Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 11, 2020
Date Accepted: May 16, 2021
Date Submitted to PubMed: May 19, 2021
A 5-Minute Cognitive Assessment For Remote Safety Use In COVID-19 Patients: Clinical Case Series
ABSTRACT
Background:
Background:
Early experience with the COVID-19 Pandemic has begun to elucidate brain function changes that may result in compromised cognition both acutely and during variable recovery periods. Reported cognitive assessment is often limited to orientation alone. Further assessment may seem an inappropriate burden in acute COVID-19 cases characterized by fatigue and confusion as well as examiner safety.
Objective:
Objective:
To assess cognition in COVID-19 cases as comprehensively as possible in a brief format, all while observing safety; and to establish clear-face value of its external validity.
Methods:
Method: We adapted a brief cognitive assessment, previously applied to liver transplant candidates and medical/surgical inpatients, for remote use in patients hospitalized for COVID-19 treatment. Collecting quality assurance data from telephone-administered assessments, this report presents a series of six COVID-19 case vignettes to illustrate the 5-Minute Assessment use in diagnosis and treatment of brain effects. Primary medical teams referred the cases for neuropsychiatric consultation.
Results:
Results:
Varying over four decades in age, none were able to engage meaningfully with their surroundings on admission. On follow-up exam 6 to 10 days later, four of the six had recovered Working Memory, and only one had recovered calculation ability. Two were capable of complex Judgment responses while none of the cases completed frontal executive function testing in the normal range.
Conclusions:
Conclusions:
Cognitive assessment in COVID-19 cases, using this remote examination, reveals patterns of cognitive recovery that vary among cases and are far more complex than loss of orientation. In this series, testing specific temporal, parietal, and three frontal lobe functions suggests that calculation ability, judgment, and especially frontal executive functions, may characterize COVID-19 brain effects. Used widely, and serially, this exam method can potentially inform our understanding of COVID-19 brain effects with healing from the virus. Clinical Trial: N/a
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