Cognitive Trajectory of COVID-19 and Long COVID in Adult Survivors

Abstract

Introduction: Cognitive functioning and psychological well-being are considered negatively affected by COVID-19. An estimated 15%-40% of COVID-19 patients report disrupted cognitive performance. Higher rates of anxiety, depression and sleep disturbances are also reported post infection. Objectives: We examined the profile of cognitive changes in a group of adults with a confirmed COVID-19 diagnosis, compared to those without a COVID-19 diagnosis (cross-sectional betweensubjects investigation); and for a subgroup, compared to their pre-COVID-19 cognitive function (longitudinal within-subjects investigation). Methods: One hundred and twenty-one adults (57 with no known history of COVID-19; 64 with confirmed COVID-19; 17/64 with long COVID symptoms) were assessed online for psychological well-being and cognitive function (attention, processing speed, working memory, episodic memory and executive function). Pre-COVID-19 cognitive data were available for 56 of 121 adults (24 adults with a confirmed diagnosis of COVID-19; 22 with no known history of COVID-19) through the MyCognition database. Results: The COVID-19 group showed reduced processing speed in both cross-sectional and longitudinal investigations, and also showed significant attentional impairment when examined crosssectionally. Five long COVID symptoms (abdominal pain, chest pain, sore eyes/conjunctivitis, sore throat and vomiting/nausea) were associated with reduced performance in multiple cognitive domains. Higher levels of depression and anxiety were also present in the COVID-19 group but these symptoms were mostly unrelated to cognitive performance. Conclusions: COVID-19 survivors, especially those with long COVID symptoms, are very likely to experience cognitive disruption. Measures need to be implemented to support their cognitive recovery in addition to the physical recovery.