Impacto de la COVID-19 en la función cognitiva de los supervivientes tras la hospitalización en cuidados intensivos
cohorte prospectiva
DOI:
https://doi.org/10.1590/ce.v30i0.96346ptPalabras clave:
COVID-19, Unidades de Cuidados Intensivos, Cognición, Disfunción Cognitiva, Pruebas de Estado Mental y DemenciaResumen
Objetivo: Analizar el impacto de la COVID-19 sobre la cognición en adultos a los 14, 30 y 90 días después del alta de la Unidad de Cuidados Intensivos.
Método: Cohorte prospectiva con 167 pacientes mayores de 18 años, evaluados mediante el Short Portable Mental Status Questionnaire de Pfeiffer, con datos de hospitales de la región este del estado de Paraná (Brasil), en el periodo comprendido entre 2021 y 2022. Para el análisis de los datos, se utilizó la prueba de Friedman para comparar muestras emparejadas en los tres momentos de recogida, y la prueba de Mann-Whitney para comparar el comportamiento cognitivo entre hombres y mujeres.
Resultados: Se calculó una edad media de 49,3 años, con un rango de edad de 40 a 49 años, siendo el 52,7 % del sexo masculino, con una estancia media de 16,6 días. Persistieron los cambios cognitivos y las mujeres presentaron un peor perfil evolutivo.
Conclusión: La recuperación fue satisfactoria. Tras tres meses de alta de la Unidad de Cuidados Intensivos, el 4,1 % de los participantes presentaban discapacidades leves teniendo en cuenta las limitaciones descritas al inicio del estudio.
Citas
1. Mojica-Crespo R, Morales-Crespo M. Pandemia COVID-19, la nueva emergencia sanitaria de preocupación internacional: una revisión. Semergen [Internet]. 2020 [cited 2024 Aug 2]; 46(1):72-84 Available from: https://doi.org/10.1016/j.semerg.2020.05.010
2. World Health Organization (WHO) [Internet]. Geneva: WHO; [2024] [cited 2024 Aug 2]. Coronavirus disease (COVID-19) outbreak;[about 2 screens]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019
3. Helms J, Kremer S, Merdji H, Schenck M, Severac F, Clere-Jehl R, et al. Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients. Crit Care [Internet]. 2020 [cited 2024 Aug 2];24:491. Available from: https://doi.org/10.1186/s13054-020-03200-1
3. Singer AJ, Morley EJ, Meyers K, Fernandes R, Rowe AL, Viccellio P, et al. Cohort of four thousand four hundred four persons under investigation fse seor covid-19 in a New York hospital and predictors of ICU care and ventilation. Ann Emerg Med [Internet]. 2020 [cited 2024 Aug 2];76(4):394-404. Available from: https://doi.org/10.1016/j.annemergmed.2020.05.011
4. Hosey MM, Needham DM. Survivorship after COVID-19 ICU stay. Nat Rev Dis Primers. [Internet]. 2020 [cited 2024 Aug 3];6(1):60. Available from: https://doi.org/10.1038/s41572-020-0201-1
5. Altuna M, Sánchez-Saudinós MBS, Lleó A. Cognitive symptoms after COVID-19. Neurology Perspectives [Internet]. 2021 [cited 2024 Aug 3];1:S16-S24. Available from: https://doi.org/10.1016/j.neurop.2021.10.005
6. Woo MS, Malsy J, Pöttgen J, Zai SS, Ufer F, Hadjilaou A, et al. Frequent neurocognitive deficits after recovery from mild COVID-19. Brain Commun [Internet]. 2020 [cited 2024 Aug 3];2(2):fcaa205. Available from: https://doi.org/10.1093/braincomms/fcaa205
7. Tabacof L, Tosto-Mancuso J, Wood J, Cortes M, Kontorovich A, McCarthy D, et.al post-acute COVID-19 syndrome negatively impacts physical function, cognitive function, health-related quality of life, and participation. Am J Phys Med Rehabil [Internet]. 2022 [cited 2024 Aug 3];101(1):48-52. Available from: https://doi.org/10.1097/PHM.0000000000001910
8. Aiyegbusi OL, Hughes SE, Turner G, Rivera SC, McMullan C, Chandan JS, et al. Symptoms, complications and management of long COVID: a review. Journal of the Royal Society of Medicine [Internet]. 2021 [cited 2024 Aug 3];114(9):428-442. Available from: https://doi.org/10.1177/01410768211032850
