Risk factors for the development and characteristics of cognitive dysfunction in patients with a history of COVID-19 infection

Background. Regardless of the severity of COVID-19 and the duration of the post-COVID period, patients continue to complain of cognitive dysfunction, the onset of which coincided with the active phase of the infection. Objective. To study the risk factors for cognitive dysfunction and the characteristics of cognitive impairment in patients who have had COVID-19. Materials and Methods. A comprehensive examination of 48 patients (8 men and 40 women) with nonpsychotic mental disorders in the form of cognitive dysfunction and asthenic disorders diagnosed in the post-COVID period was conducted at the First Clinical Psychiatric Unit of the Mental Health Research Institute of the Tomsk Nation-al Research Medical Center. The following methods were used: clinical-psychopathological, physical, psychological, clinical-laboratory, instrumental, and statistical. To determine cognitive resources, the following tests were used: Schulte tables, the Method of memorizing 10 words according to A.R. Luria. State anxiety was assessed using the Spielberger-Khanin State Anxiety Assessment Method. Results. A feature of the psychodiagnostic examination of patients was the presence of more than two comorbidities of internal organs and other pathological conditions, i.e., polymorbidity, which is an unfavorable background for overcoming a viral infection. In 68.75% of patients, COVID-19 was mild, but a de-crease in cognitive functioning remained. Regardless of the severity of COVID-19, patients did not differ significantly in age, polymorbidity index, level of state anxiety, the results of the methods performed to assess cognitive functions (at-tention, memory). At the time of the examination, patients had difficulty concentrating on the meaning of a task for a long time, could keep a limited number row in memory, without noticing or correcting errors. Work efficiency, degree of warming-up and mental stability; “exhaustion curve” and “memory curve” were analyzed as well as the relationship between cognitive functioning indices and state anxiety. The lowest cognitive resource was noted in the group of men suffering from heart rhythm disorders and chronic obstructive pulmonary disease. Women with hypothyroidism showed good ability to work on tasks, but reduced resistance to stress during task completion. Direct correlations were found be-tween the state anxiety indicator after treatment and the time required to complete the task when working with Schulte tables (R=0.310, p=0.031875 – Table 3; R=0.350, p=0.014573 – Table 5). Conclusion. Analysis of risk factors for the development of cognitive impairment showed that in the presence of high polymorbidity indices, individual conditions and diseases cause statistically significant differences compared to their absence, affecting the mental health and performance of patients with cerebral disorders exhibiting cognitive dysfunction. The diversity and ambiguity of the revealed relationships require a differentiated approach to diagnosis and therapeutic tactics in the management of patients with complaints of cognitive dysfunction in the structure of organic nonpsychotic disorders with polymorbid somatic pathology.