Early in the COVID-19 pandemic, the World Health Organization stressed the importance of daily clinical assessments of infected patients, yet current approaches frequently consider cross-sectional timepoints, cumulative summary measures, or time-to-event analyses. Statistical methods are available that make use of the rich information content of longitudinal assessments. We demonstrate the use of a multistate transition model to assess the dynamic nature of COVID-19-associated critical illness using daily evaluations of COVID-19 patients from 9 academic hospitals. We describe the accessibility and utility of methods that consider the clinical trajectory of critically ill COVID-19 patients.

There is evidence in the literature that cognitive functions in schizophrenia (SC) may be improved by atypical neuroleptics (NLPs) in contrast to typical medication, but there is still controversy regarding this apparent superiority of atypical drugs. In this study, we assessed the differential effects of risperidone and haloperidol on verbal memory, attention, and psychiatric symptoms in SC. The performance of 28 SC participants, randomly assigned to risperidone (2–6 mg/day) or haloperidol (2–40 mg/day), was compared with that of healthy controls. The California Verbal Learning Test (CVLT), the d2 Cancellation Test, and the Positive and Negative Symptoms Scale were administered at baseline and 3, 6, and 12 months. Relative to controls, all SC participants showed markedly impaired verbal memory and processing speed at each assessment period. There was no differential effect between the two NLPs on CVLT and d2 performance. However, risperidone was more effective than haloperidol in reducing psychiatric symptoms. Improvement in symptom severity was not associated with improvement in neurocognitive performance on these specific tests. Neither conventional nor atypical neuroleptic medications improved neurocognitive functioning over a 12-month follow-up, suggesting that psychopathological improvement under risperidone is independent of cognitive function. (JINS, 2008, 14, 110–118.)

This study describes changes in cognitive function in patients who are typically excluded from longitudinal studies due to their inability to complete most standardized batteries. Thirty-three patients with moderate to severe Alzheimer's disease were assessed by means of the Severe Impairment Battery (SIB), Mini Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and measures of functional status. Follow-up evaluations were conducted, and annual rates of change were calculated. Patients with severe cognitive impairment demonstrated rates of progression similar to patients who were moderately impaired at initial evaluation. Rates of decline on the SIB were unrelated to baseline cognitive function, and annual rate of decline in Year 1 was not correlated with disease progression in the subsequent year. This study demonstrates that, with appropriate assessments, severely impaired patients can exhibit a range of performance and rates of decline that are comparable to those of moderately impaired patients. (JINS, 1998, 4, 512–516.)