Outcome of Severe COVID-19: Spotlight on Fatigue, Fatigability, Multidomain Complaints and Pattern of Cognitive Deficits in a Case Series Without Prior Brain Dysfunction and Without COVID-19-related Stroke And/or Cardiac Arrest

Overview

Journal J Med Case Rep

Publisher Biomed Central

Specialty General Medicine

Date 2024 Feb 2

PMID 38303088

Authors

Valerie Beaud

Sonia Crottaz-Herbette

Vincent Dunet

Jean-Francois Knebel

Pierre-Alexandre Bart

Stephanie Clarke

Affiliations

Soon will be listed here.

Abstract

Background: Population-wide surveys and large-scale investigations highlighted the presence of cognitive deficits in the acute and postacute stages of severe COVID-19; a few studies documented their occurrence in cases without prior or COVID-19-related brain damage. The evolution of cognitive deficits in the latter population and their relationship to the post-COVID-19 fatigue syndrome are poorly understood.

Case Presentation: We report the outcome at 12 months after severe COVID-19 involving an intensive care unit stay and mechanical ventilation in six (five Caucasian and one Asian) patients (age range: 53-71 years, mean age 61.7 ± 6.5 years) without history of prior brain dysfunction and without stroke and/or cardiac arrest during or after COVID-19. All patients reported pervading mental and physical fatigue as well as numerous multidomain complaints, which impacted everyday life. Individual patients described mental fatigability, apathy, and/or anxiety. Standardized neuropsychological tests revealed isolated symptoms of cognitive dysfunction or performance at the lower limit of the norm in the attentional, executive, and/or working memory domains in four of the six patients. Somatic scales documented dyspnoea, muscle weakness, olfactory disorder, and/or minor sleep problems in some, but not all, patients.

Conclusion: Fatigue, fatigability, multidomain complaints, cognitive difficulties, or dysfunction, as well as isolated neurobehavioral and/or psychiatric and/or somatic symptoms, tend to occur in the aftermath of severe COVID-19 and persist at 12 months, even in the absence of prior and/or COVID-19-related brain damage. This clinical situation, which impacts everyday life, calls for a detailed investigation of patients' complaints, its neural underpinning, and an elaboration of specific rehabilitation programs.

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