Cognitive Symptoms Associated With Long COVID Linked to Greater Functional Impairment


Participants of a recent study who experienced more daily cognitive symptoms had a greater likelihood of reporting moderate interference with functioning, less likelihood of full-time employment, and greater severity of depressive symptoms.

People with long COVID report a high prevalence of cognitive symptoms that often occur with depressive symptoms and can lead to functional impairment, according to new research published in the journal JAMA Network Open.1 Researchers said the findings highlight the need for better screening and more effective treatments.

Long COVID / Parradee -

Long COVID / Parradee -

Long COVID is common among people who were infected with the SARS-CoV-2 virus, with some studies suggesting that around 10% of patients will experience symptoms. Previous research has found that cognitive deficits are widespread after a COVID-19 infection, but it remains unknown if these early findings are relevant to infections that occurred later in the pandemic.1

Key Takeaways

  • Research highlights a substantial occurrence of cognitive symptoms in individuals with long COVID, often accompanied by depressive symptoms, emphasizing the need for improved screening and treatment strategies.
  • The study indicates that individuals experiencing daily cognitive symptoms post-COVID-19 infection are more likely to report moderate interference with daily functioning, lower odds of full-time employment, and increased severity of depressive symptoms.
  • The findings underscore the importance of considering cognitive symptoms in the assessment and management of post–COVID-19 conditions, emphasizing the necessity for a deeper understanding of the biological mechanisms involved to facilitate the development of effective treatments.

“Developing effective public health strategies for post–COVID-19 condition requires better understanding of the symptoms that compose this syndrome, their prevalence, and their association with functional outcomes,” the authors wrote. “The recognition that the sequelae of COVID-19 represent a persistent public health crisis prompted a National Academy of Medicine effort to refine post–COVID-19 condition definitions and substantial investment from the US government to understand mechanisms and develop treatments….”

A team of investigators led by the Massachusetts General Hospital in Boston conducted a study to examine how self-reported long COVID cognitive symptoms are associated with employment status, functional outcomes, and mood. Data was gathered from 2 waves of the COVID States Project, an online survey of adults living in the US that contained a broad range of questions on sociodemographic variables, functional outcomes, and symptoms.

The study cohort included 14767 adults who reported a test-confirmed COVID-19 infection at least 2 months before the survey was conducted. The mean age of participants was 44.6 years. Of participants, 73.2% were White, 10% were Black, 9.5% were Hispanic, and 2.8% were Asian. Additionally, 68% were women and 32% were men.

READ MORE: Pre-Existing Depression, Anxiety Linked With Increased Risk of Insomnia After COVID-19 Infection

In total, 1683 of the participants reported having long COVID, with 955 saying they experienced at least 1 cognitive symptom daily. Participants who experienced more daily cognitive symptoms had a greater likelihood of reporting moderate interference with functioning, less likelihood of full-time employment, and greater severity of depressive symptoms. The most common cognitive symptoms reported by participants included trouble with decision making and trouble concentrating.

Investigators also found associations between cognitive symptoms and at least moderate interference with everyday functioning, as well as between cognitive symptoms and lower odds of full-time employment, after including depressive symptoms in regression models.

Study limitations include an inability to calculate response rate or estimate nonresponse bias, the reliance on self-reporting, the cross-sectional nature of the study, an inability to examine the association with other comorbidities or treatments, and that the interval from infection or severity of initial infection was not examined.

“Taken together, these results suggest the importance of considering cognitive symptoms in the evaluation and management of post–COVID-19 condition, as they are associated with differences in functioning and quality of life,” the authors said. “They also underscore the need to better understand the biological mechanism underlying these factors to develop effective treatments.”

“Our results extend a growing body of research on the cognitive sequelae of COVID-19, clarifying both the nature of such symptoms and their correlates in a nationally representative cohort reflective of late-pandemic post–COVID-19 condition prevalence,” the authors concluded.

READ MORE: COVID-19 Resource Center

1. Jaywant A, Gunning FM, Oberlin LE, et al. Cognitive Symptoms of Post–COVID-19 Condition and Daily Functioning. JAMA Netw Open. 2024;7(2):e2356098. doi:10.1001/jamanetworkopen.2023.56098
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