Please enable JavaScript.

Coggle requires JavaScript to display documents.

Long Covid CI vs CRCI - Coggle Diagram

- - - - consistent anecdotal evidence of problems with attention and memory post covid
    - - Not much known about range of symptoms or illness trajectory. Majority of research centres around fatal or sever illness - to minimise mortality
      - Patient driven research largely from Body Politik online support group. Online survey investigating symptoms and trajectory. 3762 ppts. 56 countries
      - most frequent symptoms reported after month 6 were: fatigue (77.7%), post-exertional malaise (72.2%), and cognitive dysfunction (55.4%,
      - most common symptoms : poor attention or concentration 74.8% difficulty thinking 64.9%, difficulty with executive functioning (planning, organizing), 57.6% , difficulty problem-solving or decision-making 54.1% and slowed thoughts (49.1%,
      - Relapse triggers: : worsening symptoms, physical exertion, stress, mental activity
      - 55.5% still had cog dysfunction at month 7
      - clusters of symptoms that persist longest include a combination of the neurological/cognitive and systemic symptom
      - Prolonged symptoms were most likely to be reported as “moderate”
    - - (ncreasing evidence that COVID-19 can damage the brain (1, 2, 4, 8-12).
        include ischaemic stroke, encephalopathy, encephalitis, and peripheral neurological disorders (2,4 8
        cambridge cognition)
      - estimated 30% of patients with neurological symptoms are also thought to suffer from impaired cognition, with deficits reported in attention, executive function, short term memory, and psychomotor processing (1,3, 9, 10). cambridge cogntiion
        
        some researchers have predicted that some COVID-19 survivors will experience long-term cognitive dysfunction and decline, creating a “secondary pandemic of neurological disease” (3, 5).
        
        Preliminary data suggests that recovered COVID-19 patients experiencing fatigue 2-3 months after disease onset also had deficits in executive function and visuospatial processing (6). Impairments in cognitive communication and attention have also been reported in COVID-19 survivors (10, 13).
  - - - sequelae of COVID-19, or ‘long COVID’, also include serious long-term mental and cognitive changes, inc. ‘brain fog. Stafano et al. 2021
- - - - In addition to neurological effects of COVID-19 on cognition, there is some evidence that poor mental health in COVID-19 survivors may contribute to cognitive impairment. Between one quarter and one third of survivors of the SARS and MERS epidemics, caused by similar viruses to COVID-19, reported symptoms of anxiety, depression, or post-traumatic stress disorder for up to 5 years after acute ICU admission (13) cambridge cogntion
  - - - possible that SARS-CoV-2 can directly impair mitochondrial energy metabolism via targeted action on oxygen availability and utilization.
        Stefano
      - The brain is especially vulnerable to hypoxia because cognitive neural processes adjust poorly to hypoxic conditions Stefano
      - Hypoxia is also pro-inflammatory
      - Therefore, as the viral load increases, cognitive impairment and confusion increase, a condition known as ‘brain fog’ Stefano
      - reported that several neurological disorders can be initiated by chronic inflammation [26,27] Stefano
      - Finland autopsy study also found a key cause of brain damage is lack of oxygen – even though several of those who died had not evidence of oxygen deprivation during COVID infection. harvard article
  - - - These mechanically ventilated patients experi- enced prolonged periods of ‘iatrogenic hypoxaemia’, as it is common to maintain PaO2 values as low as 55 mm Hg (7.3 kPa) or SaO2 concentrations as low as 88% in ARDS management.28 Ventilated patients were commonly agitated and required pro- longed sedation with multiple agents to prevent self or staff harm.
      - delirium, are common in hospitalised COVID-19 patients:Delirium itself is associated with subsequent cognitive decline,26 and is a common occur- rence in ICU patients, as observed in ARDS.2
- - - - majority of participants had struggled to access necessary services, often being refered from NHS111 (designed for acute Covid-19) to GPs for long term management, but were then referred bacl to NHS111. They suggested a missing support network to help patients self-manage long-covid. Ladds et al.
  - - - manifests in reduced quality of life and impaired ability to perform activities of daily living (ADLs) and instrumental ADLs (IADLs)
      - often undiagnosed
- - - - may benefit our cumulative research efforts to
        consider the long-term effects of COVID-19 in alignment with anaes- thesia and surgery, which are known precipitants of inflammation-related cognitive and functional decline.
      - Vast body of literature addressing perioperative neurocognitive disor- ders, which have a similar inflammatory component, may facilitate advances in strategies for both, and other neurolog- ical injuries, in a relatively short timeframe.