Cognitive and emotional impairments associated with COVID-19 (literature review)

Background. Currently, there are two main areas of study of the impact of a new coronavirus infection on mental processes: the first is in connection with the regime of self-isolation and restrictions in a pandemic; the second – with the impact of the pathological process itself and the post-covid syndrome on the central nervous system. The results of the studies indicate the relationship of this infection with local lesions of the brain and the corresponding disturbances in the functioning of mental processes.
The aim of the research. To systematize and analyze the results of studies on the main routes of penetration of the SARS-CoV-2 virus into the central nervous system, cognitive and emotional disorders in people who have recovered from COVID-19, and to discuss the areas of psychological rehabilitation for this group of patients.
Materials and methods. Information search was carried out using Internet resources (PubMed, Web of Science, Scopus, bmj.com, eLibrary.ru, frontiersin.org, sciencedirect. com, ncbi.nlm.nih.gov), literature sources were analyzed for the period from May of 2020 to November of 2021 for the following keywords: COVID-19, SARS-CoV-2, cognitive functions, cognitions, cognitive impairments, emotional dysfunction, affective dysfunction.
Results. According to the analysis of the literature, most researchers identify the neurogenic pathway of SARS-CoV-2 penetration into the CNS, as well as penetration through the bloodstream or through cerebral lymphatic drainage, which are a possible cause of mental disorders of a neurological nature. Correction of these violations involves the creation of a comprehensive system of rehabilitation with the inclusion of psychotherapeutic methods.
Conclusions. Despite the lack of a single picture describing the specifics of cognitive and affective symptoms in COVID-19, in the most general terms, there is a certain consensus. So, quite often, post-COVID cognitive symptoms are characterized by impaired memory and attention, and post-COVID affective symptoms are characterized by increased levels of anxiety, depression, and fatigue. The issues of diagnosis and correction of disorders in post-COVID syndrome and the admissibility of the existence of this diagnosis are still relevant.

1. Alnefeesi Y, Siegel A, Lui LMW, Teopiz KM, Ho RCM, Lee Y, et al. Impact of SARS-CoV-2 infection on cognitive function: A systematic review. Front Psychiatry. 2021; 11: 621773. doi: 10.3389/fpsyt.2020.621773

2. Zubair AS, McAlpine LS, Gardin T, Farhadian S, Kuruvilla DE, Spudich S. Neuropathogenesis and neurologic manifestations of the coronaviruses in the age of Coronavirus Disease 2019: A review. JAMA Neurol. 2020; 77(8): 1018-1027. doi: 10.1001/jamaneurol.2020.2065

3. Shepeleva II, Chernysheva AA, Kir’yanova EM, Sal’nikova LI, Gurina OI. The nervous system damages and psychological and psychiatric complications on the COVID-19 pandemic. Sotsial’naya i klinicheskaya psikhiatriya. 2020; 30(4): 76-82. (In Russ.)

4. Kira IA, Alpay EH, Turkeli A, Shuwiekh HAM, Ashby JS, Alhuwailah A. The effects of COVID-19 traumatic stress on executive functions: The case of Syrian refugees in Turkey. J Loss Trauma. 2021; 26(7): 666-687. doi: 10.1080/15325024.2020.1869444

5. Bouças AP, Rheinheimer J, Lagopoulos J. Why severe COVID-19 patients are at greater risk of developing depression: A molecular perspective. Neuroscientist. 2022; 28(1): 11-19. doi: 10.1177/1073858420967892

6. Panariello F, Cellini L, Speciani M, De Ronchi D, Atti AR. How does SARS-CoV-2 affect the central nervous system? A working hypothesis. Front Psychiatry. 2020; 11: 582345. doi: 10.3389/fpsyt.2020.582345

7. Belopasov VV, Samoilova EM, Baklaushev VP. The nervous system damage in COVID-19 patients. Journal of Clinical Practice. 2020; 11(2): 60-80. (In Russ.). doi: 10.17816/clinpract34851

