Assessment of cognitive abilities of students who have recovered from COVID-19

Full Text

Introduction. In recent years, the COVID-19 pandemic has had a significant impact on global health, causing not only acute respiratory illness but also a wide range of long-term sequelae known as "long COVID". One of the most concerning aspects of Long COVID is its potential impact on cognitive function. Numerous patient reports indicate decreased attention, memory, processing speed, and executive functions after the disease. However, quantifying these cognitive impairments and determining their prevalence in the student population remains understudied[2].
Cognitive ability is the ability of the brain to learn and process information. Cognitive ability includes several concepts, as shown in Figure 1[1].
Figure 1 Cognitive ability

The impact of COVID-19 on cognitive ability is a complex issue, and the pathophysiological mechanisms are not fully understood. However, there are a number of proposed mechanisms that may play a role:

1. Direct viral effects on the brain: Neuronal infection: SARS-CoV-2 can directly infect neurons and glial cells in the brain, causing cell damage and death. This may occur through the ACE2 receptor, which is expressed on neurons and endothelial cells in the brain. Infection may lead to neuroinflammation and synaptic dysfunction. Neurotoxicity of viral proteins: Viral proteins such as the spike protein can have neurotoxic effects by inducing apoptosis (programmed cell death) and neuronal damage. Disruption of the blood-brain barrier (BBB): Viral infection can damage the BBB, making it more permeable. This allows viral particles, inflammatory cytokines, and other harmful substances to enter the brain, increasing inflammation and neuronal damage[3].

2. Systemic inflammation and cytokine storm: Inflammatory response: COVID-19 causes a strong inflammatory response in the body, which can also affect the brain. Increased levels of pro-inflammatory cytokines (e.g. IL-6, TNF-α) can contribute to neuroinflammation, neuronal damage, and cognitive impairment. This is especially true in severe forms of COVID-19, which are accompanied by a "cytokine storm". Microthrombosis: COVID-19 is often accompanied by microthrombosis (formation of small blood clots) in various organs, including in the blood vessels of the brain. This leads to ischemia (insufficient blood supply) and hypoxia (lack of oxygen) in certain areas of the brain, damaging neurons and impairing cognitive function. 3. Hypoxia and Ischemia: Respiratory Failure: Severe COVID-19 often causes respiratory failure, leading to hypoxia and brain damage due to lack of oxygen. Vasculitis: Inflammation of the blood vessels in the brain (vasculitis) can also lead to ischemia and stroke, impairing cognitive function.

4. Other Factors: Post-Infectious Encephalitis: In some cases, COVID-19 can cause post-infectious encephalitis, an inflammation of the brain that leads to cognitive impairment. Stress and Depression: The experience of COVID-19 itself, as well as its consequences (e.g., prolonged illness, social isolation), can cause stress and depression, which can negatively impact cognitive function. Sleep Disturbance: Sleep plays an important role in memory consolidation and other cognitive processes. Sleep disturbances, which are common in COVID-19, may contribute to cognitive problems.[4] It is important to note that these mechanisms may act independently or in concert, and the extent of their impact may vary depending on the severity of the disease, the presence of comorbidities, and individual patient characteristics. Further research is needed to fully understand the pathophysiology of cognitive impairment following COVID-19.

COVID-19 can cause a wide range of cognitive impairments. These impairments can be acute or chronic, and their severity varies significantly from person to person. These include: memory problems (short-term memory: difficulty remembering recently learned information, names, events, working memory: problems holding information in mind and manipulating it to complete tasks, long-term memory: in rare cases, there may be problems accessing already stored information), problems with attention and concentration (difficulty concentrating: inability to focus on tasks, absent-mindedness, decreased attention: easily tired during mental work, problems switching attention: difficulty switching from one task to another), problems with executive functions (problems with planning and organization: difficulty organizing tasks, making plans and following multi-step instructions, decreased speed of information processing: slower thinking and reactions, impaired mental flexibility problems: difficulty switching between different problem-solving methods, decreased ability to think abstractly: Difficulty understanding complex concepts[5].

It is important to note that these cognitive impairments can occur both in the acute phase of COVID-19 and during the recovery period (the so-called "Long COVID"). Not all people who have recovered from COVID-19 experience cognitive impairment, and the severity of symptoms can vary greatly. If such symptoms occur, you should consult a doctor for diagnosis and treatment plan development.

The purpose of the work To analyze the impact of COVID-19 on the development of cognitive impairment in students of the VSMU named after N.N. Burdenko.

Materials and methods of the study. An anonymous survey was conducted among students of the VSMU named after N.N. Burdenko of different courses and faculties. The survey involved 100 people aged 18 to 24 years. The questionnaire was compiled on the basis of: the CAS test - a cognitive assessment system, the Montreal Cognitive Assessment Scale (MoCA).

Research results. As a result of the study, a statistical analysis of the questionnaire was carried out. The analysis took into account the questionnaires of people who contacted a doctor with COVID-19. The results of people who were sick but did not contact a doctor were not taken into account in the analysis, since the data may be unreliable. The results of the study were presented in Table No. 1.
Table No. 1 "Assessment of students' cognitive impairment"
Men Women All
Have had COVID-19 53.75 32.41 38.63
Have not had COVID-19 19.3 34 31.6
According to the data obtained, people who have had COVID-19 have a higher number of points on the cognitive impairment assessment school. If we compare by gender, men who have had the disease have more cognitive impairment on average than women. While, when comparing uninfected people, uninfected women more often exhibit cognitive impairment. The average scores differ insignificantly between women who were and were uninfected.

Conclusion. The obtained results of the study of cognitive abilities of students who recovered from COVID-19 demonstrate a significant impact of the infection on various aspects of cognitive function, including memory, attention, and executive skills. A decrease in cognitive performance in this group of students may negatively affect their academic performance and social interaction, which highlights the need for a deeper understanding of the long-term consequences of COVID-19.

About the authors

Alena Alexandrovna Kostenko

Voronezh State Medical University named after N. N. Burdenko

Email: kostenkoalena2005@yandex.ru
ORCID iD: 0009-0004-0857-5332

student

Russian Federation, Voronezh, st. Studencheskaya, 10.

Marina Valerievna Luschik

Voronezh State Medical University named after N. N. Burdenko

Author for correspondence.
Email: patfiz@vrngmu.ru
ORCID iD: 0000-0002-1273-8374

Candidate of Biological Sciences, Associate Professor of the Department of Pathological Physiology

Voronezh, st. Studencheskaya, 10.

References

Supplementary files

There are no supplementary files to display.