiatric Services ◽

10.1176/appi.ps.52.4.526 ◽

2001 ◽

Vol 52 (4) ◽

pp. 526-528 ◽

Cited By ~ 47

Author(s):

Mary F. Brunette ◽

Robert E. Drake ◽

Mary Woods ◽

Timothy Hartnett

Keyword(s):

Residential Treatment ◽

Dual Diagnosis ◽

Treatment Programs ◽

Short Term ◽

Residential Treatment Programs

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IMPACT OF COGNITIVE DYSFUNCTION AND ROLE OF PHYSICAL EXERCISES TO ENHANCE COGNITIVE FUNCTIONS AMONG SUBJECTS WITH TYPE 2 DIABETES MELLITUS

10.36106/5336413 ◽

2021 ◽

pp. 47-48

Author(s):

Manju Unnikrishnan ◽

Titto Cherian

Keyword(s):

Type 2 Diabetes ◽

Cognitive Impairment ◽

Cognitive Ability ◽

Physical Performance ◽

Cognitive Functions ◽

Mortality And Morbidity ◽

Causes Of Mortality

Diabetes has become a widespread epidemic, characterized by hyperglycemia resulting from an error in insulin secretion, insulin action, or both, and is one of the leading causes of mortality and morbidity worldwide. Studies reveal that diabetes is linked to long-term complications in the brain, which appear in the form of impaired cognitive ability compared to people without diabetes( Van Duinkerken et al 2020). Reduced physical performance is one of the most important problems faced by patients which has a direct relationship with an individual's cognitive ability. The study aims to analyse the direct and positive relationship between physical exercise and cognitive functions among people with type 2 diabetes, so this must be veried along with gaining a comprehensive understanding of cognitive impairment in diabetes and its effect on physical performance. vice versa. This study is based on the reviewed research results of various researchers. In this study, the term "cognitive impairment" in relation to diabetes refers to any deviation in cognitive performance compared to people without diabetes.

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Tracing Long- and Short-term Migrants for Participation in Demographic and Epidemiological Studies: Evidence from Senegal

Field Methods ◽

10.1177/1525822x19879892 ◽

2019 ◽

Vol 32 (1) ◽

pp. 38-57

Author(s):

Mufaro Kanyangarara ◽

Laetitia Douillot ◽

Gilles Pison ◽

Cheikh Tidiane Ndiaye ◽

Valerie Delaunay ◽

...

Keyword(s):

Rural Areas ◽

Statistical Power ◽

Epidemiological Studies ◽

Adult Mortality ◽

Short Term ◽

Middle Income ◽

Middle Income Countries ◽

Contact Information

Migration of participants in demographic and epidemiological studies results in missing data. One approach to reduce resulting losses in statistical power and potential biases is to follow up migrants at their new residence. We describe the follow-up of migrants who were eligible for participation in a trial of a new questionnaire to measure adult mortality in Niakhar, Senegal. We conducted a short inquiry in the migrant’s last known household to obtain contact information and then attempted to contact and interview 661 migrants who resided in Dakar, Mbour, and rural areas close to Niakhar. About two-thirds of migrants were successfully enrolled in the study. Having a contact phone number and knowing the name of the head of compound at destination increased the likelihood of successful enrollment. Following up migrants in demographic studies is feasible in low- and middle-income countries, including long-term migrants who have not been contacted for extended periods of time.

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Integrating Vocational Rehabilitation Into Treatment Programs: Two Case Studies

Journal of Applied Rehabilitation Counseling ◽

10.1891/0047-2220.21.2.38 ◽

1990 ◽

Vol 21 (2) ◽

pp. 38-44 ◽

Cited By ~ 3

Author(s):

Joan Randell ◽

Lorinda Arella ◽

Sherry Deren ◽

Charles Lyles ◽

Mary Ellen Winfield

Keyword(s):

Vocational Rehabilitation ◽

Case Studies ◽

Outpatient Treatment ◽

Treatment Programs ◽

Short Term ◽

Time Period ◽

Vocational Services ◽

Vocational Programming ◽

Long Term Impact

This paper describes an intervention designed to enhance the integration of vocational services in an outpatient treatment setting. The position of “vocational integrator” was created and implemented in two clinics to (a) raise the importance of vocational services, (b) develop vocational skills and resources available to staff, and (c) review and implement policies to facilitate vocational programming. The sequence of tasks necessary to develop and implement this position, and issues arising for the integrators and the clinics are described. Results indicated that some short term increases in vocational activities were found, and a longer time period may be needed to assess the long term impact of this type of intervention.

