Prevalence and Associated Factors of Very Early Cognitive Impairment in COVID-19 Convalescents: a Study Using Data from a Questionnaire Survey

Background COVID-19 may impair the central nervous system, but the prevalence and related factors of very early cognitive impairment in discharged COVID-19 convalescents are still unclear. Objective To assess the prevalence of very early cognitive impairment in discharged COVID-19 convalescents, and...

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Main Author: HUA Qiaoli, LIU Huiling, XU Xiaohua, ZHENG Danwen, WANG Qian, LIU Yuntao, ZHOU Xin, YANG Rongyuan, DING Banghan, GUO Jianwen, ZHANG Zhongde
Format: Article
Language:zho
Published: Chinese General Practice Publishing House Co., Ltd 2023-04-01
Series:Zhongguo quanke yixue
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Online Access:https://www.chinagp.net/fileup/1007-9572/PDF/zx20220870.pdf
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author HUA Qiaoli, LIU Huiling, XU Xiaohua, ZHENG Danwen, WANG Qian, LIU Yuntao, ZHOU Xin, YANG Rongyuan, DING Banghan, GUO Jianwen, ZHANG Zhongde
author_facet HUA Qiaoli, LIU Huiling, XU Xiaohua, ZHENG Danwen, WANG Qian, LIU Yuntao, ZHOU Xin, YANG Rongyuan, DING Banghan, GUO Jianwen, ZHANG Zhongde
author_sort HUA Qiaoli, LIU Huiling, XU Xiaohua, ZHENG Danwen, WANG Qian, LIU Yuntao, ZHOU Xin, YANG Rongyuan, DING Banghan, GUO Jianwen, ZHANG Zhongde
collection DOAJ
description Background COVID-19 may impair the central nervous system, but the prevalence and related factors of very early cognitive impairment in discharged COVID-19 convalescents are still unclear. Objective To assess the prevalence of very early cognitive impairment in discharged COVID-19 convalescents, and to identify its influencing factors. Methods This study included 574 COVID-19 convalescents from August 28 to September 30, 2020, including individuals who were discharged from designated hospitals for treating COVID-19 in Wuhan from December 2019 to April 2020 randomly selected from the hospital information system, and those with informed consent recruited through news media. According to the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8) score, the subjects were divided into a very early cognitive impairment group (AD8≥2) and a non-very early cognitive impairment group (AD8<2). A questionnaire survey was conducted with the subjects by four investigators at Hubei Provincial Hospital of Traditional Chinese& Western Medicine, using the General Information Questionnaire to collect demographic information and past disease history of the patients (including gender, age, underlying disease, classification of COVID-19 on admission, interval between discharge and the current survey, and various symptoms present at the time of follow-up), using the Generalized Anxiety Disorder-7 (GAD-7), the PTSD Check List–Civilian Version (PCL-C), and the Short Form 36 Health Survey Questionnaire (SF-36) to assess patients' anxiety, post-traumatic stress disorder, and quality of life, respectively. Three hundred and eleven cases finally completed the cognitive function screening. Multiple Logistic regression was used to evaluate the effects of gender, age, underlying disease and admission classification of COVID-19 on very early cognitive impairment. A restricted cubic spline model was used to assess the quantitative relationship between anxiety level and very early cognitive impairment. Results 311 (54.18%) who effectively responded to the survey was finally enrolled, including 170 (54.7%) with very early cognitive impairment and 141 (45.3%) without. 230 (23.9%) had residual symptoms after discharge. Comparisons of gender, age, insomnia, fatigue, chest tightness, shortness of breath, loss of appetite, generalized anxiety disorder, PTSD positive, and the score of each SF-36 entry among COVID-19 convalescents with and without very early cognitive impairment were statistically significant (P<0.05). Multivariate Logistic regression analysis suggested that females〔OR (95%CI) =2.658 (1.528, 4.625) 〕, advanced age〔OR (95%CI) =3.736 (1.083, 12.890) 〕, and having generalised anxiety disorder〔OR (95%CI) =5.081 (1.229, 21.008) 〕were influential factors in increasing very early cognitive impairment (P<0.05). Restricted cubic spline models indicated a linear quantitative relationship between anxiety level and very early cognitive impairment, with higher levels of anxiety associated with a greater likelihood of very early cognitive impairment (P for non-linear test =0.132) . Conclusion The incidence of very early cognitive impairment is high in COVID-19 convalescents, and it may be higher in those who are older, female, or have generalized anxiety symptoms. Timely interventions for psychiatric problems and alleviation of anxiety symptoms in COVID-19 convalescents, especially in older women, may help to improve their cognitive function and Alzheimer's disease.
