26 September 2022: Articles
Alleviation of Post-COVID-19 Cognitive Deficits by Treatment with EGb 761: A Case Series
Unusual or unexpected effect of treatment
Udo A. Zifko E* , Muhammad Yacob E , Benedikt J. Braun B , Gunnar P.H. Dietz EDOI: 10.12659/AJCR.937094
Am J Case Rep 2022; 23:e937094
Table 2. Overview of the findings.
| Patient 1 | Gender, age | Male, 33 y |
| Initial COVID-19 symptoms | Moderate | |
| Approximate time to first outpatient visit after COVID-19 infection | 13 wks | |
| Initial complaints and result of initial cognitive testing | Marked attention deficit, headaches, nausea, depression, hyposmia; CGIS value 5/7; MoCA 29 | |
| Treatment in addition to 160 mg EGb 761/d | Paracetamol 500 mg for headache treatment as needed | |
| Approximate time between initial visit and follow-up | 11 weeks | |
| Result at follow-up | Substantially alleviated cognitive complaints and fatigue; improved hyposmia, CGCI 05, MoCA 30 | |
| Patient 2 | Gender, age | Female, 26 y |
| Initial COVID-19 symptoms and result of initial cognitive testing | Moderate | |
| Approximate time to first outpatient visit after COVID-19 infection | 35 weeks | |
| Initial complaints | Fatigue; Attention disturbance; worsening of migraine; hyposmia; CGIS 4/7; MoCA 30 | |
| Treatment in addition to 160 mg EGb 761/d | 2×500 mg ascorbic acid/d | |
| Approximate time between initial visit and follow-up | 7 weeks | |
| Result at first follow-up | improved concentration and fatigue | |
| Time between 1 and 2 follow-up | 13 weeks | |
| Result at second follow-up | No concentration deficit, CGCI 01; MoCA 30 | |
| Patient 3 | Gender, age | Female, 32 y |
| Initial COVID-19 symptoms and result of initial cognitive testing | Mild; CGIS 4/7; MoCA 29 | |
| Approximate time to first outpatient visit after COVID-19 infection | 22 wks | |
| Initial complaints | Moderate concentration and attention deficits | |
| Treatment in addition to 160 mg EGb 761/d | None | |
| Approximate time between initial visit and follow-up | 4 months | |
| Result at follow-up | Substantially improved cognitive deficits (CGIC 05).MoCA 29 | |
| Patient 4 | Gender, age | 26, female |
| Initial COVID-19 symptoms and result of initial cognitive testing | Moderate (1×vaccinated); CGIS 4/7; MoCA 24 | |
| Approximate time to first outpatient visit after COVID-19 infection | 9 weeks | |
| Initial complaints | Besides hypotension with circulatory disturbance, serious cognitive deficits and fatigue | |
| Treatment in addition to 160 mg EGb 761/d | Continued treatment with Sertralin started already before infection; Midodrin hydrochlorid (∼3×61 mg/d) | |
| Approximate time between initial visit and follow-up | 7 weeks | |
| Result at follow-up | improved concentration and fatigue (CGIC 05; MoCA improvement by 4 points to 28) | |
| Patient 5 | Gender, age | Male, 59 |
| Initial COVID-19 symptoms and result of initial cognitive testing | Severe, but no ventilation; CGIS 4/7; MoCA 30 | |
| Approximate time to first outpatient visit after COVID-19 infection | 18 weeks | |
| Initial complaints | Cognitive deficits; moderate depression; irritability; hyposmia | |
| Initial treatment | Escitalopram and plant-based tranquilizer | |
| Approximate time between initial visit and follow-up | 6 weeks | |
| Result at first follow-up | No change in cognitive deficits; improvement in depression, fatigue, irritability, hyposmia | |
| Additional treatment after first follow-up | EGb 761 160 mg; 2×500 mg ascorbic acid/d | |
| Time between 1 and 2 follow-up | 6 weeks | |
| Result at second follow-up | Complete remission of cognitive symptoms (CGIC 1); continued stable mood; MoCA 30 |