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24h urinary free cortisol in large-scale epidemiological studies: Short-term and long-term stability and sources of variability

Psychoneuroendocrinology ◽

10.1016/j.psyneuen.2014.04.018 ◽

2014 ◽

Vol 47 ◽

pp. 10-16 ◽

Cited By ~ 20

Author(s):

Judith G.M. Rosmalen ◽

Ido P. Kema ◽

Stefan Wüst ◽

Claude van der Ley ◽

Sipke T. Visser ◽

...

Keyword(s):

Large Scale ◽

Urinary Free Cortisol ◽

Epidemiological Studies ◽

Short Term ◽

Term Stability ◽

Long Term Stability ◽

Free Cortisol

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Pharmacotherapy of mild cognitive impairment

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2004.6.4/sgauthier ◽

2004 ◽

Vol 6 (4) ◽

pp. 391-395

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Randomized Clinical Trials ◽

Acetylcholinesterase Inhibitor ◽

Acetylcholinesterase Inhibitors ◽

Prodromal Stage ◽

Short Term ◽

Amnestic Mci ◽

Symptomatic Benefit

Amnestic mild cognitive impairment (MCI) can be considered as a state with a high risk of developing Alzheimer's disease within 5 years, or as a prodromal stage of this condition. Randomized clinical trials comparing the acetylcholinesterase inhibitor donepezil with placebo have shown some symptomatic benefit on (i) cognition in one short-term (6-month) study; and (ii)conversion to dementia in one long-term (3-year) study, but not for the full duration of the study, except in subjects with the apolipoprotein E4 (APOE-4) mutation, in whoom the benefit was sustained throughout the 3 years. Results from studies on galantamine are still being analyzed; and a rivastigmine study will close in the fall of 2004. It is premature to recommend that acetylcholinesterase inhibitors be used systematically in amnestic MCI. However, important lessons have been learned from studies in this prodromal stage of AD, allowing the testing of hypotheses for disease modification.

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Prolonged Systemic Inflammation Alters Muscarinic Long-Term Potentiation (mLTP) in the Hippocampus

Neural Plasticity ◽

10.1155/2021/8813734 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Efrat Shavit-Stein ◽

Amir Dori ◽

Marina Ben Shimon ◽

Shany Guly Gofrit ◽

Nicola Maggio

Keyword(s):

Cognitive Impairment ◽

Systemic Inflammation ◽

Long Term Potentiation ◽

Short Exposure ◽

Short Term ◽

Cholinergic Dysfunction ◽

Term Potentiation ◽

Hippocampal Synapses ◽

The Brain

The cholinergic system plays a fundamental role in learning and memory. Pharmacological activation of the muscarinic receptor M1R potentiates NMDA receptor activity and induces short-term potentiation at the synapses called muscarinic LTP, mLTP. Dysfunction of cholinergic transmission has been detected in the settings of cognitive impairment and dementia. Systemic inflammation as well as neuroinflammation has been shown to profoundly alter synaptic transmission and LTP. Indeed, intervention which is aimed at reducing neuroinflammatory changes in the brain has been associated with an improvement in cognitive functions. While cognitive impairment caused either by cholinergic dysfunction and/or by systemic inflammation suggests a possible connection between the two, so far whether systemic inflammation affects mLTP has not been extensively studied. In the present work, we explored whether an acute versus persistent systemic inflammation induced by LPS injections would differently affect the ability of hippocampal synapses to undergo mLTP. Interestingly, while a short exposure to LPS resulted in a transient deficit in mLTP expression, a longer exposure persistently impaired mLTP. We believe that these findings may be involved in cognitive dysfunctions following sepsis and possibly neuroinflammatory processes.

