Cognitive function in Mexican older adults 6-months after recovering from SARS-CoV-2 infection

Abstract

Background

SARS-CoV-2 infection has been associated with multiple short- and long-term complications including depression, and cognitive impairment (CI). However, older adults with CI after COVID-19 have not been fully documented.

Objective

To evaluate cognitive function in Mexican adults post-recovery from SARS-CoV-2 infection.

Methods

In this prospective observational cohort study, we assess cognitive function (CF) by the Montreal Cognitive Assessment (MOCA) test with a cut-off less than 26 points, and functional status via telemedicine. Eligible patients with a history of moderate–severe COVID-19 aged ≥60 years, cognitively healthy (evaluated by Everyday Cognition Scale) and required admission to an intensive care unit (ICU) were included. Patients with history of dementia, stroke, and delirium during the cognitive evaluation were excluded. The association between CI and COVID-19 was assessed with a Cox regression model.

Results

From the 634 patients admitted to the ICU, 415 survived, afterward 308 were excluded and 107 were analyzed. Mean age was 70 years, 58% were female, and 53% had severe COVID.

The mean MoCA score was 21 ± 5 points, CI was present in 61 patients (57%). Infection severity (RR 1.87; 95% CI: 1.11–3.15, p < 0.05), lower education (RR 0.92; 95% CI: 0.87–0.97, p < 0.01), and activity daily living disability (RR 1.87; 95% CI: 1.07–3.26, p < 0.05) were the main factors associated with CI (unadjusted model by age and sex). The delayed recall, orientation, and language (83.2, 77.6 and 72.9% respectively) domains were the most affected in patients with CI.

Conclusions

Fifty-seven percent of patients analyzed developed CI six months post-ICU discharge due to SARS-CoV-2, and COVID severity was the main factor associated to its outcome.