Treatment Outcomes in PASC Patients With Neurocognitive Impairment

Specific Aims:

1. Characterize pre-treatment quality of life and cognitive performance data for patients with Post-Acute Sequelae of COVID19 (PASC) and neurocognitive symptoms (PASC/NCS) seen at The Ohio State University Medical Center (OSUMC)
2. Describe treatment strategies deployed for these patients at the above institution.
3. Compare post-treatment quality of life and cognitive outcomes to pre-treatment values for these patients.

Significance and Impact:

Since the beginning of the epidemic, there have been 79 million COVID19 cases in the United States, and 480 million globally1. COVID19 survivors can suffer substantial long-term morbidity. Post-Acute Sequelae of COVID19 (PASC) is defined as persistent symptoms occurring weeks to months after infection with SARS-CoV-22. PASC is a multisystem disease with respiratory, cardiac, neurological, rheumatologic and other manifestations. In population-based studies, about 25% of patients report not having fully recovered 6-8 months after documented SARS-CoV-2 infection3. PASC is estimated to affect as many 17 million people worldwide4.

Neurocognitive symptoms in the setting of PASC (PASC/NCS) are seen 6 months after infection in 12-22% of COVID19 survivors5-8. They are associated with hypometabolism in brain areas controlling memory and executive function on brain imaging, and with atrophy in corresponding brain areas on post-mortem studies9-11. PASC/NCS has a significant impact on quality of life and functional ability, with 63% of affected patients reporting decreased quality of life12, and nearly half of previously employed patients unable to return to full-time work after 6 months13,14. Evidence suggests similar cellular mechanisms and patterns of neural injury between PASC/NCS and traumatic brain injury15-17.