8. Amruta N, Chastain WH, Paz M, Solch RJ, Murray-Brown IC, Befeler JB, et al. SARS-CoV-2 mediated neuroinflammation and the impact of COVID-19 in neurological disorders. Cytokine Growth Factor Rev. 2021; 58: 1-15. doi: 10.1016/j.cytogfr.2021.02.002

9. Semenova NV, Rychkova LV, Darenskaya MA, Kolesnikov SI, Nikitina OA, Petrova AG, et al. Superoxide dismutase activity in male and female patients of different age with moderate COVID-19. Bull Exp Biol Med. 2022; 173(1): 51-53. doi: 10.1007/s10517-022-05491-6

10. 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. 2020; 129: 98-102. doi: 10.1016/j.jpsychires.2020.06.022

11. Miners S, Kehoe PG, Love S. Cognitive impact of COVID-19: Looking beyond the short term. Alzheimers Res Ther. 2020; 12(1): 170. doi: 10.1186/s13195-020-00744-w

12. Priftis K, Algeri L, Villella S, Spada MS. COVID-19 presenting with agraphia and conduction aphasia in a patient with lefthemisphere ischemic stroke. Neurol Sci. 2020; 41(12): 3381-3384. doi: 10.1007/s10072-020-04768-w

13. Kumar D, Jahan S, Khan A, Siddiqui AJ, Redhu NS, Wahajuddin, et al. Neurological manifestation of SARS-CoV-2 induced inflammation and possible therapeutic strategies against COVID-19. Mol Neurobiol. 2021; 58(7): 3417-3434. doi: 10.1007/S12035-021-02318-9

14. Serrano-Castro PJ, Estivill-Torrús G, Cabezudo-García P, Reyes-Bueno JA, Ciano Petersen N, Aguilar-Castillo MJ, et al. Impact of SARS-CoV-2 infection on neurodegenerative and neuropsychiatric diseases: A delayed pandemic? Neurologia (Engl Ed). 2020; 35(4): 245-251. doi: 10.1016/j.nrl.2020.04.002

15. Darenskaya M, Kolesnikova L, Kolesnikov S. The association of respiratory viruses with oxidative stress and antioxidants. Implications for the COVID-19 pandemic. Curr Pharm Des. 2021; 27(13): 1618-1627. doi: 10.2174/1381612827666210222113351

16. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic manifestations of hospitalized patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020; 77(6): 683-690. doi: 10.1001/jamaneurol.2020.1127

17. Stefano GB, Ptacek R, Ptackova H, Martin A, Kream RM. Selective neuronal mitochondrial targeting in SARS-CoV-2 infection affects cognitive processes to induce ‘brain fog’ and results in behavioral changes that favor viral survival. Med Sci Monit. 2021; 27: e930886. doi: 10.12659/MSM.930886

18. Ptacek R, Ptackova H, Martin A, Stefano GB. Psychiatric manifestations of COVID-19 and their social significance. Med Sci Monit. 2020; 26: e930340. doi: 10.12659/MSM.930340

19. Lu Yi, Li X, Geng D, Mei N, Wu PY, Huang CC, et al. Cerebral micro-structural changes in COVID-19 patients – An MRI-based 3-month follow-up study. EClinicalMedicine. 2020; 25: 100484. doi: 1016/j.eclinm.2020.100484

20. Heneka MT, Golenbock D, Latz E, Morgan D, Brown R. Immediate and long-term consequences of COVID-19 infections for the development of neurological disease. Alzheimers Res Ther. 2020; 12(1): 69. doi: 10.1186/s13195-020-00640-3

21. Hosey MM, Needham DM. Survivorship after COVID-19 ICU stay. Nat Rev Dis Primers. 2020; 6(1): 60. doi: 10.1038/s41572-020-0201-1

22. Tanashyan MM, Kuznetsova PI, Raskurazhev AA. Neurological aspects of COVID-19. Annals of Clinical and Experimental Neurology. 2020; 14(2): 62-69. (In Russ.). doi 10.25692/ACEN.2020.2.8

