Cognitive Screening, Mental Health and Long COVID

In the modern economy, the majority of work is about mental effort.
It is mental effort, cognitive functioning that will have the greatest impact on the performance and productivity of your staff and organisation.
Managing mental health and cognitive performance has always been important and in these times probably never more so.

Why employee psychological health makes business sense
If you have employees absent from work, you will know the costs are huge and a drain on your resources. These costs can be attributed to many factors including:
• Wages paid to absent employees
• High-cost replacement workers (overtime pay for other employees and/or temporary workers)
• Administrative costs of managing absenteeism
• Personal injury claims
• Malingering / fraudulent claims

Indirect costs include:
• Poor quality of output resulting from overtime fatigue or under-staffing
• Reduced productivity
• Excess manager time – dealing with discipline or finding suitable cover
• Poor morale among employees who have to “fill in” or do extra work to cover absent co-workers.
• Safety issues created by inadequately trained employees filling in for others, rushing to catch up after arriving as a replacement, etc
• Training and support of replacement staff

Then there are the expensive intangible costs
• The reputation of your organisation
• Errors due to temps or less skilled staff covering key roles or activities
• Your best and brightest have to step down to cover – and possibly suffering stress themselves as result

Long Covid
Research suggests that Long Covid is thought to occur in at least 10% of those infected, Common symptoms include fatigue that can be overwhelming, headaches, respiratory difficulties, and digestive problems.

COVID is ‘neurotropic’ meaning that it can infect the brain and central nervous. This explains the loss of the senses of smell and taste and problems with concentration: Many describe brain fog.

Additionally, an estimated 15–25% of people with the viral illness may have neurological symptoms, including:
• loss of sense of taste and smell
• altered mental state
• headaches

While losing the sense of smell may not seem serious at first, it is still important, since it is tied directly to brain function.

With Long Covid, common symptoms include this brain fog and problems with memory. concentration, focus, decision making and slower thinking. This clearly has implications for work as well as at home. Long Covid symptoms can range from mild to severe and at worst individuals are unable to function. The symptoms can persist although most report improvement over time.

The olfactory bulb, part of the brain receiving sensations of smell, harbours a high concentration of these receptors. The olfactory bulb also has strong connections to the hippocampus — the area responsible for memory.

According to Dr. de Erausquin, “The trail of the virus, when it invades the brain, leads almost straight to the hippocampus.”
“That is believed to be one of the sources of the cognitive impairment observed in COVID-19 patients. We suspect it may also be part of the reason why there will be an accelerated cognitive decline over time in susceptible individuals,” he adds.

[The complete article from the Medical News Today is below]

What can you do?
Supporting your staff’s mental health and cognitive performance is crucial and the first step is to assess any impact so that suitable support and/or interventions can be put in place.
We offer cognitive and mental health screening which once completed can be used to determine the most appropriate course of action.

The Cognitive Screening Assessment Covers:
• Processing Speed
• Executive Function
• Complex Attention
• Cognitive Flexibility
• Working Memory
• Sustained Attention
• Psychological Functioning

And can also be expanded to include:
• Neurodiversity
• Measures of Depression, Anxiety and Stress

Click below if you would like to know more information or arrange a cognitive assessment.

Cognitive Assessment

Most importantly the reports will identify the steps that can be taken, including reasonable adjustments. To reduce the impact of these difficulties and to facilitate rehabilitation.

Benefits for your organisation:
• Objectivity – They dramatically reduce bias and personal perspective.
• Clarity – They provide a robust framework and structure.
• Equality and fairness for all individuals – Tests are standardised so that all individuals receive the same treatment.
• Increase the likelihood of being able to predict future job performance – They have a high level of ‘predictive validity’.
• Screen for possible psychological and cognitive factors – That contribute to work performance.
• Identify the steps that can be taken, including reasonable adjustments. – To reduce the impact of these difficulties and to facilitate rehabilitation.

Benefits for attendees:
• A clear understanding of what aspects of their behaviour resulted in their work performance
• Objective and neutral third-party assessment of their work performance.
• A clear set of recommendation as to how to address any issues identified.

Arcadia Alive provide these assessments remotely using a combination of online assessment batteries with interviews and feedback undertaken through Zoom, Microsoft Teams or other.

We have found that remote assessments and interviews allow flexibility, with no problems with building the rapport necessary to be able to provide a reliable and valid assessment. They are cost-effective and provide, where necessary, the flexibility to allow for the assessment process to be broken up into chunks to have breaks, or to run the sessions over several sessions.