9. Liu TC, Yoo SM, Sim MS, Motwani Y, Viswanathan N, Wenger NS. Perceived cognitive deficits in patients with symptomatic SARS-CoV-2 and their association with post-COVID-19 condition. JAMA Netw Open [Internet]. 2023 [cited 2025 Apr 3];6(5):e2311974. Available from: https://doi.org/10.1001/jamanetworkopen.2023.11974
10. Albu S, Zozaya NR, Murillo N, García-Molina A, Chacón CAF, Kumru H. What’s going on following acute COVID-19? Clinical characteristics of patients in an out-patient rehabilitation program. NeuroRehabilitation [Internet]. 2021 [cited 2025 Apr 3];48(4):469-480. Available from: https://doi.org/10.3233/NRE-210025
11. Garrigues E, Janvier P, Kherabi Y, Le Bot A, Hamon A, Gouze H, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect [Internet]. 2020 [cited 2024 Aug 4];81(6):e4-e6. Available from: https://doi.org/10.1016/j.jinf.2020.08.029
12. Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. J Am Geriatr Soc [Internet]. 1975 [cited 2024 Aug 3];23(10):433-441. Available from: https://doi.org/10.1111/j.1532-5415.1975.tb00927.x
13. Teigão FCM, Moser ADL, Jerez-Roig J. Translation and cross-cultural adaptation of Pfeiffer’s Short Portable Mental Status Questionnaire (SPMSQ) for Brazilians older adults. Rev Bras Geriatr Geronto [Internet]. 2021 [cited 2024 Aug 4];23(4):e200128. Available from: https://doi.org/10.1590/1981-22562020023.200128
14. Alemanno F, Houdayer E, Parma A, Spina A, Del Forno A, Scatolini A, et al. COVID-19 cognitive deficits after respiratory assistance in the subacute phase: a COVID-rehabilitation unit experience. PloS ONE [Internet]. 2021 [cited 2024 Aug 4];16(2):e0246590. Available from: https://doi.org/10.1371/journal.pone.0246590
15. Sasannejad C, Ely EW, Lahiri S. Long-term cognitive impairment after acute respiratory distress syndrome: a review of clinical impact and pathophysiological mechanisms. Crit Care [Internet]. 2019 [cited 2024 Aug 4];23(1):352. Available from: https://doi.org/10.1186/s13054-019-2626-z
16. Pistarini C, Fiabane E, Houdayer E, Vassallo C, Manera MR, Alemanno F. cognitive and emotional disturbances due to COVID-19: an exploratory study in the rehabilitation setting. Front Neurol [Internet]. 2021 [cited 2024 Aug 5];12:643646. Available from: https://doi.org/10.3389/fneur.2021.643646
17. Garg M, Maralakunte M, Garg S, Doria S, Sehgal I, Bhalla AS, et al. The Conundrum of 'Long-COVID-19': a narrative review. Int J Gen Med [Internet]. 2021 [cited 2024 Aug 5];14:2491-2506. Available from: https://doi.org/10.2147/IJGM.S316708
18. Blomberg B, Mohn KGI, Brokstad KA, Zhou F, Linchausen DW, Hansen BA, et al. Long COVID in a prospective cohort of home-isolated patients. Nat Med [Internet]. 2021 [cited 2024 Aug 5];27:1607-1613. Available from: https://doi.org/10.1038/s41591-021-01433-3
19. Del Pueblo VMS, Serrano-Heras G, Sánchez CMR, Landete PP, Rojas-Bartolome L, Feria I, et al. Brain and cognitive changes in patients with long COVID compared with infection-recovered control subjects. Brain [Internet]. 2024 [cited 2025 Apr 3];147(10):3611-3623. Available from : https://doi.org/10.1093/brain/awae101
20. Hellmuth J, Barnett TA, Asken BM, Kelly JD, Torres L, Stephens ML, et al. Persistent COVID-19-associated neurocognitive symptoms in non-hospitalized patients. J Neurovirol [Internet]. 2021 [cited 2024 Aug 5];27(1):191-195. Available from: https://doi.org/10.1007/s13365-021-00954-4
21. Zhou H, Lu S, Chen J, Wei N, Wang D, Lyu H, et al. The landscape of cognitive function in recovered COVID-19 patients. J Psychiatr Res [Internet]. 2020 [cited 2024 Aug 6];129: 98-102. Available from: https://doi.org/10.1016/j.jpsychires.2020.06.022
22. Ortona E, Malorni W. Long COVID: to investigate immunological mechanisms and sex/gender related aspects as fundamental steps for tailored therapy.
