Andréanne BERNATCHEZ
Persistent neurologic and cognitive symptoms in elderly patients having recovered from an acute SARSCoV-2 infection
Introduction. Post-COVID-19 condition (PCC), as defined by the World Health Organization, encompasses various symptoms, including neurological and cognitive symptoms that may persist after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This condition is of particular concern in older adults, who may be at higher risk of developing PCC and experiencing functional decline several months after infection. However, uncertainties remain about the evolution of symptoms over time and their impact on quality of life.
Objectives. This retrospective cohort study aims to determine and compare the proportion of patients reporting new neurological and cognitive symptoms 6 and 12 months after an emergency department visit, and to explore the relationship between the presence of these symptoms and health-related quality of life among the following 4 groups: 1) ≥ 65 years old who tested positive for SARS-CoV-2; 2) ≥ 65 years old who tested negative; 3) 18-64 years old who tested positive; 4) 18-64 years old who tested negative.
Methodology. This research will include data collected from over 8,000 patients tested for SARS-CoV-2 in emergency departments participating in the Canadian COVID-19 Emergency Department Rapid Response Network registry between October 18, 2020 and February 28, 2022. The presence of neurological and cognitive symptoms (anosmia, dysgeusia, sleep disturbances, post-exertional malaise, dizziness/lightheadedness, memory and concentration difficulties) will be analyzed from responses to the Post COVID-19 Condition Assessment (PCCA), and health-related quality of life will be assessed from responses to the Veterans Rand 12-Item Health Survey (VR-12). The proportion of patients reporting new neurological and cognitive symptoms will be analyzed using hierarchical logistic regression models (with sensitivity analyses in patients ≥ 65 years), separately at 6 and 12 months. Hierarchical linear regression models will be performed to explore the relationship between symptoms and health-related quality of life.
Relevance. The findings of this study will help characterize the neurological and cognitive symptoms of PCC in older adults, and better understand their relationship with health-related quality of life. They may also help guide enhanced surveillance and tailored multidisciplinary care programs for older adults living with neurological and cognitive symptoms of PCC or other post-viral syndromes, thus providing an opportunity to improve their functioning and quality of life.