Cognitive Performance Remains Intact 1 Year After COVID-19 in Middle-Aged Adults

COVID-19 is not associated with cognitive impairment in the first year after infection among middle-aged individuals, according to study findings published in Open Forum Infectious Diseases.

COVID-19 has been associated with chronic and disabling symptoms after the acute phase, a condition called long COVID. Some research has suggested a negative impact on cognitive function, with some reports of persistent memory loss, reduced attention, and brain fog. However, prospective longitudinal research to support that link is lacking.

Researchers conducted a longitudinal cohort study to examine cognitive function following COVID-19 infection in patients who completed baseline cognitive assessments before disease onset. Cognitive function was measured using the computerized Cognivue Clarity^® device at the University Hospitals Cleveland Medical Center in Ohio, and all patients had assessments available from before the pandemic and about 1 year after infection (follow-up assessments were taken no earlier than 90 days). Patients were then stratified into 2 groups depending on whether they contracted COVID-19 during that period.

Although emerging evidence has described persistent neurocognitive symptoms such as memory loss, reduced attention, and brain fog following COVID-19, our study did not support these findings when objectively assessing cognitive function.

A total of 110 patients were included in the final analysis, of whom the median age was 45 years, 35% were women, and 46% were White.

Half of patients had a documented case of COVID-19 during follow-up. The median time between baseline and follow-up cognitive assessments was 400 (IQR, 364-554) days in the COVID-19-positive group and 404 (IQR, 328-725) days in the COVID-19-negative group. At baseline, groups had similar cognitive scores, with a mean (SD) overall score of 78.0 (15.0) in the COVID-19-positive group and 74.8 (15.2) in COVID-19-negative group (P =.2).

The only cognitive measure that changed significantly during follow-up in patients who developed COVID-19 were memory scores, which improved by an average of 3.9 points (P =.03). There were no changes in the overall score or the other 5 cognitive subdomains.

Patients without COVID-19, however, saw significant improvements in the overall Cognivue^® score (+2.0; P =.03) and in scores on the following domains: visuospatial (+1.9; P =.04), executive function (+2.2; P =.02), and naming/language (+2.2; P =.01). There were, however, no significant between-group differences in the changes in overall or subdomain scores from baseline to follow-up.

Study limitations include the need for additional research using a larger sample size and analysis of additional factors, the lack of testing among control patients for asymptomatic SARS-CoV-2 infection, and the lack of cognitive assessments during the acute phase of infection and at additional times during follow-up.

The researchers concluded, “Although emerging evidence has described persistent neurocognitive symptoms such as memory loss, reduced attention, and brain fog following COVID-19, our study did not support these findings when objectively assessing cognitive function.”

Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Infectious Disease Advisor