1406 Predictors of Post-COVID Clinical and Cognitive Consequences: An Update

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Abstract Introduction “Post-acute sequelae of SARS-COV-2 infection (PASC)” is a condition with a wide range of physical and mental health consequences that are present four or more weeks after SARS-COV-2 infection. Fatigue is one of the common post-COVID conditions, but whether sleep disturbances due to COVID-19 infection influence the chronic physical and mental health consequences are unknown. The goal of this pilot study is to assess if sleep disturbances and sleep apnea severity contribute to PASC. Methods We prospectively collected sleep, quality of life (QoL) and neurocognitive data in patients with PASC and control participants with OSA but without past COVID-19 infection. Questionnaires were administered at baseline and after 3 months to evaluate sleepiness, fatigue, sleep disturbance, and QoL. Cognitive testing included Trail Making Test (TMT) A and B, Paced Auditory Serial Addition Test (PASAT), Stroop Task, Digit Coding, Hopkins Verbal Learning Test-R (HVLT-R), Weschler Abbreviated Scale Intelligence II (WASI), Weschler Memory Scale IV (WMS), and Psychomotor Vigilance Test (PVT), respectively. COVID-infection related data was also collected. Results We have enrolled 104 total participants thus far; 47 patients with PASC (39 males, 8 females; age: 60.0±12.9 years, BMI: 31.6±5.6 kg/m2, AHI: 36.6±27.8 events/hr, Education: 14.5±2.1 years) and 57 controls (48 males, 9 females; age: 64.6±11.9 years, BMI: 32.1±8.5 kg/m2, AHI: 41.4±27.5 events/hr, Education: 14.3±2.6 years). Baseline data in PASC vs. controls are given as: FSS Total Score: 39.0±13.4 vs. 33.4±14.9.4(p=0.06), ESS: 10.4±4.6 vs.9.0±5.5, PROMISE Sleep Impairment Score: 22.6±9.3 vs.18.7±8.3 (p< 0.05), 6-Minute Walk Test Total Distance Walked: 467.7±102.5 vs. 420.4±84.4 meters, FOSQ Total Score: 16.1±3.0 vs. 15.8±3.9, TMT-A 93.6±16.5 vs. 105.0±14.8 (p< 0.01), TMT-B: 92.9±21.1 vs. 101.6±17.8 (p=0.07), HVLTR Total Recall: 82.8±17.3 vs. 86.6±15.7, WMSIV Visual Reproduction Delayed Recall: 99.0±18.2 vs. 103.8±18.7, Stroop Color-Word Score: 92.0±15.5 vs. 94.8±13.2, WASI-II FISQ4 Score: 93.9±14.9 vs. 94.5±14.8, PASAT Rate 2 Correct: 31.8±24.1% vs. 34.4±14.8%, PVT Mean Reaction Time: 392.9±376.4 vs. 346.7±245.9 ms, PVT lapses 9.5±26.7 vs 1.5±3.2. Conclusion Sleep impairment, reduced attention span and increased lapses in vigilance were noted in patients with PASC vs controls. Additional analyses will delineate the associations between post-COVID symptoms, sleep disturbances and cognitive consequences following SARS-CoV-2 infection. Support (if any) VHA RR&D # RX004396

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