Loss of memory and attention is a phenomenon frequently reported by survivors of severe Covid-19. However, this type of sequelae was also observed in people who had a mild form of the disease more than 18 months after infection, report researchers from the University of São Paulo (USP) in a study published in the journal BMC Psychology. According to the authors, the discovery warns of the need for more comprehensive rehabilitation programs, which take into account the cognitive impacts of long COVID.
At the study carried out with 302 individuals, cognitive difficulties were present in 11.7% of participants who had mild Covid-19, in 39.2% of those who had moderate conditions and in 48.9% of those who survived the severe form.
“We observed that the greater the severity of the disease, the greater the intensity of the damage related to attention deficit, memory loss and decreased processing speed. Even so, the number of people – which reached one hundred in our study – who presented mild and moderate cases of the disease and have the same sequelae is not negligible”, says Antônio de Pádua Serafim, researcher at the Institute of Psychology (IP) of USP and first author of the article.
The results of the research, funded by FAPESP, highlight the potential impacts of neuroinflammation resulting from SARS-CoV-2 infection.
“It is known that loss of memory and attention can be associated with complications from anesthetic procedures and intubation itself. In these cases, what we call post-intensive treatment syndrome occurs. However, in this study, we have people who did not need ICU or who did not even have enough symptoms to be hospitalized and, even so, they had loss of attention and memory. The results, therefore, open our eyes to the issue of Covid-19 neuroinflammation”, says Serafim.
Attention and memory are two important cognitive functions that impact everyday functionality. Therefore, among study participants who did not obtain good scores on memory and attention tests, reports of problems remembering words or carrying out everyday activities were common, for example, forgetting pans on the stove or failing to pick up their child from school.
“Thinking in a hierarchy, attention would be the primary function of all mental activity, hence the huge impact of this sequelae on people’s daily lives. You need to have attentional quality to be able to think and act on several things at the same time. The impact on attention has repercussions on the individual's memory capacity. In some cases, attentional activity is so dispersed that each new stimulus [atividade que deve ser feita] fades, to the point where the person cannot remember what they were doing. This also affects processing speed, which involves making quick decisions based on information”, explains the researcher.
Cognitive rehabilitation
According to Serafim, it is already clear that, in addition to affecting the lungs, kidneys, heart and muscles, SARS-CoV-2 can have an impact on the central nervous system. The question that remains open is the extent of the damage. “We still don’t know whether the cognitive impairments of Covid-19 are permanent or not. And we are currently evaluating ways to intervene in this process,” he says.
In partnership with other researchers from USP, Serafim is developing programs to try to alleviate the cognitive losses caused by Covid-19. The proposal is to verify whether techniques known as neurostimulation and neurofeedback could mitigate or reverse attention and memory problems.
“Both non-invasive techniques aim to improve brain function through neuromodulation, which can stimulate greater connection between the brain’s neurons [sinapse]. For now, we only have case studies. For example, that of a doctor who spent 34 days in the ICU [unidade de terapia intensiva]. We performed a neurofeedback protocol, widely used in patients with attention deficit disorder, and he recovered very well. But it is an isolated case”, he says.
“I believe that, based on what we already know about cognitive stimulation techniques and cognitive rehabilitation, it would be possible to obtain an improvement in neural connectivity through training that stimulates cognitive ability. The serious phase of the pandemic has passed, but the consequences persist. So it's not a closed case. There were many people infected and many who are experiencing sequelae of this type. However, we still do not have an effective program to intervene not only in the emotional aspects, but also in the cognitive difficulties resulting from COVID-19”, he ponders.
The article Cognitive performance of post-covid patients in mild, moderate, and severe clinical situations can be read at: https://bmcpsychology.biomedcentral.com/articles/10.1186/s40359-024-01740-7 .
Source: CNN Brasil