Eur Respir J [Internet]. 2022 [cited 2024 Aug 5];59(2):2102245. Available from: https://doi.org/10.1183/13993003.02245-2021
23. Sivan M, Rayner C, Delaney B. Fresh evidence of the scale and scope of long covid. BMJ [Internet]. 2021 [cited 2024 Aug 6];373 :n853. Available from: https://doi.org/10.1136/bmj.n853
24. Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, et al. Attributes and predictors of long COVID. Nat Med [Internet]. 2021 [cited 2024 Aug 6];27(4):626-31. Available from: https://doi.org/10.1038/s41591-021-01292-y
25. Rubin R. as their numbers grow, COVID-19 "Long Haulers" stump experts. JAMA [Internet]. 2020 [cited 2024 Aug 6];324(14):1381-1383. Available from: https://doi.org/10.1001/jama.2020.17709
26. Iodice F, Cassano V, Rossini PM. Direct and indirect neurological, cognitive, and behavioral effects of COVID-19 on the healthy elderly, mild-cognitive-impairment, and Alzheimer's disease populations. Neurol Sci [Internet]. 2021. [cited 2024 Aug 6];42(2):455-65. Available from: https://doi.org/10.1007/s10072-020-04902-8
27. Alonso-Lana S, Marquié M, Ruiz A, Boada M. Cognitive and neuropsychiatric manifestations of COVID-19 and effects on elderly individuals with dementia. Front Aging Neurosci [Internet]. 2020 [cited 2024 Aug 6];12:588872. Available from: https://doi.org/10.3389/fnagi.2020.588872
28. Grigoletto I, Cavalheri V, de Lima FF, Ramos EMC. Recovery after COVID-19: the potential role of pulmonary rehabilitation. Braz J Phys Ther [Internet]. 2020 [cited 2024 Aug 6];24(6):463-64. Available from: https://doi.org/10.1016/j.bjpt.2020.07.002
29. Hampshire A, Trender W, Chamberlain SR, Jolly AE, Grant JE, Patrick F, et al. Cognitive deficits in people who have recovered from COVID-19. EClinicalMedicine [Internet]. 2021 [cited 2025 Aug 4];39:101044. Available from: https://doi.org/10.1016/j.eclinm.2021.101044
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2025 Karla Cristiane Rogal Ruggieri, Luana Caroline Kmita, Luiza Vargas Corleto, Maria Nesryn Tiba, Auristela Duarte De Lima Moser
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Cogitare Enfermagem se reserva el derecho de realizar, en el artículo publicado, cambios de orden normativa, ortográfica y gramatical con el fin de mantener el estándar culto del idioma, respetando, sin embargo, el estilo de los autores.
El estudio publicado es de total responsabilidad del(os) autor(es), siendo exclusivamente responsabilidad de Cogitare Enfermagem la evaluación del manuscrito, en calidad de vehículo de publicación científica.
No se permitirá la adición o cambio de autoría durante la etapa de evaluación o después de la aceptación del texto presentado.
Cogitare Enfermagem no se responsabiliza por posibles violaciones a la Ley Nº 9.610/1998, Ley Brasileña de Derechos de Autor. Cogitare Enfermagem permite que el autor retenga los derechos de autor de los artículos aceptados para su publicación, sin restricciones.
