Die „vierte Welle“? COVID-19 und konsekutive kognitive Störungen

Zusammenfassung

Die COVID-19-Pandemie stellt die Gesundheitssysteme international vor Herausforderungen, die über Prävention, akute und Intensivbehandlung schwerkranker Patienten hinausgehen. Ein erheblicher Teil derjenigen, die eine akute Infektion überstanden haben – und nicht nur alte Patienten –, leiden unter einem „Post-COVID-Syndrom“. Risikofaktoren sind vorbestehende somatische Multimorbidität, kognitive und zerebrale Veränderungen, somatische Multimorbidität sowie Pneumonie mit Hypoxie, Intensivbehandlung und Verwirrtheitszustände während der akuten COVID-19-Infektion. Meist überdauert ein frontales Dysexekutiv-Syndrom, das einerseits mit Erschöpfung und Verstimmtheit, andererseits mit Störungen von Aufmerksamkeit und Gedächtnis assoziiert sein kann. Einige Pathomechanismen der COVID-Enzephalopathien sind bekannt, aber bisher wurden noch keine spezifischen Behandlungsstrategien für die nachfolgenden Defizite etabliert. Es ist damit zu rechnen, dass sich Hausärzte, Psychiater, Neurologen, Sozialpädagogen und andere in den nächsten Monaten und Jahren vermehrt der Aktivierung, Reintegration und Begutachtung betroffener Patienten widmen werden.

Abstract

The COVID-19 pandemic poses new challenges for the healthcare systems world-wide which will go beyond prevention, acute and intensive care treatment of patients with severe illness. A large proportion of “COVID-survivors” – and not only elderly patients – suffers from “post-COVID-syndrome”. Risk factors are preexisting somatic multimorbidity, cognitive and cerebral changes together with pneumonia and hypoxemia, intensive care treatment and confusional states during the acute phase of illness. Post-COVID cognitive deficits usually manifest as a frontal dysexecutive syndrome combined with fatigue and dysphoria and/or with attentional and memory deficits. Several pathogenetic mechanisms of COVID encephalopathy are understood, but no specific treatment strategies have been established so far. We assume that general practitioners, psychiatrists, neurologists and social workers will need to take care of the activation, reintegration and expert appraisals of patients with post-COVID fatigue and cognitive deficits during the years to come.

Schlüsselwörter

COVID-19 - Dysexekutiv-Syndrom - Enzephalopathie - Erschöpfung - kognitive Defizite - Post-COVID-Syndrom

Key words

cognitive COVID - COVID-19 - dysexecutive syndrome - encephalopathy - fatigue - post-COVID-syndrome

Publication History

Article published online:
06 May 2021

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