“…The patient remained cognitively impaired at 10 months following acute infection , indicating a prolonged thromboinflammatory state, potentially leading to long-term dysregulation of cerebromicrovascular endothelial function, impairing executive function and processing speed. Additionally, multiple studies have shown persistent cognitive dysfunction in COVID-19 patients with CSVD pathology, ( Backman et al, 2022 , De Stefano et al, 2020 , Tristán-Samaniego et al, 2022 ), and impaired gait patient during acute infection ( Abdi et al, 2020 ), a marker of CSVD-associated cognitive decline ( Mukli et al, 2022 ). Cerebrospinal fluid (CSF) was tested for the presence of SARS-CoV-2 by RT-PCR in nine cases and all were negative for the virus ( Abdi et al, 2020 , De Stefano et al, 2020 , Haroon et al, 2020 , Liang et al, 2021 , Neppala et al, 2021 , Piazza et al, 2021 , Rajendran et al, 2021 , Tristán-Samaniego et al, 2022 , Zhang et al, 2021 ).…”