Cognitive inhibition deficit in long COVID-19: An exploratory study

Abstract

Background and objectivesAn increasing number of research studies point toward the importance and prevalence of long-term neurocognitive symptoms following infection with COVID-19. Our objectives were to capture the prevalence of cognitive impairments from 1 to 16 months post-COVID-19 infection, assess the changes in neuropsychological functions over time, and identify factors that can predict long-term deficits in cognition.MethodologyA cross-sectional research design was adopted to compare four sub-samples recruited over a 16-month timeframe (1–4, 5–8, 9–12, and 13–16 months). Phone interviews were conducted at least 6 weeks after being infected by COVID-19. Sociodemographic and clinical questionnaires were administered followed by standardized neurocognitive and psychological tests and health questionnaires screening cognitive symptoms, anxiety, depression, fatigue, and autonomy.ResultsRegarding general health questionnaires, 55.2% of the 134 participants had symptoms of psychiatric illness, while 21.6% of patients had moderate-to-severe anxiety or depression. Cognitive efficiency was diminished in 19.4% of our population. Executive dysfunction was screened in 56% of patients, and an impairment of cognitive flexibility and inhibition was revealed in 38.8%. Depression, hospital or intensive care unit (ICU) admission, and the duration of hospital or ICU stay were associated with an inhibition deficit. The duration elapsed from the initial infection, and the neurocognitive assessment was not associated with a decrease in inhibition deficit. The prevalence of cognitive impairments, other than inhibition deficit, tended to decrease during the study period.DiscussionThis study supports the extensive literature on the cognitive and neuropsychiatric sequelae of COVID-19 and highlights long-lasting inhibition deficits, while other cognitive functions seemed to improve over time. The severity of infection could interact as a catalyst in the complex interplay between depression and executive functions. The absence of a relation between inhibition deficits and sociodemographic or medical factors reinforces the need for cognitive screening in all COVID-19 patients. Future research should focus on inhibition deficits longitudinally to assess the progression of this impairment.

Treatment of Cognitive Deficits and Behavioral Symptoms Following COVID-19-Associated Autoimmune Encephalitis With Intravenous Immunoglobulin: A Case Report and Review of the Literature

“…He had persisting working memory deficits as well. This is consistent with existing studies showing deficits in interference, verbal memory, and working memory to persist after the COVID-19 infection [ 10 , 23 ]. Treatment of behavioral symptoms and cognitive deficits associated with long COVID-19 continues to be an area of active research [ 3 ].…”

Cortical GABA Levels Are Reduced in Post-Acute COVID-19 Syndrome

“…Furthermore, they had lower scores on the Multidimensional Inventory of Subjective Cognitive Impairment (MISCI) [93] than the population norms, which is indicative of greater cognitive deficits. This finding is aligned with numerous reports of cognitive dysfunction associated with PASC [89,90,94,95]. Overall, this pattern of deficits is consistent with lingering cognitive complaints colloquially termed "brain fog", referring to long-term neurologic sequelae known as neuro-PASC [32].…”

Cognitive decline in post-COVID-19 syndrome does not correspond with persisting neuronal or astrocytic damage

“…Limitations of our study are the lack of sequential biomarker and neuropsychological assessments. While there is data showing improvement of cognitive deficits over time, other cohorts found a persisting decrease of processing speed over a 6-month period 34 , 35 .To provide further longitudinal neuropsychological testing in PCS, some participants of our cohort from the study centre in Cologne were evaluated in neuropsychological follow ups. Due to ongoing analyses, results of these follow ups will be published separately.…”