These assessments are only undertaken by Registered and Chartered Psychologists who adhere to the professional standards of both the British Psychological Society (BPS) and the Health Professions Council (HPC), which is the regulatory body for psychologists.

For more information or to arrange a cognitive assessment please call us on 0845 2600 126

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Medical News Today Article

Nearly 1 year after the novel coronavirus, SARS-CoV-2, was identified, global cases have surpassed 88 million. Although a number of vaccines have been approved, the rollout will take time.

In the meantime, researchers continue studying COVID-19 in an attempt to slow the spread and reduce severe symptoms.

Other scientists are trying to piece together a picture of what life may look like in the long run for someone who has had COVID-19.

A recent perspective article, which appears in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, reviews research into past viral illnesses, including the flu pandemic from a century earlier. The authors believe the research indicates COVID-19 could cause a lasting effect on the brain.

Neurotropic viruses

Scientists consider the SARS-CoV-2 virus a “neurotropic” virus because it can enter nerve cells. Neurotropic viruses include the mumps, rabies, and Epstein-Barr viruses. While some neurotropic viruses cause milder symptoms, others can cause swelling in the brain, paralysis, and death.

Some flu-like viruses are neurotropic and similar in structure to the novel coronavirus. As such, researchers looked at these viruses to try to gain insight into what type of long-term effects to expect in people who have recovered from COVID-19.

“Since the flu pandemic of 1917 and 1918, many of the flu-like diseases have been associated with brain disorders,” says lead author Dr. Gabriel A. de Erausquin.

Dr. de Erausquin, who is a neurology professor at the University of Texas Health Science Centre at San Antonio, explains: “Those respiratory viruses included H1N1 and SARS-CoV. The SARS-CoV-2 virus, which causes COVID-19, is also known to impact the brain and nervous system.”

According to the scientists, an elevated risk of Alzheimer’s disease, Parkinson’s disease, and mental health problems could potentially be connected to these flu-like illnesses.

Importance of neurological symptoms
Some people with COVID-19 do not experience any symptoms, while others have symptoms ranging from mild to severe.

Some of the hallmark symptoms include:

• dry cough
• fever
• difficulty breathing

Additionally, an estimated 15–25% of people with the viral illness may have neurological symptoms, including:
• loss of sense of taste and smell
• altered mental state
• headache

While losing the sense of smell may not seem serious at first, it is still important, since it is tied directly to brain function.

To enter cells, SARS-CoV-2 binds to ACE2 receptors on cell membranes. The olfactory bulb, which is the part of the brain receiving sensations of smell, harbours a high concentration of these receptors. The olfactory bulb also has strong connections to the hippocampus — the area responsible for memory.

According to Dr. de Erausquin, “The trail of the virus, when it invades the brain, leads almost straight to the hippocampus.”

“That is believed to be one of the sources of the cognitive impairment observed in COVID-19 patients. We suspect it may also be part of the reason why there will be an accelerated cognitive decline over time in susceptible individuals,” he adds.

Among severe neurological issues during SARS-CoV-2 infection, patients may develop fluid on the brain, inflammation in the brain, and seizures.

Lasting impact of COVID-19

COVID-19 can cause severe damage to the lungs, and that damage can be irreversible. However, according to the authors’ research, it appears that the possible fallout from COVID-19 may extend far beyond lung damage.

The authors write that “respiratory problems due to SARS-CoV-2 are thought to be due in part to brain stem dysregulation, as are possibly some of the gastrointestinal symptoms.”

Based on the idea that COVID-19 can cause damage to the brain, it is possible that people who have had the novel coronavirus but were either asymptomatic or experienced mild symptoms may face problems down the road.

However, because COVID-19 is a new disease, scientists will need to carry out longer-term studies to confirm these theories.

“As the Alzheimer’s & Dementia article points out, the under-recognized medical history of these viruses over the last century suggests a strong link to brain diseases that affect memory and behaviour,” comments Dr. Maria C. Carrillo, Alzheimer’s Association chief science officer and paper co-author.

“In this difficult time, we can create a ‘silver lining’ by capitalizing on the Alzheimer’s Association’s global reach and reputation to bring the research community together to illuminate COVID-19’s long-term impact on the brain,” says Dr. Carrillo.

 

[1] Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ2020;370:m3026. doi:10.1136/bmj.m3026 pmid:32784198

[1] Sudre CH, Murray B, Varsavsky T, et al. Attributes and predictors of long-covid: analysis of covid cases and their symptoms collected by the Covid Symptoms Study app. MedRxiv [preprint].

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