Description
Environmental changes, including pollution have a major impact on neurological health [1]. In the context of neurological pathology, environmental changes can have direct and indirect effects on the occurrence of infectious diseases (e.g., SARS-CoV-2 and post-COVID-19 condition [2]) or neurodegenerative pathologies (e.g., Parkinson's disease [3]). One of the most common features of different neurological pathologies are cognitive symptoms, assessed through detailed neuropsychological evaluations. However, despite our knowledge of cognitive symptomatology, there are still unknowns as to the specific effects of these symptoms on overall health and economic burden. Recently, studies have shown that cognitive disorders and neuropsychological assessments are statistically the best predictors of economic burden in neurodegenerative diseases such as multiple sclerosis (69’000 Australian $ annually) [4], but also of additional cost to the patient's immediate environment, estimated on average at 15,000 euros in Europe [5].
In the context of the COVID-19 pandemic, the COVID-COG project (NRP 78; grant no. 407840_198438) carried out by the Faculty of Psychology at the University of Geneva and the Geneva University Hospitals aimed to evaluate the neuropsychological, neurological, psychiatric and olfactory consequences. In the context of the COVID-COG project, 121 patients (non-hospitalized [mild], hospitalized in conventional care [moderate] and hospitalized in intensive care [severe]), with no known medical history, were evaluated at 6-9 months and 12-15 months post-infection.
The results of the project, based on innovative (Monte-Carlo) simulation statistics analyzes [6] highlighted the presence and persistence of cognitive disorders in the moderate and severe groups of patients, especially memory, executive and instrumental functions [7,8], associated with altered functional neuroimaging markers [9] , as well as immunological markers [10,11], identifying also distinct post-COVID-19 patient phenotypes [12]. Based on those observations, this project also raised the question of the potential long-term effects of cognitive disorders on society and the economic burden, opening the discussion for implementing interdisciplinary studies for the neuropsychological post-COVID-19 condition [13].
As recently discussed within a point of view, published in Journal of Global Health (JoGH) by our group [13], our recent results on the neuropsychological post-COVID-19 condition, confirmed by other research groups, could have effects on encouraging the search for the most prominent neuropsychological risk factors on direct and indirect costs paving the way for development of targeted rehabilitation programs (which are currently lacking) based on evidence-based medicine, and developing specific guidelines associating neuropsychological disorders and professional recovery. Therefore, in the context of neuropsychological disorders (cognitive deficits), environmental changes play an indirect role, but are potential drivers in some pathologies, in addition to the aging of the population (as well as other factors), of an increase in the prevalence of cognitive disorders, but of which empirical and clinical research has not yet highlighted all the implications in the long term. In the near future, in the case of post-COVID-19 neuropsychological condition, health and economical questions will be evaluated through the TRAJECTORY project [Swiss National Science Foundation (SNSF) grant no. 220041], which is a long-term follow-up of the COVID-COG project.
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