Neuropsychological post-COVID syndrome

# Following severe, moderate or mild infection

About the TRAJECTORY project

The COVID-19 infection, even in its mild or moderate respiratory forms, can lead to neuropsychological deficits. The COVID-COG project (NRP 78 2020-2023, n°: 4078P0_198438) was implemented during the first wave of the COVID pandemic, in response to the questioning at the time concerning the impact that an infection could have on neuropsychological abilities. The original project featured an exhaustive neuropsychological evaluation, as well as MRI, olfactory and neurological assessments, administered 6-9 months and 12-15 months post infection, which allowed our research team to confirm the presence of cognitive dicturbances in the short-term following SARS-CoV-2 infection. These results have since been reinforced by numerous other studies worldwide, revealing that 6 months post-infection, 35.4% of people still display cognitive impairment, and 53% have chronic fatigue, referring to this syndrome as the post-COVID condition. While several hypotheses have been put forward to explain the persistence of these neurocognitive symptoms, many questions remain unanswered, notably the evolution of these impairments in the long-term. As a follow-up to the COVID-COG project, the ongoing TREJECTORY project (SNSF ​​2023-2027, n°: 220041) aims to track the longitudinal evolution of patients 3 and 5 years after the acute phase of COVID-19.

Our projects are realized in collaboration with eight departments of the University Hospitals of Geneva, the Leenaards Memory Centre at the Lausanne University Hospital and the Ecole Polytechnique Fédérale de Lausanne. 

 
Collaborators

Frédéric Assal (Co-PI)
Neurology Department, Geneva University Hospitals, Switzerland
Faculty of Medicine, University of Geneva, Switzerland

Dan Adler
Division of Pulmonary Diseases, Geneva University Hospitals, Switzerland

Gilles Allali
Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

Lamyae Benzakour
Faculty of Medicine, University of Geneva, Switzerland
Psychiatry Department, Geneva University Hospitals, Switzerland

Olivia Braillard
Division and Department of Primary Care Medicine, Geneva University Hospitals, Switzerland

Gautier Breville
Neurology Department, Geneva University Hospitals, Switzerland
Faculty of Medicine, University of Geneva, Switzerland

Matteo Coen
Faculty of Medicine, University of Geneva, Switzerland
Internal Medicine Department, Geneva University Hospitals, Switzerland

Alessandra Griffa
Faculty of Medicine, University of Geneva, Switzerland
Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland

Idris Guessous
Faculty of Medicine, University of Geneva, Switzerland
Division and Department of Primary Care Medicine, Geneva University Hospitals, Switzerland

Patrice H. Lalive
Neurology Department, Geneva University Hospitals, Switzerland
Faculty of Medicine, University of Geneva, Switzerland

Basile N. Landis
Faculty of Medicine, University of Geneva, Switzerland
Rhinology-Olfactology Unit, Otorhinolaryngology Department, Geneva University Hospitals, Switzerland

Karl-Olof Lövblad
Faculty of Medicine, University of Geneva, Switzerland
Diagnostic and Interventional Neuroradiology Department, Geneva University Hospitals, Switzerland

Mayssam Nehme
Division and Department of Primary Care Medicine, Geneva University Hospitals, Switzerland

Radek Ptak
Faculty of Medicine, University of Geneva, Switzerland
Neurorehabilitation Department, Geneva University Hospitals, 1205 Geneva, Switzerland

Jérôme Pugin
Faculty of Medicine, University of Geneva, Switzerland
Intensive Care Department, Geneva University Hospitals, Switzerland

Jean-Luc Reny
Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals and Geneva University, Switzerland

Jacques Serratrice
Faculty of Medicine, University of Geneva, Switzerland
Internal Medicine Department, Geneva University Hospitals, Switzerland

Dimitri Van De Ville
Faculty of Medicine, University of Geneva, Switzerland
Institute of Bioengineering, Center for Neuroprosthetics, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland

 

Funding

Swiss National Science Foundation, UNIGE
"Longitudinal evolution of cognitive functions following SARS-CoV-2 infection: factors of chronicization" ​​(2023-2027)
Grant N°: 220041

Swiss National Science Foundation, UNIGE
"Short and long-term neuropsychological impairment following COVID-19"
NRP 78 "Covid-19" – 2020 - 2023
Grant N°: 4078P0_198438

 

Post-Covid Recommendations

The newest recommendations from the Swiss Federal Office of Public Health (FOPH) for primary care physicians regarding the diagnostic and treatment of the post-COVID-19 condition can be found on the Altea (FOPH) and RAFAEL (HUG) platforms.

Publications overview:

