Milagros I. Figueroa Ramos, RN, PhD

“Long-term Cognitive and Psychological Outcomes in Puerto Rican COVID-19 Survivors”

Milagros I. Figueroa Ramos, RN, PhD, studied nursing at the School of Nursing-MSC and her doctorate at the University of California, San Francisco (UCSF). Throughout her nursing career, she has focused on clinical work with critical care populations, an area that has also served as the foundation for her research career. She is currently a professor and Assistant Dean of Research at the School of Nursing- MSC. In addition, she continues to develop research, with a particular interest in delirium, agitation, sleep in adult and pediatric populations in intensive care units. Through this work, she has gained important knowledge about conducting research on symptom occurrence and long-term outcomes in the critically ill population and continues pursuing the goal of investigating safe and feasible strategies to improve clinical outcomes in critically ill patients.


Project Summary:

The Coronavirus Disease 2019 (COVID-19) was declared a pandemic by the World Health Organization in early March. A minority of COVID-19 patients develop hypoxemia requiring hospitalization, which can lead to acute respiratory distress syndrome (ARDS) and the need for life support, including mechanical ventilation. A large percent of ARDS survivors demonstrate Post-Intensive Care Syndrome (PICS) that is characterized by acquired dementia, post-traumatic stress disorder (PTSD), and depression. In addition, neurotropism of coronaviridae is known to have occurred in both the SARS and MERS epidemics. The intense cough, ventilator desynchrony, and infectious potential reported in COVID-19 patients result in management with large quantities of sedatives, immobilization, and social isolation that are associated to PICS development. The cognitive and psychological long-term consequences among those admitted to wards and ICUs are unknown.

The main objectives of the proposed study are to determine the epidemiology of cognitive impairment, PTSD, and depression and to identify modifiable risk factors associated with worse long-term cognitive impairment, PTSD, and depression at 6 months in 277 adult survivors who were hospitalized with COVID-19 infection. Using a prospective, follow-up observational study, we will collect sociodemographic and clinical data retrospectively from patient record review and prospectively from survivors by phone-battery assessment for cognition, PTSD, and depression. Characterizing COVID-19’s effect on the development of acquired dementia, PTSD, and depression is fundamental to fully characterizing COVID-19’s epidemiology and societal impact. This understanding will also allow us to design interventions to help better meet the cognitive and psychological needs of COVID-19 survivors and better prepare us for the next coronavirus-related pandemic.