COGNITIVE IMPAIRMENTS AS A SYMPTOM OF POST-COVID SYNDROME AMONG THE BULGARIAN POPULATION IN THE CONTEXT OF A GLOBAL PANDEMIC: AN ONGOING STUDY

Abstract

Isolated in China at the end of 2019, the novel Corona virus - SARS-CoV 2 spread worldwide with remarkable speed, causing a state of global health emergency just a few months later. And yet as we passed the acute phase of the COVID 19 pandemics, healthcare workers face the challenge of its late consequences. Therefore, the World Health Organization defined a new condition - post-COVID syndrome (PCS, Post-acute COVID Syndrome or long-COVID). According to several studies, the incidence of PCS varies from 10% to 35% among non-hospitalized patients and up to 85% among hospitalized patients. Moreover, various study results show that the syndrome affects both patients with a symptomatic form of the infection and those with an asymptomatic course. The syndrome itself presents with a wide range of non-specific complaints, most frequent of which are fatigue, shortness of breath and impaired cognitive functions. The exact pathogenetic mechanisms, responsible for these prolonged neuropsychological manifestations of long COVID 19 are yet to be established but most authors assume that they are caused by chronic neuroinflammation.

Purpose: The aim of our study is to assess the most common cognitive impairments among the Bulgarian population, thus providing information about their characteristics and incidence.

Methods and materials: We conducted a prospective study among 75 patients, all of which have recovered from COVID 19 infection at least 3 months prior to testing. All participants were between 20 and 60 years old and had no previous neurological or psychiatric disease. To assess cognitive functions, we used a computer test - the Cogstate Brief Battery, which provides a measure of four core cognitive domains: processing speed, attention, visual learning and working memory.

Results: The study is still ongoing, as we intend to conduct a follow-up testing on the sixth month. So far, our results are in accordance with findings in other countries, showing that executive functions and memory are predominantly affected. Therefore, it is important to underline the fact that there are objective findings for the non-specific subjective complaints.

Conclusion: Outlining the possible clinical features of long-COVID and emphasizing its undeniable medico-social meaning is of undeniable importance to healthcare workers. And given the progressively rising morbidity from this novel syndrome, a more precise description of these "cognitive impairments" is required in order to formulate epidemiologically based health strategies and ensure early prevention, especially in patients in an active age.