Subtle cognitive impairments in memory, attention, and executive functioning in patients with post-COVID syndrome and their relationships with clinical variables and subjective complaints

Abstract

Background and objectives. Cognitive symptoms persisting beyond 3 months following COVID-19 present a considerable disease burden. We aimed to establish a domain-specific cognitive profile of post-COVID syndrome, and relationships with clinical variables, to provide relevant information for outcome prediction and treatment decision-making. Methods. We compared cognitive performance on the Oxford Cognitive Screen-Plus between a large post-COVID cohort (n = 282) and a socio-demographically matched healthy control group (n = 52). We assessed task- and domain-level dysfunction and relationships between clinical and patient-reported outcomes. Results. Patients scored significantly lower on delayed verbal memory, attention, and executive functioning than healthy controls and in each of these domains, 10-20% of patients scored below cutoff. Delayed Memory was particularly affected and a rather small proportion of its variace was explained by hospitalization (β = -.67, p < .01) and age (β = -.03, p < .01; R2adj. = .06). Hospitalization further predicted attention performance (β = -.83, p < .001; R2adj. = .04). Interpretation. Post-COVID syndrome is associated with long-term cognitive dysfunction, particularly in delayed verbal memory, attention, and executive functioning, relatively independent of original disease severity. Next, longitudinal investigation of the domain-dysfunctions in this cohort is needed to examine their trajectory.

Vascular Dysfunctions Contribute to the Long-Term Cognitive Deficits Following COVID-19

“…Therefore, this condition is called “Long COVID” [ 12 ]. Long-term cognitive outcomes can affect patients’ daily living functions, employment, and the ability to return to work, leading to a large disease burden [ 13 ]. Several mechanisms are suggested for long-term cognitive impairment, including disruption of the BBB, neuro-inflammation, synaptic dysfunction, disturbed neurotransmitter release, and neuronal loss.…”