RESUMO
Background: COVID-19 patients may experience lon-lasting symptoms from weeks to even months. Aim: To evaluate long-term cognitive impairment based on the severity of symptoms of COVID-19 infection in a primary health system setting. Material and methods: From a database of 363 patients, 83 cases aged 47 +or- 15 years, (58% females) were selected from June to August 2020. In patients who survived the virus, 24 infection-related symptoms were collected to create three severity clusters (mild, moderate, and severe). The follow-up time was at least seven months. Comparing the first two clusters with the severe cluster, the existence of brain fog and risk factors (obesity, hypertension, diabetes, chronic lung disease, and hypothyroidism) were analyzed. Results: Thirty-one patients (37%) had persistent symptoms lasting up to 240 days. Fifty-one patients (61%) experienced brain fog. Concentration was affected by symptom severity (odds ratio [OR] 3.63, 95% confidence interval [CI] 1.26-10.46, p = 0.02). Short- or long-term memory loss was not affected. Moreover, symptom severity was related to brain fog (OR 3.16, 95% CI 1.05-9.51, p = 0.04). Patients with persistent symptoms had a concentration impairment associated with severity patterns (OR 24.3, 95% CI 1.73-340.11, p = 0.03). Conclusions: Brain fog is associated with symptom severity in COVID-19 survivors and lasts for more than eight months.
RESUMO
Due to the current pandemic, the importance of health management increases, especially in the management of chronic pain syndromes and those in need in primary care periodic evaluations. In this scenario, we aim to assess the factors involved in this new interaction of Covid-19 in the various aspects that contribute to the patient with chronic pain. Essential data from global recommendations that arise based on hospital experiences that treat and support patients infected with the new coronavirus are reported. The risks of patients with previous chronic pain syndromes and comorbidities in patients with Covid-19 infection are analyzed. Medication treatments and the pathophysiological pathways involved are discussed, as well as factors that could put the patient at risk of developing or maintaining chronic pain syndrome after hospitalization with Covid-19. Additionally, ways of rehabilitation using telemedicine were illustrated. Chronic pain causes a significant increase in suffering for patients with Covid-19, therefore, logistical strategies and identification of risk factors for these patients are useful, containing a global assessment of associated comorbidities, in maintaining or including appropriate therapy. The use of telemedicine provides a way to alleviate acute health resource needs, as well as to monitor psychological aspects and post-event trauma associated with chronic pain. The policies to be adopted must be adapted to each location for good management of resources and good rehabilitation after the event. © 2020 Academia Nacional de Medicina. All rights reserved.