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Ketogenic Diets and Chronic Disease: Weighing the Benefits Against the Risks

Frontiers in Nutrition ◽

10.3389/fnut.2021.702802 ◽

2021 ◽

Vol 8 ◽

Author(s):

Lee Crosby ◽

Brenda Davis ◽

Shivam Joshi ◽

Meghan Jardine ◽

Jennifer Paul ◽

...

Keyword(s):

Chronic Disease ◽

Chronic Diseases ◽

Diet Quality ◽

Disease Risk ◽

Epidemiological Studies ◽

Short Term ◽

Chronic Disease Risk ◽

Ketogenic Diets ◽

Low Carbohydrate

Very-low-carbohydrate ketogenic diets have been long been used to reduce seizure frequency and more recently have been promoted for a variety of health conditions, including obesity, diabetes, and liver disease. Ketogenic diets may provide short-term improvement and aid in symptom management for some chronic diseases. Such diets affect diet quality, typically increasing intake of foods linked to chronic disease risk and decreasing intake of foods found to be protective in epidemiological studies. This review examines the effects of ketogenic diets on common chronic diseases, as well as their impact on diet quality and possible risks associated with their use. Given often-temporary improvements, unfavorable effects on dietary intake, and inadequate data demonstrating long-term safety, for most individuals, the risks of ketogenic diets may outweigh the benefits.

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Abstract P349: Neuroprotective Effects of L-Carnitine on Vascular Dementia in Hemodialysis Patients

Stroke ◽

10.1161/str.52.suppl_1.p349 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Yuji Ueno ◽

Takao Urabe ◽

Nobutaka Hattori

Keyword(s):

Magnetic Resonance Imaging ◽

Cognitive Impairment ◽

White Matter ◽

Magnetic Resonance ◽

Diffusion Magnetic Resonance Imaging ◽

Hemodialysis Patients ◽

Resonance Imaging ◽

Short Term ◽

Microstructural Damage

Background and purpose: L-carnitine alleviated oxidative stress and white matter lesions in an experimental study. Cognitive decline is not uncommon in hemodialysis patients, the pathogenesis of which has not been elucidated. Methods: Using novel diffusion magnetic resonance imaging techniques, white matter microstructural changes and cognitive decline in hemodialysis patients, and the effects of l-carnitine on such disorders were investigated. Fourteen hemodialysis patients underwent diffusion tensor imaging, diffusion kurtosis imaging, neurite orientation dispersion and density imaging, and laboratory and neuropsychological tests, which were compared between two groups based on the duration of l-carnitine treatment: (1) no or short-term l-carnitine treatment; and (2) long-term l-carnitine treatment. Ten age and sex-matched controls were enrolled. Results: On neuropsychological testing, the majority of hemodialysis patients were categorized as having mild cognitive impairment. Seven patients were classified into the no or short-term l-carnitine treatment and long-term l-carnitine treatment groups. Compared to controls, microstructural disorders of white matter were widely detected in no or short-term l-carnitine treatment on diffusion magnetic resonance imaging. An autopsy study from the no or short-term l-carnitine treatment group showed rarefaction of myelinated fibers in white matter. In long-term l-carnitine treatment, microstructural damage on diffusion magnetic resonance imaging was alleviated along with lower levels of high-sensitivity C-reactive protein ( P <0.001) and substantial increases of carnitine levels ( P <0.001). The long-term l-carnitine treatment group showed better achievement in Trail Making Test-A ( P =0.017), which was correlated with amelioration of disorders in bilateral anterior thalamic radiations, the left cingulum in the cingulate gyrus, the right superior longitudinal fasciculus, and the forceps major ( P <0.05). Conclusion: Novel diffusion magnetic resonance imaging tractography detected abnormalities of white matter tracts in hemodialysis patients. Long-term treatment with l-carnitine alleviated white matter microstructural damage and cognitive impairment.

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