Cognitive Assessment in COVID-19 Positive Patients Using the DANA App
Condition: COVID-19
MeSH terms: COVID-19
Study type: Observational

Summary: 
      The Defense Automated Neurobehavioral Assessment (DANA) is a battery of cognitive tests
      delivered via an electronic tablet or smartphone. The overarching goal of this study is to
      evaluate the post-acute trajectory of cognitive functioning in patients hospitalized for
      COVID-19 using the DANA.
    

Detailed description: 
      The sequelae of COVID-19 are increasingly appreciated to be systemic and persistent among
      certain populations. Retrospective review of severe COVID-19 cases revealed increased altered
      mental status, encephalitis, psychosis, and neurocognitive abnormalities in the three weeks
      following discharge. During severe COVID-19 infection, there is additional evidence of
      cerebrovascular events, including ischemic stroke and intracerebral hemorrhage. The most
      common long-term neurological sequelae are loss of taste/smell, headache, and vertigo.
      However, there is additional evidence for cognitive impairment among those with severe
      COVID-19, with 33% of patients discharged from one intensive care unit (ICU) exhibiting
      clinically relevant inattention, disorientation, and poorly organized movements. Another
      study utilizing a three-week telephone cognitive screening four weeks after discharge showed
      that 42% of those who experienced delirium during ICU stay had lasting lower cognitive scores
      compared to those who did not experience delirium.

      The majority of currently available knowledge about neurocognitive symptoms associated with
      COVID-19 comes from cross-sectional studies of patients in the acute setting. Existing data
      suggests that following hospitalization, COVID-19 survivors may most frequently demonstrate
      deficits in letter-cued verbal fluency and executive function. However, this body of research
      is in its early stages and further investigation is needed. The model of traditional
      face-to-face cognitive testing using paper and pencil instruments is poorly suited to a
      global infectious disease pandemic. The Defense Automated Neurobehavioral Assessment (DANA)
      is a battery of cognitive tests delivered via an electronic tablet or smartphone. The
      platform allows higher temporal precision and frequency of measurement than traditional
      neuropsychological methods while including previously standardized cognitive tests and
      allowing individuals to repeatedly self-administer the battery in the individuals' own homes
      without examiner supervision. Hence, the DANA battery bypasses several of the major
      limitations associated with in-person cognitive exams.
    

Intervention name(s): DANA app
Intervention type(s): Other
Intervention description(s): The Defense Automated Neurobehavioral Assessment (DANA) is a battery of cognitive tests delivered via an electronic tablet or smartphone. The platform allows higher temporal precision and frequency of measurement than traditional neuropsychological methods while including previously standardized cognitive tests and allowing individuals to repeatedly self-administer the battery in their own homes without examiner supervision. Hence, the DANA battery bypasses several of the major limitations associated with in-person cognitive exams.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Participants must have a documented pulmonary illness due to COVID and being treated in the
        PACT clinic. They should have access to an internet-connected electronic device (e.g.,
        Android or iOS phone or tablet) able to use the DANA app.
      
Keywords: COVID-19 cognition