With such a novel virus, little research has thus been compiled to fully understand the long term negative effects on neuropsychological functioning. While it is suspected that long-term physical implications may persist after recovering from COVID-19, it is yet unclear what kind of persisting issues may remain cognitively and psychologically. This article review aimed to investigate possible implications for the current COVID-19 pandemic by examining a 2020 article by Rabinovitz, Jaywant, & Fridman in which researchers explored existing literature on similar coronaviruses and the effects of undergoing long-term treatment in an intensive care unit (ICU).
Previous strains of the coronavirus such as SARS-CoV and MERS-CoV are thought to have had neuro-invasive and neuro-virulent properties and the ability to cause central nervous system impairments through several possible mechanisms such as; hypoxia-mediated injury, brain barrier disruption, inducing a pro-inflammatory state, neuronal degeneration, edema, seizure development, altered consciousness, infection of the cerebrospinal fluid, encephalitis, motor deficits, meningitis, ataxia, hyper-intensities within brain structures, and possible potential to impact the function of glial cells. Other implications for psychiatric related symptoms included that of increased depressed mood, delirium, anxiety, and insomnia (Rabinovitz, Jaywant, & Fridman, 2020).
Similarly, for individuals who have been in the ICU for extended periods of time, discharge does not always mean dissipation of symptoms. A recent study on the novel COVID-19 found that 58/64 patients who were admitted to the ICU and had been discharged after recovering, showed executive functioning difficulties in areas of attention, orientation, and command organization (Rabinovitz, Jaywant, & Fridman, 2020). Another study also showed that 33% of individuals who were discharged experienced difficulties with similar cognitive functioning symptoms and added that in some patients symptoms may largely go away after a year, yet for many the weaknesses in memory, processing speed, attention, and executive functioning can likely persist and they may never return to baseline functioning (Rabinovitz, Jaywant, & Fridman, 2020).
Because most research has been compiled through case studies or small sample sizes, it is difficult to ascertain whether any, many, or several of these neurocognitive impairments may take place for any given individual. However, it is important to note that it is entirely possible but largely unknown due to the novelty of the virus, as this disallows for long-term longitudinal research to have been completed due to its ongoing nature. To help the situation, neuropsychologists are encouraged to examine patients, perform cognitive screenings, and gather information while hospitalized with COVID-19 and following discharge, both immediately and longitudinally, to better understand the long-term implications of coronavirus strains. Neuropsychologists can also be helpful in providing brief psychotherapeutic interventions and psychoeducation regarding the possible/probable deficits that have been observed. As such, the teamwork of an interdisciplinary network is said to yield the best results and for this reason, an increased involvement in treatment on behalf of the neuropsychologist is certainly suggested.
Rabinovitz, B., Jaywant, A., & Fridman, C. B. (2020). Neuropsychological functioning in severe acute respiratory disorders caused by the coronavirus: Implications for the current COVID-19 pandemic. The Clinical Neuropsychologist, 1-27. doi:10.1080/13854046.2020.1803408
Monica Babaian, MA
WKPIC Doctoral Intern