New research at Danderyd Hospital: Long-term consequences after moderate coronavirus infection

New research shows that cognitive functions are affected long after mild to moderate COVID-19 infection, and can lead to long-term consequences on patients' social and professional lives. Despite the fact that COVID-19 has been around for several years, there is no evidence on which type of rehabilitation is most appropriate.

Post-Covid Cognitive Reception at Danderyd Hospital sees patients with long-term cognitive symptoms and fatigue after coronavirus infection. Patients with persistent symptoms undergo a comprehensive neuropsychological examination. But it has not yet been confirmed whether mild infection with COVID-19 can cause cognitive impairment or whether there are other underlying causes of the problems.

In a first research study conducted in 2020, where patients were treated in hospitals and intensive care, it was found that weak cognitive functions lasted much longer than motor functions. The decrease may be due to the harsh intensive care to which patients were exposed. In a second study from 2023, we also showed the same results in Covid patients who were mildly ill and were not being cared for in hospital, which means it is a direct effect of the virus, says Christian Borg, chief physician and professor at Karolinska Institutet Department of Clinical Sciences, Hospital. Dandreads.

Decreased cognitive outcomes after infection with the Coronavirus
Many of the patients referred to the clinic had no pre-existing illnesses, worked in responsible and knowledgeable jobs, and had extensive education.
– Cognitive test results were much lower than expected. At the group level, memory, attention, and processing speed were tested, functions that are basic requirements for a well-functioning work life. The study also shows that there is great variation in the impact of disabilities on the individual – which for the person concerned has significant consequences in social life, and not least in professional life. Some individuals have memory problems while others have significant processing speed problems and great difficulty learning new things. It can be concluded that they cannot cope with work at the level they were before, says Marika Müller, Neuropsychologist and Associate Professor at Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.

Team-based multimodal rehabilitation assessment
– Currently, there is no evidence on which type of rehabilitation is most appropriate. Until several therapeutic studies are published, we must, according to the recommendations of the World Health Organization, rely on rehabilitation methods used in other fields. For some patients, a neuropsychological examination with psychological support may be enough for them to understand their problems and be able to adapt to work and daily life to help them function. For others, rehabilitation efforts by an entire team of doctors, psychologists, occupational therapists, physical therapists, and counselors may be needed until the patient progresses. This is where a holistic perspective is important, which is the cornerstone of rehabilitation. There is a study currently underway where we are evaluating the effects of team-based multimodal rehabilitation,” says Christian Borg, Chief Physician and Professor at Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital.

Links to research articles in the University Clinic of Rehabilitation Medicine.

Archives of Rehabilitation and Clinical Translation Research.https://www.sciencedirect.com/science/article/pii/S2590109523000563)

Journal of Internal Medicine. https://onlinelibrary.wiley.com/doi/10.1111/joim.13720