AUTHOR=Damiano Rodolfo Furlan , Rocca Cristiana Castanho de Almeida , Serafim Antonio de Pádua , Loftis Jennifer M. , Talib Leda Leme , Pan Pedro Mário , Cunha-Neto Edecio , Kalil Jorge , de Castro Gabriela Salim , Seelaender Marilia , Guedes Bruno F. , Nagahashi Marie Suely K. , de Souza Heraldo Possolo , Nitrini Ricardo , Miguel Euripedes Constantino , Busatto Geraldo , Forlenza Orestes V. , HCFMUSP COVID-19 Study Group , Utiyama Edivaldo M. , Segurado Aluisio C. , Perondi Beatriz , Miethke-Morais Anna , Montal Amanda C. , Harima Leila , Fusco Solange R. G. , Silva Marjorie F. , Rocha Marcelo C. , Marcilio Izabel , Rios Izabel Cristina , Kawano Fabiane Yumi Ogihara , Jesus Maria Amélia de , Kallas Ésper G. , Carmo Carolina , Tanaka Clarice , Marchini Julio F. M. , Carvalho Carlos R. , Ferreira Juliana C. , Levin Anna Sara , Oliveira Maura Salaroli , Guimarães Thaís , Lázari Carolina dos Santos , Duarte Alberto José da Silva , Sabino Ester , Magri Marcello M. C. , Barros-Filho Tarcisio E. P. , Francisco Maria Cristina Peres Braido TITLE=Cognitive impairment in long-COVID and its association with persistent dysregulation in inflammatory markers JOURNAL=Frontiers in Immunology VOLUME=14 YEAR=2023 URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1174020 DOI=10.3389/fimmu.2023.1174020 ISSN=1664-3224 ABSTRACT=Objective

To analyze the potential impact of sociodemographic, clinical and biological factors on the long-term cognitive outcome of patients who survived moderate and severe forms of COVID-19.

Methods

We assessed 710 adult participants (Mean age = 55 ± 14; 48.3% were female) 6 to 11 months after hospital discharge with a complete cognitive battery, as well as a psychiatric, clinical and laboratory evaluation. A large set of inferential statistical methods was used to predict potential variables associated with any long-term cognitive impairment, with a focus on a panel of 28 cytokines and other blood inflammatory and disease severity markers.

Results

Concerning the subjective assessment of cognitive performance, 36.1% reported a slightly poorer overall cognitive performance, and 14.6% reported being severely impacted, compared to their pre-COVID-19 status. Multivariate analysis found sex, age, ethnicity, education, comorbidity, frailty and physical activity associated with general cognition. A bivariate analysis found that G-CSF, IFN-alfa2, IL13, IL15, IL1.RA, EL1.alfa, IL45, IL5, IL6, IL7, TNF-Beta, VEGF, Follow-up C-Reactive Protein, and Follow-up D-Dimer were significantly (p<.05) associated with general cognition. However, a LASSO regression that included all follow-up variables, inflammatory markers and cytokines did not support these findings.

Conclusion

Though we identified several sociodemographic characteristics that might protect against cognitive impairment following SARS-CoV-2 infection, our data do not support a prominent role for clinical status (both during acute and long-stage of COVID-19) or inflammatory background (also during acute and long-stage of COVID-19) to explain the cognitive deficits that can follow COVID-19 infection.