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spelling doaj.art-ef9a6cba47d34a91b69fb97181efc0ef2024-04-09T07:40:19ZzhoChinese General Practice Publishing House Co., LtdZhongguo quanke yixue1007-95722023-04-0126101234124010.12114/j.issn.1007-9572.2022.0870Prevalence and Associated Factors of Very Early Cognitive Impairment in COVID-19 Convalescents: a Study Using Data from a Questionnaire SurveyHUA Qiaoli, LIU Huiling, XU Xiaohua, ZHENG Danwen, WANG Qian, LIU Yuntao, ZHOU Xin, YANG Rongyuan, DING Banghan, GUO Jianwen, ZHANG Zhongde01. The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510006, China;2. Physical Examination Center, Hubei Provincial Hospital of Traditional Chinese& Western Medicine, Wuhan 430000, China;3. Department of Emergency, the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, China;4. Guangdong Provincial Key Laboratory of Research on Emergency in TCM, Guangzhou 510120, ChinaBackground COVID-19 may impair the central nervous system, but the prevalence and related factors of very early cognitive impairment in discharged COVID-19 convalescents are still unclear. Objective To assess the prevalence of very early cognitive impairment in discharged COVID-19 convalescents, and to identify its influencing factors. Methods This study included 574 COVID-19 convalescents from August 28 to September 30, 2020, including individuals who were discharged from designated hospitals for treating COVID-19 in Wuhan from December 2019 to April 2020 randomly selected from the hospital information system, and those with informed consent recruited through news media. According to the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8) score, the subjects were divided into a very early cognitive impairment group (AD8≥2) and a non-very early cognitive impairment group (AD8<2). A questionnaire survey was conducted with the subjects by four investigators at Hubei Provincial Hospital of Traditional Chinese& Western Medicine, using the General Information Questionnaire to collect demographic information and past disease history of the patients (including gender, age, underlying disease, classification of COVID-19 on admission, interval between discharge and the current survey, and various symptoms present at the time of follow-up), using the Generalized Anxiety Disorder-7 (GAD-7), the PTSD Check List–Civilian Version (PCL-C), and the Short Form 36 Health Survey Questionnaire (SF-36) to assess patients' anxiety, post-traumatic stress disorder, and quality of life, respectively. Three hundred and eleven cases finally completed the cognitive function screening. Multiple Logistic regression was used to evaluate the effects of gender, age, underlying disease and admission classification of COVID-19 on very early cognitive impairment. A restricted cubic spline model was used to assess the quantitative relationship between anxiety level and very early cognitive impairment. Results 311 (54.18%) who effectively responded to the survey was finally enrolled, including 170 (54.7%) with very early cognitive impairment and 141 (45.3%) without. 230 (23.9%) had residual symptoms after discharge. Comparisons of gender, age, insomnia, fatigue, chest tightness, shortness of breath, loss of appetite, generalized anxiety disorder, PTSD positive, and the score of each SF-36 entry among COVID-19 convalescents with and without very early cognitive impairment were statistically significant (P<0.05). Multivariate Logistic regression analysis suggested that females〔OR (95%CI) =2.658 (1.528, 4.625) 〕, advanced age〔OR (95%CI) =3.736 (1.083, 12.890) 〕, and having generalised anxiety disorder〔OR (95%CI) =5.081 (1.229, 21.008) 〕were influential factors in increasing very early cognitive impairment (P<0.05). Restricted cubic spline models indicated a linear quantitative relationship between anxiety level and very early cognitive impairment, with higher levels of anxiety associated with a greater likelihood of very early cognitive impairment (P for non-linear test =0.132) . Conclusion The incidence of very early cognitive impairment is high in COVID-19 convalescents, and it may be higher in those who are older, female, or have generalized anxiety symptoms. Timely interventions for psychiatric problems and alleviation of anxiety symptoms in COVID-19 convalescents, especially in older women, may help to improve their cognitive function and Alzheimer's disease.https://www.chinagp.net/fileup/1007-9572/PDF/zx20220870.pdfcovid-19|sequelae|early cognitive dysfunction|microcog|anxiety|preventive health programs
spellingShingle HUA Qiaoli, LIU Huiling, XU Xiaohua, ZHENG Danwen, WANG Qian, LIU Yuntao, ZHOU Xin, YANG Rongyuan, DING Banghan, GUO Jianwen, ZHANG Zhongde
Prevalence and Associated Factors of Very Early Cognitive Impairment in COVID-19 Convalescents: a Study Using Data from a Questionnaire Survey
Zhongguo quanke yixue
covid-19|sequelae|early cognitive dysfunction|microcog|anxiety|preventive health programs
title Prevalence and Associated Factors of Very Early Cognitive Impairment in COVID-19 Convalescents: a Study Using Data from a Questionnaire Survey
title_full Prevalence and Associated Factors of Very Early Cognitive Impairment in COVID-19 Convalescents: a Study Using Data from a Questionnaire Survey
title_fullStr Prevalence and Associated Factors of Very Early Cognitive Impairment in COVID-19 Convalescents: a Study Using Data from a Questionnaire Survey
title_full_unstemmed Prevalence and Associated Factors of Very Early Cognitive Impairment in COVID-19 Convalescents: a Study Using Data from a Questionnaire Survey
title_short Prevalence and Associated Factors of Very Early Cognitive Impairment in COVID-19 Convalescents: a Study Using Data from a Questionnaire Survey
title_sort prevalence and associated factors of very early cognitive impairment in covid 19 convalescents a study using data from a questionnaire survey
topic covid-19|sequelae|early cognitive dysfunction|microcog|anxiety|preventive health programs
url https://www.chinagp.net/fileup/1007-9572/PDF/zx20220870.pdf
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