Changes in cognitive impairment after multidimentional rehabilitation in Neuro COVID severe respiratory failure patients

Background

A Post Intensive Care Syndrome Unit (PICSU) was developed during COVID 19 pandemic. The aim of this study was to evaluate Cognitive Impairment (CI) evolution after PICSU treatment in Neuro COVID patients.

Methods

Prospective observational study. Population: Neuro COVID patients treated in a PICSU. CI was achieved by means of the Spanish version of the MoCA at ICU discharge and one month after, muscle function was evaluated by means of Medical Research Council test for Intensive Care Acquired Weakness (ICUAW). Statistical analysis was performed by ANOVA and Chi squared test. Age, sex, comorbidities, mechanical ventilation days and length of stay at the PICSU wre also measured.

Patients were submitted to an intensive rehabilitation program that included physical, swallowing, speech therapy, occupational therapy ones, as well as nutritional and psychological support.

Results

27 patients were admitted to PICSU, 5 were female, average age was 57 yo. 30% of them presented normal cognition. Regarding CI patients mean initial MoCA value was 18 and improved to 23 (p < 0.05), MRC values were 42 y 52 respectively (p < 0.05). According MoCA values using a cutoff point of 26 to determinate normal cognition, 16 to 25 for MCI and 15 for Mild Dementia, 26% had MCI and 74% at ICU discharge that evolved to normal (26%), MCI (58%) and MD (16%) (p < 0.05). There was a close relationship between MoCA and MCR enhancement, CI and ICUAW improved simultaneously (p < 0.05).

Conclusion

PICSU rehabilitation program was useful for cognition and motor function improvement. The close relationship between cognition and motor function could be explained by the myokines and neurotrophic factors release toward muscle activity. This could be an opportunity for future research.