Neurocognitive Profiles in Patients With Persisting Cognitive Symptoms Associated With COVID-19

Abstract

Objective A subset of individuals with coronavirus disease 2019 (COVID-19) appears to develop persisting cognitive and medical symptoms. Research in the acute stages of illness, generally utilizing cognitive screening measures or case reports, suggests presence of deficits in attention and executive function. This observational study investigated cognitive functioning among individuals with persistent cognitive complaints about 5.5 months after COVID-19 infection. Methods Patients with polymerase chain reaction confirmed COVID-19 and persistent cognitive complaints underwent comprehensive in-person neuropsychological evaluations. Patients with prior neurological disorders were excluded. When diagnosed, 40% required hospitalization, 15% were in an intensive care unit, 10% needed mechanical ventilation, and 10% experienced delirium. Results This sample was predominately women (90%), White non-Hispanic (70%), with average education of 15 years. Mild cognitive deficits were seen on tests involving attention and processing speed or executive function. Seventy percent of patients were diagnosed with a mood disorder prior to COVID-19 infection. At the time of testing, 35%–40% endorsed moderate to severe mood symptoms and 85% noted significant fatigue as measured by the Fatigue Severity Scale. Conclusions The pattern of cognitive deficits, although mild, is consistent with prior research at the acute stage of the illness. These findings suggest that psychological factors and other persisting symptoms (e.g., sleep, fatigue) may play a significant role in subjective cognitive complaints in patients with persisting complaints post COVID-19 who did not require intensive treatment. These patients would likely benefit from resources to manage persisting or new mood symptoms and compensatory strategies for the cognitive inefficiencies they experience.

Post-COVID-19 fatigue: the contribution of cognitive and neuropsychiatric symptoms

“…Taken altogether, these findings suggest a relationship between fatigue, neuropsychiatric and cognitive disorders. However, with the notable exception of Krishnan et al [ 24 ], few studies have investigated whether these three dimensions of the post-COVID-19 condition are interrelated or are independent entities. In the present study, we explored how associated these symptomologies are in a larger sample of patients who were diagnosed with COVID-19 and presented with subjective cognitive complaints on average 8 months after disease onset.…”

Examining Association of Personality Characteristics and Neuropsychiatric Symptoms in Post-COVID Syndrome

“…Cognitive and olfactory symptoms are often reported among the most frequent symptoms after acute infection [ 31 ]. The main cognitive domains involved in post-COVID syndrome are attention/executive functioning and episodic memory [ 28 , 32 ]. In this study, we included a comprehensive protocol for neuropsychological assessment including the main cognitive domains.…”

Rehabilitation Strategies for Cognitive and Neuropsychiatric Manifestations of COVID-19

“…Cognitive impairments in areas of working memory, executive functioning, memory, visuospatial ability, abstraction, and orientation have also been found [ 17 , 27 ]. Recovery in some or most of these areas in the post-acute phase of the illness has been demonstrated [ 28 ]; however, there are persisting deficits seen in this phase, including patients who were not hospitalized [ 29 ].…”

“…Cognitive deficits were widespread in those with and without ICU stays and occurred most commonly on measures of oral processing speed and verbal fluency as well as learning and memory [ 30 , 31 ]. Those who required hospitalization were also more likely to have objective cognitive deficits persisting after the acute phase [ 29 ]. However, there have also been conflicting findings suggested that cognitive deficits are not greater in those requiring higher levels of acute care [ 35 , 36 ].…”