Global Health Asia-Pacific May 2022 May 2022 - Page 61

SOURCE : ACCESS HEALTH INTERNATIONAL complications while hospitalised for COVID-19 , in particular , were twice as likely to perform worse on cognitive assessments , compared to individuals not diagnosed during hospitalisation . For instance , over 50 percent reported being unable to return to daily activities , while 59 percent of those previously employed had not been able to return to work .
The researchers also observed that , among those that completed their mental health outcome tests , 62 percent of individuals previously hospitalised for COVID-19 scored worse for anxiety , sleep , fatigue , and depression , in contrast to population averages . When they compared their COVID-19 groups with and without neurological diagnosis , no significant differences were found . This suggests that poor mental health outcomes may be linked to the experience of being severely sick with the virus , but mental health issues alone do not explain why some are unable to return to their daily activities .
How long do COVID-19-related neurological complications last ? A new study by Rass et al . from Austria attempted to answer this question by interviewing previously hospitalised COVID-19 patients three months after infection and then again one year later . While a few participants experienced some cognitive improvement , 73 percent showed no difference between three-months and a year . In fact , at one year , almost 60 percent of respondents continued to report neurological symptoms , including fatigue , concentration difficulties , sleep disturbances , headaches , impaired sensation , and loss of smell . To their surprise , the prevalence of these symptoms did not correlate with disease severity .
Another NYU Langone study , Valdes et al . found that patients who were unemployed or had fewer years of education were more likely to perform worse on cognitive assessments six months after being hospitalised for COVID-19 , compared to other demographic groups . The authors speculate that the observed differences are a consequence of social and economic disparities .
These observations raise troubling long-term issues for those who have had COVID-19 . They may not realise their brain health has weakened . And not everyone may be able to recognise brain fog , early attention and focus problems , forgetfulness , depression , anxiety , or poor sleep as part of this important long COVID problem .
It ’ s therefore important that we now begin to understand and check for the potential of brain damage among COVID-19 patients , a problem that may be silent now but is likely to become bigger .
What this means is that we need to recognise COVID-19-related long-term disabilities and dysfunctions as a reality and use the latest brain checking tools , like advanced digital brain function tests , to screen patients with COVID and post-COVID . This can tell us earlier where lifestyle changes and selected medications can be impactful . Global scientific research is revealing that COVID-19 has not only caused a serious pandemic but also a post-pandemic period where many of those previously infected are still
Table : Summary of incidence of new neurological complications following hospitalisation
Study
Frotnera et al . 2021
Rass et al . 2022
Valdes et al . 2021
Incidence of New Neurological Complications
Commonly Reported Symptoms
346 / 382 ( 91 %) Limited daily activities ( 56 %) Abnormal cognition ( 50 %) Worse anxiety ( 46 %) Worse sleep ( 36 %) Fatigue ( 36 %) Depression ( 25 %)
48 / 81 ( 59 %) Fatigue ( 38 %) Concentration difficulties ( 25 %) Forgetfulness ( 25 %) Sleep disturbances ( 22 %) Myalgia ( 17 %) Limb weakness ( 17 %) Headache ( 16 %) Impaired sensation ( 16 %) Hyposmia ( 15 %)
106 / 215 ( 49 %) Orientation difficulties ( 86 %) Impaired language skills ( 60 %) Attention impairments ( 39 %) Executive function deficits ( 39 %) Memory problems ( 14 %)
suffering from the damaging effects of long COVID . This is especially the case when we look at the deterioration in overall brain health in long COVID patients . What ’ s important to note is that this includes those who have cognitive decline but are unaware of it . Early recognition of brain health problems using the latest digital brain health screening tools would therefore be useful in the early and proactive treatment and reversal of this major organ illness .
Dr Prem Pillay is a neurosurgeon at the Singapore Brain-Spine-Nerves Centre .
Dr Vivek Sehgal is a radiologist at Northeastern University in the US .
Dr Yaesshna Pillay is a neurologist at the Department of Neurology , University of Texas .
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