CAS COVID MME L - itsbrain

Clinical case : Mrs. L, 59 years old

Context of the assessment : Mrs. L is a 59-year-old woman with a good sociocultural background who wasinfected with COVID-19 in September 2020. The infection was severe and led to hospitalization. Since then, Mrs. L has been on leave and unable to resume any professional activity, even on a part-time basis. Mrs. L experiences a significant complaint regarding fatigue, as well as executive dysfunction: attention deficits, feelings of overwhelm and overload, an inability to organize, and a significant slowing down.

Since her infection, Mrs. L has also developed significant sleep disturbances and a significant anxiety-depressive symptomatology, which remains untreated.

The patient was first seen in March 2021 when an initial MindPulse assessment was conducted. However, due to personal reasons, the patient was unable to continue the evaluation process until March 2023 when a comprehensive neuropsychological assessment, including the MindPulse again, was conducted.

Neuropsychological assessment March 2023

Interpretation : The neuropsychological assessment highlights Mrs. L's good intellectual level. Language skills are satisfactory, without any comprehension or speech production difficulties. No significant word finding difficulties emerge. The logical reasoning is of good quality.

However, the executive function is impaired, which is marked by a significant slowing down in various tasks and a combined lack of precision, indicating the effects of executive overload in Mrs. L. This executive alteration impacts the memory performance of Mrs. L, with a recovery disorder that is found in auditory-verbal memory.

Finally, the questionnaires highlight depressive symptomatology, cognitive and executive complaints, as well as significant and untreated insomnia to this day, which should be interpreted in connection with Mrs. L's neuropsychological profile.

MindPulse test:

In 2021, the MindPulse assessment reveals severe perceptual-motor slowing, associated with a secondary but significant executive slowing. However, both precision and reaction to difficulty are within normal range.

En 2023, le ralentissement perceptivo-moteur s’est nettement aggravé, et le ralentissement exécutif c’est maintenu. La précision et la réaction à la difficulté restent normales.

In 2021, the analysis of response times highlights a significant dispersion within the 3 parts of the MindPulse: Mrs. L is unable to effectively sustain her attention over time.

Furthermore, an anticipatory error is observed in Part A, an inhibition error in Part C, and an aberrant response, indicating an attentional lapse towards the end of Part C.

In 2023, the dispersion is significantly greater within the three parts of the MindPulse. A loss of vigilance is observed, characterized by an omission error in Part C, and a persistent inhibition error.

Furthermore, Mrs. L makes two aberrant responses, indicating attentional lapses and the patient's fatigue towards the end of Part C.

Between 2021 and 2023, Mrs. L's vigilance impairments have worsened. Difficulties in selective attention and executive functions have remained stable. The executive and attentional imbalance is marked by the slowing down and variability of Mrs. L's attention.

Conclusion : MindPulse vs. Traditional FEA Comparison

The MindPulse confirms the executive and attentional profile identified through the neuropsychological evaluation.
The profile is characterized by the patient's slowing down. MindPulse highlights a primary perceptual-motor slowing, which is accompanied by a secondary and more moderate executive slowing, consistent with the expected cortico-subcortical frontal inflammatory impairments in the context of long COVID.
The worsening of attentional disturbances, particularly in vigilance during the 2023 evaluation, appears to be a consequence of the overall deterioration of the patient's condition, who now suffers from sleep and mood disorders known to have an impact on vigilance and executive functioning.
However, the profile between the two MindPulse assessments remains comparable and demonstrates stability in the functioning of Mrs. L, whose performance is maintained overall. This also indicates a lack of functional recovery in this patient, three years after the COVID-19 infection, highlighting the importance of considering general factors (e.g., sleep, fatigue, mood) in the management of COVID-19.
By enabling the identification of the nature of Mrs. L's executive and attentional impairments, MindPulse provides a better understanding of the intricacies of the patient's profile, allowing for improved guidance in the continuation of her care.