Memória de trabalho de indivíduos que tiveram a apresentação grave da Covid-19

Abstract

Introduction: In March 2020, the World Health Organization declared that humanity was witnessing the COVID-19 pandemic caused by the SARS-CoV-2 virus responsible for causing multiple changes in human body systems. Such a virus has as one of its proteins the spike protein or spike (S) that binds to cells in parts of the body, through the protein- conserving angiotensin 2 enzyme, where it replicates the S proteins using ribosomes of the host cells and thus enabling the onset of infection. The spread of SARS-CoV is exorbitant, especially when there is an interruption of the cytokine IFN-a, which works in association with other cells to inhibit the multiplication of virus cells by initially infected cells. The increase in viral load associated with interruption of IFN-a action leads to an uncontrolled hyperactivation of defense cells, causing an exacerbated storm of pro-inflammatory cytokines that lead to a set of neurological symptoms, due to systemic inflammation, as it can lead to multiple organ failure and consequently the worsening of the patient's clinical condition. After the binding of the S protein of SARS-CoV-2 with the ECA2 receptors present in the precursor cells of oligodendrocytes, astrocytes (substantia nigra and cortex) and in the endothelial cells of the cerebral capillaries, the virus reaches the cortex and hippocampus regions of the system. Allied to other regions, one of the functions of the cortex is the development of working memory, which is the ability to store a set of new information for a while to perform an activity. Objective: To characterize the working memory of individuals who had a severe presentation of COVID-19. Methods: This is an observational, cross-sectional and descriptive study. The research is part of a larger project that was contemplated in the CNPq Universal Call entitled “Effects of speech therapy intervention on communicative, cognitive, olfactory and swallowing sequelae in patients with severe presentation of COVID-19”, and was carried out in clinical schools of speech therapy from the Federal University of Sergipe - Campus Lagarto and Campus São Cristóvão and was approved by the Ethics Committee in Research with human beings under nº 5.658.792. Participants who agreed to participate signed the Informed Consent Form (TCLE) [ICF]. All participants underwent the antigen test for COVID-19, then an anamnesis was performed, and finally, the assessment of cognitive function using the Brief Neuropsychological Assessment Instrument - Neupsilin. Results: 56 people participated in the study, of which 34 (60.7%) identified themselves as men and 22 (39.3%) women. The mean age was 51.5 ± 14.3 years, the median was 52.5, with a minimum age of 20 and a maximum of 85 years. Thirty-one people (55.4%) performed within the range expected for age and education (considering the Medium and Superior performance classifications) in the Ascending Digit Ordering test, 27 (48.2%) in the Span test of words in sentences and 29 (51.8%) in Total Working Memory. Conclusion: Deficits in the Working Memory skill were observed in individuals who had the severe presentation of COVID-19, suggesting a relationship between Working Memory and SARS-CoV-2 infection.