Severe Post-COVID-19 Condition after Mild Infection: Physical and Mental Health Eight Months Post Infection: A Cross-Sectional Study.

Severe acute COVID-19 infections requiring intensive care treatment are reported risk factors for the development of post-COVID-19 conditions. However, there are also individuals suffering from post-COVID-19 symptoms after mild infections. Therefore, we aimed to describe and compare the health status of patients who were initially not hospitalized and patients after critical illness due to COVID-19. The outcome measures included health-related quality of life (EQ-5D-5L, visual analogue scale (VAS)); mental health (hospital anxiety and depression scale (HADS)); general disability (WHODAS-12); and fatigue (Fatigue-Severity-Scale-7). Individuals were recruited at Schoen Clinic Bad Aibling, Germany. A total of 52 non-hospitalized individuals (47 ± 15 years, 64% female, median 214 days post-infection) and 75 hospitalized individuals (61 ± 12 years, 29% female, 235 days post-infection) were analyzed. The non-hospitalized individuals had more fatigue (87%) and anxiety (69%) and a decreased health-related quality of life (VAS 47 ± 20) compared to the hospitalized persons (fatigue 45%, anxiety 43%, VAS 57 ± 21; p < 0.010). Severe disability was observed in one third of each group. A decreased quality of life and disability were more pronounced in the females of both groups. After adjusting for confounding, hospitalization did not predict the burden of symptoms. This indicates that persons with post-COVID-19 conditions require follow-up services and treatments, independent of the severity of the acute infection.

Mind-wandering Is Accompanied by Both Local Sleep and Enhanced Processes of Spatial Attention Allocation.

Mind-wandering (MW) is a subjective, cognitive phenomenon, in which thoughts move away from the task toward an internal train of thoughts, possibly during phases of neuronal sleep-like activity (local sleep, LS). MW decreases cortical processing of external stimuli and is assumed to decouple attention from the external world. Here, we directly tested how indicators of LS, cortical processing, and attentional selection change in a pop-out visual search task during phases of MW. Participants' brain activity was recorded using magnetoencephalography, MW was assessed via self-report using randomly interspersed probes. As expected, the performance decreased under MW. Consistent with the occurrence of LS, MW was accompanied by a decrease in high-frequency activity (HFA, 80-150 Hz) and an increase in slow wave activity (SWA, 1-6 Hz). In contrast, visual attentional selection as indexed by the N2pc component was enhanced during MW with the N2pc amplitude being directly linked to participants' performance. This observation clearly contradicts accounts of attentional decoupling that would predict a decrease in attention-related responses to external stimuli during MW. Together, our results suggest that MW occurs during phases of LS with processes of attentional target selection being upregulated, potentially to compensate for the mental distraction during MW.

Early Shift of Attention Is Not Regulated by Mind Wandering in Visual Search.

Unique to humans is the ability to report subjective awareness of a broad repertoire of external and internal events. Even when asked to focus on external information, the human's mind repeatedly wanders to task-unrelated thoughts, which limits reading comprehension or the ability to withhold automated manual responses. This led to the attentional decoupling account of mind wandering (MW). However, manual responses are not an ideal parameter to study attentional decoupling, given that during MW, the online adjustment of manual motor responses is impaired. Hence, whether early attentional mechanisms are indeed downregulated during MW or only motor responses being slowed is not clear. In contrast to manual motor responses, eye movements are considered a sensitive proxy of attentional shifts. Using a simple target detection task, we asked subjects to indicate whether a target was presented within a visual search display by pressing a button while we recorded eye movements and unpredictably asked the subjects to rate their actual level of MW. Generally, manual reaction times increased with MW, both in target absent and present trials. But importantly, even in trials with MW, subjects detected earlier a presented than an absent target. The decoupling account would predict more fixations of the target before pressing the button during MW. However, our results did not corroborate this assumption. Most importantly, subject's time to direct gaze at the target was equally fast in trials with and without MW. Our results corroborate our hypothesis that during MW early, bottom-up driven attentional processes are not decoupled but selectively manual motor responses are slowed.