Cognitive defect and covid-19

Abstract

The increasingly recognized neuroinvasive potential of the SARS-CoV-2 virus raises numerous questions regarding the possibility of neurological manifestations. In this paper our aim is to compiling, in an analytic way, information in the medical literature regarding the neurological consequences of COVID-19 in general, its effects on cognition in particular, and its impact on patients with prior cognitive impairment. The direct and indirect cognitive effects of the virus on the central nervous system (CNS), the relevance of dementia as a comorbidity and prognostic factor, and its role in therapeutic treatment escalation decision-making are explored. The cognitive adverse effects of drugs used to treat this infection and their interaction with medication often used in patients with cognitive impairment and behavioral changes are also reviewed. A reflection on the overall impact of this pandemic on the provision of health care to patients with dementia and on the conduct of clinical trials, in an era of great investment of material and human resources in research into new therapeutic modalities for neurodegenerative diseases, is also included. The evidence currently available, although scarce and not very robust, points to the fact that COVID-19 carries a greater risk of neurological compromise than previously thought, forcing it to be seen as a probable source of cognitive damage, highlighting its role as a potential etiological agent of CNS infection and cerebral vascular disease. In addition, the inevitable interference of the pandemic in the chain of care for patients with cognitive disease forces neurologists to reinvent their practice in order to mitigate the potential adverse effects on the diagnosis, treatment and monitoring of these patients.