| Poster | Poster Session 09 Program Schedule
02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)
Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease
Final Abstract #68
Cognitive Trajectory of Post-Acute Sequelae of COVID-19 (PASC) in a Clinical Sample at Baseline and Follow-up
Jamie Robinson, UAB, Birmingham, United States
Brennan Hickson, UAB, Birmingham, United States
Shruti Agnihotri, UAB, Birmingham, United States
Richard Kennedy, UAB, Birmingham, United States
Roy Martin, UAB, Birmingham, United States
David Vance, UAB, Birmingham, United States
Pariya Wheeler, UAB, Birmingham, United States
Kristine Lokken, UAB, Birmingham, United States
Category: Infectious Disease (HIV/COVID/Hepatitis/Viruses)
Keyword 1: cognitive functioning
Keyword 2: infectious disease
Keyword 3: reaction time
Objective:
To examine the cognitive trajectory of PASC within a clinical sample.
Participants and Methods:
One hundred seventy-two patients underwent baseline neuropsychological assessment for cognitive complaints persisting >90 days post COVID-19 infection. Patients were referred as part of a Post COVID Treatment Program at a large university medical center. Patients were primarily female (70%), of Caucasian (78%) and African American (21%) race, with mean age of 50 (range: 18 to 78) and mean education of 15.37 (SD=2.61) years. Data collection is ongoing, and a total of 72 patients (42%) completed repeat neuropsychological assessment several months after baseline assessment (M=7.66 months, range: 6-13 months) to examine natural cognitive course of PASC.
Patients underwent a clinical diagnostic interview and comprehensive telehealth cognitive assessment battery that included measures of global cognition, working memory, processing speed, executive functioning, verbal fluency, visuospatial construction, and memory. Patients also completed self-report questionnaires of emotional and physical functioning via Research Electronic Data Capture (REDCap). Paired T-tests were performed to compare cognitive performance and questionnaire data from Time 1 to Time 2.
Results:
Full sample (N=172) baseline cognitive assessment indicated inefficiencies in specific cognitive domains, including global cognition (MoCA: M=24.78, SD=3.29), processing speed (OSDMT: M=73.22, SD=21.05), and immediate recall (CVLT-3 immediate recall trials [IRT]: M=87.71, SD=16.65), in comparison to normative data. Statistically significant improvements were seen from Time 1 testing to Time 2 on measures of global cognition (MoCA; Time 1 M=25.07, SD=3.28; Time 2 M=26.31, SD=2.86; t=-3.74, p<.001, d=-.44), semantic verbal fluency (Animal Naming; Time 1 M=93.98, SD=16.24; Time 2 M=100.07, SD=16.98; t=-3.41, p=.001, d=-.40), immediate memory (CVLT-3 IRT; Time 1 M=90.82, SD=16.95; Time 2 M=96.37, SD=16.89; t=-3.21, p<.01, d=-.38), delayed memory (CVLT-3 long delay free recall; Time 1 M=95.81, SD=17.00; Time 2 M=100.99, SD=16.85; t=-2.69, p<.01, d=-.32), and semantic memory (CVLT-3 full; Time 1 M=94.18, SD=15.28; Time 2 M=98.53, SD=14.35; t=-3.17, p<.01, d=-.38). Contrary to expectations, visuospatial construction (RBANS Figure Copy) performance worsened from Time 1 (M=101.85, SD=19.18) to Time 2 (M=94.18, SD=22.63; t=2.17, p<.05, d=.29). No statistically significant performance differences in the domains of working memory, processing speed, executive functioning, and visual memory were observed.
Significant improvements on self-report measures of depression, anxiety, stress, somatic symptoms, sleep, perceived cognitive function, and fatigue were observed (p’s<.05, small to moderate effect sizes). Trauma symptoms did not improve over time (PCL-5; ns).
Conclusions:
Results indicate cognitive improvements over time for patients with PASC in the areas of global cognition, semantic fluency, and verbal learning and memory. Patients also reported improvements in depression, anxiety, stress, somatic symptoms, sleep, and fatigue over time, suggesting that cognitive improvements may be moderated by changes in emotional and/or physical functioning.
Inefficiencies in processing speed and executive function are among the most common cognitive complaints endorsed by individuals experiencing PASC. Notably, the present study observed these domains to be most resistant to change, suggesting need for more targeted interventions. The anomalous finding of a decline in visuospatial constructional abilities over time should be further explored.
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