  • Nuber-Champier, A., Breville, G., Voruz, P., Jacot de Alcântara, I. J., Cionca, A., Allali, G., Lalive, P.H., Benzakour, L., Lövblad, K.-O., Braillard, O., Nehme, M., Coen, M., Serratrice, J., Reny, J.-L, Pugin, J., Guessous, I., Landis, B.N., Assal F., & Péron, J. A. (accepted). Systemic cytokines related to cognitive function 6-9 months and 12-15 months after SARS-CoV-2 infection. Scientific Reports.
  • Voruz, P., Jacot de Alcântara, I., Nuber-Champier, A., Cionca, A., Guérin, D., Allali, G., Benzakour, L., Lalive, L., Lövblad, K.-O., Braillard, O., Nencha, U., Nehme, M., Coen, M., Serratrice, J., Reny, J.-L., Pugin, J., Guessous, I., Landis, BN, Assal , F. and Peron, J. (2024). Persistence and emergence of new neuropsychological deficits following SARS-CoV-2 infection: a follow-up evaluation of the Geneva COVID-COG cohort. Journal of Global Health.14.
  • Thomasson†, M., Voruz†, P., Cionca, A., Jacot de Alcântara, I., Nuber-Champier, A., Allali, G., Benzakour, L., Lalive, P., Lövblad, K. -O., Braillard, O., Nehme, M., Coen, M., Serratrice, J., Reny, J.-L., Pugin, J., Guessous, I., Landis, BN, Griffa, A. , Van De Ville, D., Assal F. and Péron, JA (2023). Markers of limbic system damage following SARS-CoV-2 infection. Brain Communications. † These authors participated equally in this work.
  • Nuber-Champier, A., Cionca, A., Breville, G., Voruz, P., Jacot de Alcântara, I., Allali, G., Lalive, PH, Benzakour, L., Lövblad, K.-O. Braillard, O., Nehme, M., Coen, M., Serratrice, J., Reny, J.-L, Pugin, J., Guessous, I., Landis, BN, Griffa, A., Van De Ville , D., Assal, F., & Péron, JA (2023). Acute TNFα levels predict cognitive impairment 6-9 months after COVID-19 infection. Psychoneuroendocrinology, 153 , 106104.
  • Nuber-Champier, A., Voruz, P., Cionca, A., De Alcântara, IJ, Péron, JA and Assal, F. (2023). Covid long: neurological aspects. Revue Médicale Suisse, 19 (827), 972-974.
  • Voruz, P., Jacot De Alcântara, I., Cionca, A., Nuber-Champier, A., Assal, F. and Peron, JA (2023). Post-COVID-19 neuropsychological syndrome. Revue Médicale Suisse, 19 (824), 800-802.
  • Voruz, P., Assal, F. and Péron, JA (2023). The economic burden of post-COVID-19 illness: underestimated long-term consequences of neuropsychological deficits. Journal of Global Health, 13 .
  • Jacot de Alcântara †, I., Nuber-Champier †, A., Voruz, P. ; Cionca, A., Assal, F., Péron, JA (2023). Cognitive deficits during the acute phase of COVID-19: a review and meta-analysis. Journal of Clinical Medicine , 12(762). https://doi.org/10.3390/ jcm12030762. † These authors participated equally in this work.
  • Nuber-Champier, A., Voruz, P., Jacot de Alcantara, I., Breville, G., Allali, G., Lalive, P., Assal, F., Péron, J. (2022). Monocytosis in the acute phase of SARS-CoV-2 infection predicts the presence of anosognosia for cognitive deficits in the chronic phase. Brain, Behavior, & Immunity-Health, 26, 100511.
  • Voruz, P., Cionca, A., Jacot de Alcântara, I., Nuber‐Champier, A., Allali, G., Benzakour, L., ... & Péron, J. A. (2022). Brain functional connectivity alterations associated with neuropsychological performance 6–9 months following SARS‐CoV‐2 infection. Human Brain Mapping.
  • Voruz, P., Jacot de Alcântara, I., Nuber-Champier, A., Cionca, A., Allali, G.,  Benzakour, L., Lalive, P., Lövblad, K.O., Braillard, O., Nehme, M.,  Coen, M., Serratrice, J., Reny, JL., Pugin, J., Guessous, I., Ptak, R., Landis, BN.,Assal, F., & Péron, J.A. (2022). Frequency of Abnormally Low Neuropsychological Scores in Post-COVID-19 Syndrome: the Geneva COVID-COG Cohort, Archives of Clinical Neuropsychology.
  • Voruz, P., Allali, G., Benzakour, L., Nuber-Champier, A., Thomasson, M., Jacot, I., Pierce, J., Lalive, P., Lövblad, K.O., Braillard, O., Coen, M., Serratrice, J., Pugin, J., Ptak, R., Guessous, I., Landis, B., Assal, F., & Péron, J. (2022). Long COVID neuropsychological deficits after severe, moderate or mild infection. Clinical and Translational Neuroscience, 6 (2): 9. https://doi.org/10.3390/ctn6020009.
  • Voruz, P., Cionca, A. Jacot de Alcântara, I., Nuber-Champier, A., Allali, G., Benzakour, L., Thomasson, M., Lalive, P., Lövblad, KO., Braillard, O., Nehme, M., Coen, M., Serratrice, Pugin, J., Guessous, I., Landis, BN., Adler, D. Griffa, A., Van De Ville, D, Assal, F., & Péron, J. (2022). Functional connectivity underlying cognitive and psychiatric symptoms in post-COVID syndrome: Is anosognosia a key determinant? Brain Communications, 9;4(2):fcac057. doi: 10.1093/braincomms/fcac057. Video abstract.
  • Voruz, P., Assal, F., Péron, J. (2021). L’infection au SARS-CoV-2 entraîne des troubles neuropsychologiques à court et long termes : état des lieux et observations cliniques [SARS-CoV-2 infection leads to short- and long-term neuropsychological disorders: Current situation and clinical observations], Revue de neuropsychologie, (13), p. 96-98.
  • Benzakour, L., Assal, F., & Péron, J. (2021). Covid long neuropsychologique : origine neurologique ou psychiatrique ? [Neuropsychological long-COVID : neurologic or psychiatric origin?]. Revue Médicale Suisse. 28;17(736):822-826.
  • Voruz, P., Assal, F. & Péron, J. (2020). L’infection au SARS-CoV-2 entraîne-t-elle des troubles neuropsychologiques ? [Are there any neuropsychological sequelae of COVID-19?]. Revue de Neuropsychologie, 12 (2) : 187-90.