Executive Functioning and Sleep Fragmentation in COVID-19 Patients

Study Overview
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Brief Summary
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This project aims to investigate executive functioning abilities (primary outcome) and quality of sleep (secondary outcome) in patients with COVID-19 (while distinguishing between those with and without sleep fragmentation), compared with an age- and education matched control group of healthy individuals who did not experience contagion. Prefrontal electrical activity will be recorded with EEG in patients, and related to sleep and cognitive-executive metrics. The main questions it aims to answer are: is executive functioning impaired in COVID-19 patients compared with individuals who were not infected? is there a relationship between altered sleep and impaired executive functioning in COVID-19 patients? is such relationship related to altered prefrontal brain activitity in COVID-19 patients?

Detailed Description
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While impaired executive functioning has been often reported in association with COVID-19 contagion, it is still unclear whether, and to what extent, executive deficits might be explained by an altered quality of sleep, that been also frequently reported in COVID-19 patients. On this basis, this project aims to investigate executive functioning abilities (primary outcome) in patients hospitalized for a COVID-19 contagion, while distinguishing between those with and without sleep fragmentation (quality of sleep; secondary outcome), compared with an age- and education matched control group of healthy individuals who did not experience contagion. To this purpose, 35 COVID-19 patients and 35 controls will be administered questionnaires and cognitive tasks aimed to assess: a) executive functioning/inhibitory control (GoNogo task); b) quality of sleep (NOSAS; Insomnia Severity Index; Epworth sleepiness scale). Prefrontal electrical activity will be recorded with EEG in COVID-19 patients, and related to sleep and cognitive-executive metrics. Statistical analyses will be aimed to investigate: a) a possible decrease of executive skills in COVID-19 patients compared with healthy controls, and in COVID-19 patients with fragmented sleep compared with those with normal sleep; b) possible differences in the relationship between executive performance and quality of sleep across the three experimental groups; c) whether possible differences in such relationship relate to prefrontal brain activity in patients. The results of this study will provide novel insights into the consequences of COVID-19 at the cognitive level, thus informing about treatment strategies.

Official Title
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Executive Functioning and Sleep Fragmentation in COVID-19 Patients

Conditions
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COVID-19, Healthy Volunteers

Intervention / Treatment
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* Other: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: For patients: current contagion from COVID-19 For patients and controls: age>18 years absence of clinical conditions, cognitive and sensory deficits, and severe psychiatric disorders that would impair participation in research identified through clinical history. Exclusion Criteria: current or past neuro-psychiatric disorder current or past sleep disorder

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| COVID-19 patients<br>35 patients admitted to the intensive care unit due to COVID-19 contagion | Other: No intervention<br>* No intervention<br>|
| Healthy control participants<br>an age- and education-matched group of 35 healthy individuals who did not report a previous COVID-19 contagion | Other: No intervention<br>* No intervention<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Executive/Inhibitory skills | Performance in a GoNogo task | Assessment day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Risk of sleep-disordered breathing | NOSAS (Neck, Obesity, Snoring, Age, Sex) | Assessment day | 
| Severity of nighttime and daytime components of insomnia | Insomnia Severity Index | Assessment day | 
| Sleepiness | Epworth Sleepiness Scale | Assessment day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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COVID-19;executive functioning;quality of sleep