key: cord-0296411-22q7tngp authors: Hall, P. A.; Meng, G.; Hudson, A.; Sakib, M. N.; Hitchman, S. C.; Fong, G. T. title: Executive dysfunction following SARS-CoV-2 infection: A cross-sectional examination in a population-representative sample date: 2022-01-02 journal: nan DOI: 10.1101/2022.01.01.22268614 sha: da770951db27b04cb078f504d185dbb49d896ac8 doc_id: 296411 cord_uid: 22q7tngp Objective: To determine whether SRS-CoV-2 infection and COVID-19 symptom severity are associated with executive dysfunction among members of the general population, including those not hospitalized or exposed to intubation. Design: Cross-sectional observation study with data from an ongoing national cohort study of young and middle-aged adults. The Canadian COVID-19 Experiences Survey (CCES) involves 1,958 adults with equal representation of vaccinated and vaccine hesitant adults between the ages of 18 and 54 years. Setting: Population-based survey of community dwelling adults, representative of the broader Canadian population. Participants: Men and women between 18 and 54 years of age from English and French speaking provinces. The sample comprised 1,958 adults with a mean age of 37 years (SD=10.4); 60.8% were female. Exposures: SARS-CoV-2 infection with COVID-19 symptoms of any severity, ranging from negligeable to life-threatening infection requiring hospitalization. Primary Outcome: Symptoms of cognitive dysfunction assessed via an abbreviated form of the Barkley Deficits in Executive Functioning Scale (BDEFS). Results: Those who reported a prior SARS-CoV-2 infection regardless of COVID-19 symptom severity (Madj=1.89, SE=0.08, CI: 1.74, 2.04; n=175) reported a significantly higher number of symptoms of executive dysfunction than their non-infected counterparts (Madj=1.63, SE=0.08, CI: 1.47,1.80; n=1,599; {beta}=0.26, p=.001). Among those infected, there was a dose-response relationship between COVID-19 symptom severity and level of executive dysfunction, with moderate ({beta}=0.23, CI: 0.003-0.46) and very/extremely severe ({beta}= 0.69, CI: 0.22-1.16) COVID-19 symptoms being associated with significantly greater dysfunction. These effects remained reliable and of similar magnitude after removing those who had been received intubation. Conclusions: Positive SARS-CoV-2 infection history and COVID-19 symptom severity are associated with executive dysfunction among young and middle-aged adults with no history of medically induced coma. Cognitive dysfunction is one of the potential adverse consequences of SARS-CoV-2 46 infection. It is understood that SARS-CoV-2 could impact the brain through a number of 47 non-exclusive, indirect mechanisms including hypoxia, thrombosis, coagulopathy, 48 cytokine storm, and megakaryocyte invasion [1] [2] [3] [4] [5] [6] .Studies of hospitalized patients have 49 revealed cognitive deficits in the areas of memory, spatial navigation, attention, short-50 term memory, and executive function 5,7 Further, the cognitive impairments following 51 SARS-Cov-2 infection may persist after the acute phase of infection 5 , a phenomenon 52 known as "long covid" 8, 9 . Participants were recruited as part of the Canadian COVID-19 Experiences Project 75 (CCEP15), a multi-study project which includes a national cohort survey of 1,958 adults 76 aged 18 to 54. One research objective was to examine differences between fully 77 vaccinated and vaccine-hesitant individuals on a broad set of demographic, 78 psychosocial, and experiential variables. Thus, the cohort was recruited to have an 79 equal proportion of fully vaccinated and vaccine-hesitant Canadians: 50.2% received 80 two vaccine shots, 43.3% had received no shots, and 5.5% received one vaccine shot, 81 but were not intending to receive a second shot). The mean age was 37 (SD=10.4) and 82 60.8% were female. . CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted January 2, 2022. The five-point response scale was 1=not at all severe, 2=slightly severe, 3=moderately 117 severe, 4=very severe, 5=extremely severe. Those reporting "had no symptoms but 118 tested positive" were incorporated into the second question as 1=not at all severe. CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 2, 2022. Baseline characteristics of the sample are presented in Table 1 . The majority of the 138 participants were female (60%) and from the 25-39 (40%) and 40-54 (43%) age groups 139 ( Table 1 ). 84% of participants reported that they had not been infected; those who 140 reported having been infected reported symptoms to be "not at all severe" (3%), "slightly 141 severe" (2.4%), "moderately severe" (2.7%), with relatively few experiencing 142 "very/extremely severe" (1%; Table 1 ). impacts at the level of the brain itself will be required, using functional brain imaging 224 paradigms. In summary, the current study used a population-representative sample consisting of CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 2, 2022. ; https://doi.org/10.1101/2022.01.01.22268614 doi: medRxiv preprint . CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted January 2, 2022. ; https://doi.org/10.1101/2022.01.01.22268614 doi: medRxiv preprint . CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) The copyright holder for this preprint this version posted January 2, 2022. CC-BY-NC 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. 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