Understanding Cognitive Post-Acute Sequelae of COVID-19: Joanna Hellmuth, MD, MHS


The cognitive neurologist at the University of California San Francisco provided insight on how she’s taken a cognitive neurology approach to the COVID-19 pandemic, and how her background in HIV influenced her recent research. [WATCH TIME: 5 minutes]

WATCH TIME: 5 minutes

"To me, this was an opportunity to try to understand virally associated cognitive disorders in a way that we haven’t before. This is not really a recognized discipline within neurology at the moment. It falls between the fields of infectious disease and cognitive neurology and neither have taken it on."

New and persistent cognitive symptoms are a common post-acute sequelae (PASC) of SARS-CoV-2 infection and can follow severe disease or mild illness; however, it is unclear why some adults develop cognitive PASC after infection while others do not. A recently published study evaluated the clinical features associated with cognitive PASC in an effort to help inform groups who may be at greater risk and highlight possible underlying mechanisms.

A cohort of 22 adults reporting cognitive PASC and 10 not reporting cognitive symptoms after mild SARS-CoV-2 infection underwent neuropsychological testing, structured interviews, and optional cerebrospinal fluid (CSF) evaluations. Among those with cognitive PASC, 43% reported a delayed onset of cognitive symptoms starting 1 or more month after first COVID-19 symptom. Additionally, these patients reported a higher number of pre-existing cognitive risk factors (2.5 vs 0; P = .03) and a higher proportion with abnormal CSF findings (77% vs 0%; P = .01) versus controls.

Senior author, Joanna Hellmuth, MD, MS, claims her background in researching HIV-associated neurocognitive disorder, a virally associated disorder that happens in about a third of people living with HIV, had major influence on her interest in this topic. Hellmuth, cognitive neurologist, University of California San Francisco, claims the cognitive changes seen from that disease are eerily similar to that of COVID-19-infected individuals.

In an interview with NeurologyLive®, she detailed the reasons for conducting the study, the need to continue to evaluate virally associated cognitive disorders, and the importance of detailed, clinical characterizations of patients and their neurological history, which in turn may lead to understanding more about the pathogenesis of COVID-19.

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