Future Research on the Pathogenesis of COVID-19, Cognitive Changes: Joanna Hellmuth, MD, MS

The cognitive neurologist at the University of California San Francisco discussed the need to continue research on why patients develop cognitive changes following COVID-19 infection and how clinicians can care for them. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

"There’s a strong likelihood that this is a neurologic condition. For some people, it might be a manifestation of stress or anxiety, or other factors. But when all of those have been ruled out, or even if they have stress or anxiety because they have cognitive disorders, we need to tell patients that we don’t know what this is but that we’re working on it. We will be there by your side, working with you to try to understand this. We need to not do more damage in this pandemic."

Since the beginning of the COVID-19 pandemic, scientists across the globe have uncovered a plethora of material regarding the virus’s impact, who may be most at-risk, and the lingering symptoms associated with it. Although there has been a progressive effort to understand more about the pathophysiology of the infection, there remains a great deal of concern for its long-term effects, mainly its role in cognitive decline and other neurodegenerative disorders such as Alzheimer disease.

Patients with even the mildest cases have reported cognitive changes in the months following their infection. Previous research of these after-effects has shown weaknesses in attention and working memory, suggesting involvement of frontostriatal and/or frontoparietal brain networks. It is unclear why some adults develop cognitive post-acute sequelae (PASC) after COVID-19 infection while others do not.

Research by Joanna Hellmuth, MD, MS, et al used rigorous structured interviews, neuropsychological testing, and optional cerebrospinal fluid evaluations to further characterize the changes seen by patients and highlight possible risk factors of which patients should be aware.1 Hellmuth, a cognitive neurologist at the University of California, San Francisco, sat down with NeurologyLive® to discuss the most crucial aspects of COVID-19 worth researching at this stage in the pandemic. She stressed the importance of developing more objective data to “feed” clinicians so that they can feel more empowered to legitimize their patient’s condition.

1. Apple AC, Oddi A, Peluso MJ, et al. Risk factors and abnormal cerebrospinal fluid associate with cognitive symptoms after mild COVID-19. Ann Clin Transl Neurol. Published online January 19, 2022. doi:10.1002/can3.51498