Post-COVID-19 Neurocognitive Screening in Routine Pilot Aeromedical Evaluations

Area of Science:

• Aerospace Medicine
• Neuroscience
• Aviation Psychology

Background:

• Subtle post-COVID-19 neurocognitive impairments pose a risk to flight safety by potentially going undetected during aeromedical examinations.
• The Trail Making Test (TMT) and Symbol Digit Modalities Test (SDMT) are recognized tools for assessing cognitive domains vital for pilot performance.

Purpose of the Study:

• To evaluate the effectiveness and clinical utility of the TMT and SDMT as screening tools for post-COVID-19 neurocognitive impairments in pilots.
• To assess the acceptability and feasibility of implementing these cognitive screening tools in routine aeromedical evaluations.

Main Methods:

• A mixed-methods approach was employed to compare the performance of TMT and SDMT between post-COVID-19 cases and healthy controls.
• Diagnostic accuracy was analyzed using receiver operating characteristic (ROC) curve analyses.

Main Results:

• The TMT (Part B: AUC=0.853, Part A: AUC=0.769) and SDMT (SDC version: AUC=0.817) demonstrated significant diagnostic accuracy in identifying neurocognitive impairments.
• Post-COVID-19 neurocognitive deficits were found to impact skills critical for safe pilot operation.
• Airline pilots recognized cognitive screening as an essential flight safety intervention.

Conclusions:

• Airline pilots, aviation psychologists, and medical experts support the critical role of screening for post-COVID-19 neurocognitive impairments.
• Routine screening of pilots for these impairments is recommended to enhance flight safety.
• Further research with larger sample sizes is required to validate these preliminary findings and recommendations.