Cognitive impairment has emerged as a common post-acute sequela of coronavirus disease 2019 (COVID-19). We hypothesised that cognitive impairment exists in patients after COVID-19 and that it is most severe in patients admitted to the intensive care unit (ICU). This prospective controlled cohort study of 213 participants performed at the Helsinki University Hospital and the University of Helsinki, Finland, comprised three groups of patients—ICU-treated (n = 72), ward-treated (n = 49), and home-isolated (n = 44)—with confirmed COVID-19 between March 13 and December 31, 2020, participating in a comprehensive neuropsychological evaluation six months after the acute phase. Our study included a control group with no history of COVID-19 (n = 48). Medical and demographic data were collected from electronic patient records and interviews carried out four months after the acute phase. Questionnaires filled six months after the acute phase provided information about change in cognitive functioning observed by a close informant, as well as the presence of self-reported depressive and post-traumatic symptoms. The groups differed (effect size η2p = 0.065, p = 0.004) in the total cognitive score, calculated from neuropsychological measures in three domains (attention, executive functions, and memory). Both ICU-treated (p = 0.011) and ward-treated patients (p = 0.005) performed worse than home-isolated patients. Among those with more than 12 years of education, ICU-treated patients performed worse in the attention domain than ward-treated patients (p = 0.021) or non-COVID controls (p = 0.045); ICU-treated male patients, in particular, were impaired in executive functions (p = 0.037). ICU-treated COVID-19 patients, compared to patients with less severe acute COVID-19 or non-COVID controls, showed more severe long-term cognitive impairment. Among those with more than 12 years of education, impairment existed particularly in the domains of attention and for men, of executive functions. Trial registration number: ClinicalTrials.gov NCT04864938, retrospectively registered February 9, 2021

中文翻译：

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ICU 治疗的 COVID-19 患者的长期认知功能受损：一项综合对照神经心理学研究

认知障碍已成为 2019 年冠状病毒病 (COVID-19) 常见的急性后遗症。我们假设 COVID-19 后患者存在认知障碍，并且在入住重症监护病房 (ICU) 的患者中最为严重。这项在赫尔辛基大学医院和芬兰赫尔辛基大学对 213 名参与者进行的前瞻性对照队列研究包括三组患者——ICU 治疗 (n = 72)、病房治疗 (n = 49) 和家庭隔离(n = 44)——在 2020 年 3 月 13 日至 12 月 31 日期间确诊 COVID-19，在急性期六个月后参加了全面的神经心理学评估。我们的研究包括一个没有 COVID-19 病史的对照组（n = 48）。医学和人口统计数据是从急性期后四个月进行的电子患者记录和访谈中收集的。急性期后六个月填写的问卷提供了有关知情人观察到的认知功能变化的信息，以及自我报告的抑郁和创伤后症状的存在。根据三个领域（注意力、执行功能和记忆）的神经心理学测量计算，各组在总认知得分方面存在差异（效应大小 η2p = 0.065，p = 0.004）。ICU 治疗 (p = 0.011) 和病房治疗患者 (p = 0.005) 的表现都比居家隔离患者差。在受教育超过 12 年的患者中，ICU 治疗的患者在注意力领域的表现比病房治疗的患者 (p = 0.021) 或非 COVID 对照组 (p = 0.045) 差；尤其是在 ICU 治疗的男性患者的执行功能受损（p = 0.037）。与病情较轻的急性 COVID-19 患者或非 COVID 对照组患者相比，ICU 治疗的 COVID-19 患者表现出更严重的长期认知障碍。在受教育超过 12 年的人中，尤其在注意力和执行功能方面存在障碍。试验注册号：ClinicalTrials.gov NCT04864938，2021年2月9日回顾性注册 尤其在注意力和男性执行功能方面存在障碍。试验注册号：ClinicalTrials.gov NCT04864938，2021年2月9日回顾性注册 尤其在注意力和男性执行功能方面存在障碍。试验注册号：ClinicalTrials.gov NCT04864938，2021年2月9日回顾性注册