Impact of COVID‐19 infection on cognition and its association with neurological symptoms

Abstract

Objective : To characterize the cognitive profile following COVID‐19 infection and its possible association to clinical symptoms, emotional disturbance, biomarkers, and disease severity. Methods : This was a single‐center cross‐sectional cohort study. Subjects between 20‐ and 60‐year old with confirmed COVID‐19 infection were included. Evaluation was performed between April 2020 and July 2021. Patients with previous cognitive impairment and other neurological or severe psychiatric disorders were excluded. Demographic and laboratory data were extracted from the medical records. Results : Altogether 200 patients were included, 85 subjects were female (42.3%), and mean age was 49.12 years (SD: 7.84). Patients were classified into four groups: nonhospitalized (NH, n = 21), hospitalized without intensive care unit (ICU) nor oxygen therapy (HOSP, n = 42), hospitalized without ICU but with oxygen therapy (OXY, n = 107), and ICU (ICU, n = 31) patients. NH group was younger ( p = .026). No significant differences were found in any test performed attending severity of illness ( p > .05). A total of 55 patients reported subjective cognitive complaints (SCC). Subjects with neurological symptoms (NS) performed worse in trail making test B ( p = .013), digits backwards ( p = .006), letter&numbers ( p = .002), symbol digit modalities test ( p = .016), and Stroop color ( p = .010) tests. Conclusions : OXY patients and females referred more SCC associated with symptoms of anxiety and depression. Objective cognitive performance was unrelated to SCC. No cognitive impairment was found regarding the severity of COVID‐19 infection. Results suggest that NS such as headache, anosmia, and dysgeusia during infection were a risk factor for later cognitive deficits. Tests assessing attention, processing speed, and executive function were the most sensitive in detecting cognitive changes in these patients.

Is Recovery Just the Beginning? Persistent Symptoms and Health and Performance Deterioration in Post-COVID-19, non-hospitalised University Students - A Cross-Sectional Study

“…Accordingly, examining the source variables results corrected for type I errors, our findings regarding ‘orthopedic disorders’ in males and ‘metabolic disorders’ and ‘physical health disparity’ in females were in agreement with those studies that observed deteriorated physical health in these areas in post-COVID19 patients (for reviews on orthopedic disorders see (Slouma, Abbes, Kharrat, & Gharsallah, 2022) and (Slouma et al, 2023) and for a review on metabolic disorders see (Steenblock et al, 2021). With regard to cognitive functions, our study’s findings on females’ reading time scores are consistent with earlier studies that have found an association between COVID-19 infection and impairment in information processing speed (Almeria, Cejudo, Sanz-Santos, Deus, & Krupinski, 2023; Ferrucci et al, 2021; Flegr & Latifi, 2023). However, unlike these studies, we found a significant negative correlation between COVID-19 infection and females’ reaction times in the Stroop test, indicating improved reaction times compared to those who were not infected.…”

Neurocognitive and Neuropsychiatric Sequelae in Long COVID-19 Infection

“…We did not find an association between the severity of the disease and a worse neurocognitive performance. Other studies have also indicated no link between the disease’s severity and neuropsychological performance [ 10 , 37 , 38 , 39 , 40 , 41 , 42 ]. No neuropsychological differences were observed between the four groups considering severity, indicating that an association between disease severity and neurocognitive performance cannot be established.…”

“…Previous studies [ 5 , 10 , 38 ] have pointed out that neurological symptoms at the onset of the disease may be associated with a lower neurocognitive performance. We evaluated whether presenting with neurological symptoms in the acute phase of the disease had an impact on neuropsychology at 6 months.…”

“…Our results point to this direction, given that persistent fatigue is associated with a poor neuropsychological performance in practically all cognitive areas: visual memory, attention, working memory, processing speed, cognitive flexibility, and language. Anxiety and depression were persistent symptoms associated with a worse neuropsychological performance on all administered subtests, and high rates were observed associated with fatigue [ 5 , 10 ].…”

“…SARS-CoV-2, causing COVID-19, primarily affects the respiratory tract, but mounting evidence suggests its ability to cause central nervous system (CNS) injury [ 1 , 2 , 3 , 4 ]. Neurological symptoms (NSs) like headache, anosmia, dysgeusia [ 5 , 6 , 7 , 8 , 9 ], and cognitive complaints [ 10 ] are common in SARS-CoV-2 infection. While anosmia and dysgeusia often resolve in the acute phase [ 11 ], cognitive impairment may persist [ 12 ].…”