A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case Series
BackgroundEarly clinical experience during the COVID-19 pandemic has begun to elucidate that the disease can cause brain function changes that may result in compromised cognition both acutely and during variable recovery periods. Reports on cognitive assessment of patients with COVID-19 are often li...
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| Format: | Article |
| Language: | English |
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JMIR Publications
2021-06-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2021/6/e26417 |
| _version_ | 1819292862030807040 |
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| author | Beresford, Thomas Ronan, Patrick J Hipp, Daniel |
| author_facet | Beresford, Thomas Ronan, Patrick J Hipp, Daniel |
| author_sort | Beresford, Thomas |
| collection | DOAJ |
| description | BackgroundEarly clinical experience during the COVID-19 pandemic has begun to elucidate that the disease can cause brain function changes that may result in compromised cognition both acutely and during variable recovery periods. Reports on cognitive assessment of patients with COVID-19 are often limited to orientation alone. Further assessment may seem to create an inappropriate burden for patients with acute COVID-19, which is characterized by fatigue and confusion, and may also compromise examiner safety.
ObjectiveThe aims of this study were to assess cognition in patients with COVID-19 as comprehensively as possible in a brief format, while observing safety precautions, and to establish a clear face value of the external validity of the assessment.
MethodsWe adapted a brief cognitive assessment, previously applied to liver transplant candidates and medical/surgical inpatients, for remote use in patients hospitalized for COVID-19 treatment. Collecting quality assurance data from telephone-administered assessments, this report presents a series of 6 COVID-19 case vignettes to illustrate the use of this 5-minute assessment in the diagnosis and treatment of brain effects. Primary medical teams referred the cases for neuropsychiatric consultation.
ResultsThe age of the patients varied over four decades, and none of them were able to engage meaningfully with their surroundings on admission. On follow-up examination 6 to 10 days later, 4 of the 6 patients had recovered working memory, and only 1 had recovered calculation ability. Of the 6 patients, 2 were capable of complex judgment responses, while none of the cases completed frontal executive function testing in the normal range.
ConclusionsCognitive assessment in patients with COVID-19 using this remote examination reveals patterns of cognitive recovery that vary among cases and are far more complex than loss of orientation. In this series, testing of specific temporal, parietal, and frontal lobe functions suggests that calculation ability, judgment, and especially frontal executive functions may characterize the effects of COVID-19 on the brain. Used widely and serially, this examination method can potentially inform our understanding of the effects of COVID-19 on the brain and of healing from the virus. |
| first_indexed | 2024-12-24T04:01:16Z |
| format | Article |
| id | doaj.art-4a738ce578704f6fba9a29dd46505f04 |
| institution | Directory Open Access Journal |
| issn | 2561-326X |
| language | English |
| last_indexed | 2024-12-24T04:01:16Z |
| publishDate | 2021-06-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Formative Research |
| spelling | doaj.art-4a738ce578704f6fba9a29dd46505f042022-12-21T17:16:18ZengJMIR PublicationsJMIR Formative Research2561-326X2021-06-0156e2641710.2196/26417A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case SeriesBeresford, ThomasRonan, Patrick JHipp, DanielBackgroundEarly clinical experience during the COVID-19 pandemic has begun to elucidate that the disease can cause brain function changes that may result in compromised cognition both acutely and during variable recovery periods. Reports on cognitive assessment of patients with COVID-19 are often limited to orientation alone. Further assessment may seem to create an inappropriate burden for patients with acute COVID-19, which is characterized by fatigue and confusion, and may also compromise examiner safety. ObjectiveThe aims of this study were to assess cognition in patients with COVID-19 as comprehensively as possible in a brief format, while observing safety precautions, and to establish a clear face value of the external validity of the assessment. MethodsWe adapted a brief cognitive assessment, previously applied to liver transplant candidates and medical/surgical inpatients, for remote use in patients hospitalized for COVID-19 treatment. Collecting quality assurance data from telephone-administered assessments, this report presents a series of 6 COVID-19 case vignettes to illustrate the use of this 5-minute assessment in the diagnosis and treatment of brain effects. Primary medical teams referred the cases for neuropsychiatric consultation. ResultsThe age of the patients varied over four decades, and none of them were able to engage meaningfully with their surroundings on admission. On follow-up examination 6 to 10 days later, 4 of the 6 patients had recovered working memory, and only 1 had recovered calculation ability. Of the 6 patients, 2 were capable of complex judgment responses, while none of the cases completed frontal executive function testing in the normal range. ConclusionsCognitive assessment in patients with COVID-19 using this remote examination reveals patterns of cognitive recovery that vary among cases and are far more complex than loss of orientation. In this series, testing of specific temporal, parietal, and frontal lobe functions suggests that calculation ability, judgment, and especially frontal executive functions may characterize the effects of COVID-19 on the brain. Used widely and serially, this examination method can potentially inform our understanding of the effects of COVID-19 on the brain and of healing from the virus.https://formative.jmir.org/2021/6/e26417 |
| spellingShingle | Beresford, Thomas Ronan, Patrick J Hipp, Daniel A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case Series JMIR Formative Research |
| title | A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case Series |
| title_full | A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case Series |
| title_fullStr | A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case Series |
| title_full_unstemmed | A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case Series |
| title_short | A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case Series |
| title_sort | 5 minute cognitive assessment for safe remote use in patients with covid 19 clinical case series |
| url | https://formative.jmir.org/2021/6/e26417 |
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