The role of COVID-19 in sleep quality and cognitive performance in alcohol–dependent patients
Background: COVID-19 is associated with a range of cognitive and sleep symptoms, both acutely and chronically which may persist for many months in people who have recovered from acute COVID-19. Most systematic reviews and meta-analyses indicate that sleep and cognitive symptoms are present in around 20% of people who have recovered from acute COVID-19, especially among elderly, women, unvaccinated, when infected with pre-Omicron variants. Recovery from COVID-19 may result in decreasing cognitive performance in all cognitive domains. It is well known that excessive alcohol consumption causes sleep and cognitive impairment, with a stronger association observed with heavier alcohol intake. Also, there is a bidirectional positive correlation between sleep quality and cognitive impairment in alcohol-dependent (AD) individuals. This suggests that AD individuals may experience significant consequences on cognition and mental health related to COVID-19. The aim of this study is to compare cognitive functions and sleep quality in AD individuals who have recovered from COVID (COVID) and AD individuals who have not experienced COVID (non-COVID).
Methods: The study is being conducted among outpatient and inpatient AD treatment-seeking individuals in two study points from March 2023 to March 2024. The first point of measurement is at the time of including the participant in the research and the second is after 6 months from the first assessment. It will include a minimum of 26 COVID AD individuals and 26 non-COVID AD individuals, matched by gender and age. GPower analysis was done to check the sample size. Participants meet the criteria of alcohol dependence diagnosis according to the International Classification of Diseases, 10 revision (ICD-10) and Croatian version 5.0.0. Mini International Neuropsychiatric Interview (M.I.N.I.), are abstinent on the day of testing, and between 18 and 65 years old. The psychiatric questionnaire includes sociodemographic and medical information, COVID-19 severity questionnaire (self-reported acute and long COVID-19 symptoms, need for hospitalization due to COVID-19, number of COVID-19 episodes, days passed since positive PCR testing, number of COVID-19 vaccine doses), interview on alcohol dependence history, the Alcohol Use Disorder Test (AUDIT), the Alcohol Timeline Followback Method (TLFB), the Pittsburgh Sleep Quality Index (PSQI), and the Montreal Cognitive Assessment (MoCA).
Results and conclusions: Preliminary results indicate that COVID AD individuals who experienced more severe COVID-19 have poorer cognitive performance and impaired sleep quality compared to non-COVID AD individuals. It appears that COVID-19 plays a mediating role between sleep quality and cognitive performance in COVID AD patients. Some sociodemographic features and alcohol dependence severity show a positive correlation with cognitive and sleep impairment (p<0.01).
