AUTHOR=Henneghan Ashley M. , Lewis Kimberly A. , Gill Eliana , Kesler Shelli R. 

TITLE=Cognitive Impairment in Non-critical, Mild-to-Moderate COVID-19 Survivors

JOURNAL=Frontiers in Psychology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2022.770459

DOI=10.3389/fpsyg.2022.770459

ISSN=1664-1078

ABSTRACT=<sec><title>Importance</title><p>Previous studies of post-acute COVID-19 syndrome have focused on critical cases with severe disease. However, most cases are mild to moderate in disease severity.</p></sec><sec><title>Objective</title><p>We aimed to examine cognitive outcomes in cases of non-critical, mild-to-moderate COVID-19. Design, Setting, and Participants: In this cross-sectional study, we enrolled 72 adults aged 22 to 65 years in Central Texas who had non-critical, mild-to-moderate COVID-19 infection between 13 January 2021 and 20 April 2021.</p></sec><sec><title>Main Outcomes and Measures</title><p>We remotely administered cognitive-behavioral testing to determine the frequency of cognitive impairment and examine demographic, clinical, and psychosocial contributors to impairment.</p></sec><sec><title>Results</title><p>The frequency of objective cognitive impairment was 40%. The largest number of participants (24%) showed impairment on a measure of executive functioning. Attention and processing speed was more impaired in males (<italic>OR</italic> = 1.5, 95%CI = 0.23–2.9). Males endorsed lower adherence to social distancing guidelines (<italic>U</italic> = 590, <italic>p</italic> = 0.01), which was in turn associated with cognitive impairment across participants (<italic>r</italic> = −0.30, <italic>p</italic> = 0.01). Younger age was correlated with impairment (<italic>r</italic> = −0.26, <italic>p</italic> = 0.03) but was also associated with racial/ethnic minority status (<italic>r</italic> = −0.31, <italic>p</italic> = 0.01) and increased psychological symptoms (<italic>p</italic> &lt; 0.04). Greater number of COVID-19 symptoms was correlated with lower subjective cognitive function (<italic>r</italic> = −0.38, <italic>p</italic> = 0.001) as well as psychosocial function (<italic>r</italic> &gt; 0.24, <italic>p</italic> &lt; 0.05). Moderate COVID-19 severity was associated with attention/processing speed impairment (<italic>r</italic> = 0.27, <italic>p</italic> = 0.03), increased pain (<italic>r</italic> = 0.31, <italic>p</italic> = 0.01), and higher number of COVID-19 symptoms (<italic>r</italic> = 0.32, <italic>p</italic> = 0.01).</p></sec><sec><title>Conclusion and Relevance</title><p>Mild or moderate COVID-19 infection may be associated with cognitive impairments, especially in the domain of executive functioning. A subgroup of younger individuals may be more vulnerable to cognitive and psychosocial effects of COVID-19.</p></sec><sec><title>Highlights</title><p>Question: How frequent is cognitive impairment among non-critical, mild-to-moderate COVID-19 survivors?</p></sec><sec><title>Findings</title><p>In this cross-sectional study of 72 adults, 40% demonstrated cognitive impairment, particularly in executive function.</p></sec><sec><title>Meaning</title><p>Neurologic sequelae, such as cognitive impairment, may be common following COVID-19 infection.</p></sec>