SARS-CoV-2 infection and cognitive impairment in older adults at a family medicine unit in Mexico

Introduction: It has been documented that SARS-CoV-2 infection can cause alterations in brain function, although the specific neurocognitive sequelae are not yet fully understood. Mechanisms involved include inflammation mediated by proinflammatory cytokines such as IL-4 and IL-6, generation of autoantibodies and an abnormal TH2-mediated immune response. In addition, other mechanisms such as reactivation of latent viruses, direct viral invasion into the central nervous system, disruption of the blood-brain barrier, hypercoagulation and the presence of microhaemorrhages have been proposed, all of which may contribute to the pathophysiology of neurological damage. General objective: To determine the association between cognitive impairment and SARS-CoV-2 infection in mild post-COVID 19 older adults in the Family Medicine Unit No. 64 of the “Instituto Mexicano del Seguro Social” (Mexican Institute of Social Security (IMSS, for its acronym in Spanish)). Material and methods: A cross-sectional and analytical study in older adults aged 60-65 years old with confirmed SARS-CoV-2 infection by rapid antigen test was carried out. Sixty-four subjects per group were included and selected by non-probabilistic convenience sampling. The association between infection and cognitive impairment was analysed with Pearson’s chi-squared test, and multiple binary logistic regression was applied to control confounding factors. Results: Out of a total of 128 subjects, 93.8% of participants were cognitively impaired. Of these, 59.6% had comorbidities, with systemic arterial hypertension being the most prevalent. In the multivariate analysis, SARS-CoV-2 infection was associated with cognitive impairment with an OR of 6.86 [95% CI p<0.05]. In contrast, T2D has an [OR 1.36 (95% CI) p .53], SAH (OR 1.25, 95% CI, p .651) and obesity (OR 1.14, 95% CI, p .810). Conclusion: Cognitive impairment in older adults has been associated with SARS-CoV-2 positivity, highlighting the importance of neurocognitive assessment at the primary care level in Mexico.