23. Jaywant A, Vanderlind WM, Alexopoulos GS, Fridman CB, Perlis RH, Gunning FM. Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19. Neuropsychopharmacology. 2021; 46(13): 2235-2240. doi: 10.1038/s41386-021-00978-8

24. Wilson BA, Betteridge S, Fish J. Neuropsychological consequences of Covid-19. Neuropsychol Rehabil. 2020; 30(9): 1625-1628. doi: 10.1080/09602011.2020.1808483

25. Ritchie K, Chan D, Watermeyer T. The cognitive consequences of the COVID-19 epidemic: Collateral damage? Brain Commun. 2020; 2(2): fcaa069. doi: 10.1093/braincomms/fcaa069

26. 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. 2021; 27(1): 191-195. doi: 10.1007/s13365-021-00954-4

27. 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. 2021; 39: 101044. doi: 10.1016/j.eclinm.2021.101044

28. Fotuhi M, Mian A, Meysami S, Raji CA. Neurobiology of COVID-19. J Alzheimers Dis. 2020; 76(1): 3-19. doi: 10.3233/JAD-200581

29. Lamprecht B. Is there a post-COVID syndrome? Pneumologe (Berl). 2020; 17(6): 398-405. (In German). doi: 10.1007/s10405-020-00347-0

30. Negrini F, Ferrario I, Mazziotti D, Berchicci M, Bonazzi M, Negrini S, et al. Neuropsychological features of severe hospitalized Coronavirus Disease 2019 patients at clinical stability and clues for postacute rehabilitation. Arch Phys Med Rehabil. 2021; 102(1): 155-158. doi: 10.1016/j.apmr.2020.09.376

31. Barker-Davies RM, O’Sullivan O, Senaratne KPP, Baker P, Cranley M, Dharm-Datta S, et al. The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Br J Sports Med. 2020; 54(16): 949-959. doi: 10.1136/bjsports-2020-102596

32. Vyrupaeva EV, Semyonova NV, Rychkova LV, Petrova AG, Darenskaya MA, Kolesnikov SI, et al. Assessment of the general condition and quality of life of women of post-reproductive age who underwent COVID-19 asymptomatically and 12 months after the moderate form of the disease. Acta biomedica scientifica. 2022; 7(5-1): 77-85. (In Russ.). doi: 10.29413/ABS.2022-7.5-1.9

33. Rychkova LV, Darenskaya MA, Semenova NV, Kolesnikov SI, Petrova AG, Nikitina OA, et al. Oxidative stress intensity in children and adolescents with a new coronavirus infection. International Journal of Biomedicine. 2022; 12(2): 242-246. doi: 10.21103/Article12(2)_OA7

34. Kurashova NA, Dashiev BG, Kolesnikov SI, Dmitrenok PS, Kozlovskaya EP Kasyanov SP, et al. Changes in spermatogenesis, lipoperoxidation processes and antioxidant protection in men with pathozoospermia after COVID-19 infection. The effectiveness of correction with a promising antioxidant complex. Bulletin of Experimental Biology and Medicine. 2022; 173(5): 572-577. (In Russ.). doi: 10.47056/0365-9615-2022-173-5-572-577

35. Novikova EA, Petrova AG, Moskaleva EV, Vanyarkinа AS, Rychkova LV. Retrospective of international serological studies on the formation and dynamics of the humoral immune response to SARS-CoV-2: from 2020 to 2021. Acta biomedica scientifica. 2021; 6(2): 47-57. (In Russ.). doi: 10.29413/ABS.2021-6.2.5

36. 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. 2021; 12: 643646. doi: 10.3389/fneur.2021.643646

37. Bilder RM, Postal KS, Barisa M, Aase DM, Cullum CM, Gillaspy SR, et al. InterOrganizational practice committee recommendations/guidance for teleneuropsychology (TeleNP) in response to the COVID-19 pandemic. Clin Neuropsychol. 2020; 34(7-8): 1314-1334. doi: 10.1080/13854046.2020.1767214