New research confirms that regardless of age or severity of COVID-19 infection, prolonged effects on cognitive function are possible.
COVID-19’s impact on brain function is just beginning to be understood. It’s been known that COVID-19 patients treated in the hospital, particularly those who have respiratory support, experience delirium and other cognitive effects after leaving the hospital. Additionally, physicians and patients have reported symptoms of “long-COVID,” in which the physical effects of the infection continued long after the infection has cleared.
Long COVID is recognized by the CDC and can include any of symptoms, including cough, chest pain, fatigue, change in taste or smell and even brain fog. Long-COVID may be considered a disability by the U.S. Health and Human Services under the Americans with Disability Act.
A new study, published in October 2021 in JAMA Network Open, seems to confirm that even months after contracting COVID-19, some patients experience problems with memory, processing speed, executive function, and other cognitive impairments.
The biggest takeaway from the study is that COVID-19 of any severity and for adults in any age group can have prolonged effects on cognitive functioning, even months after viral recovery, lead investigator Jacqueline H. Becker, Ph.D., division of general internal medicine at Icahn School of Medicine at Mount Sinai, New York, said by email.
“It is well known that individuals can sustain cognitive deficits after critical illness, particularly older adults and those with other comorbid diseases. Our findings add to this knowledge by demonstrating a high frequency of cognitive impairment in a relatively young cohort across the spectrum of disease severity, even after controlling for potentially confounding factors such as depression and other comorbidities,” she said.
One limitation suggested by investigators is the potential for sampling bias. In this study, investigators followed up with 740 patients seen at the Mount Sinai Health System for an COVID-19 infection either in the outpatient setting, the emergency department, or an in-hospital setting.
Patients were given several cognitive assessment tests. Investigators found that there was a high frequency of cognitive impairment several months after patients contracted COVID-19. Hospitalized patients were more likely to have impairments in attention, executive function, category fluency, memory encoding than those seen on an outpatient setting. Patients treated in the emergency department were more likely to have impaired category fluency and memory encoding than those treated in the outpatient setting.
Investigators said the results are consistent with other studies of cognitive impairment resulting from COVID-19 infections, but patients in this study tended to be younger with a mean age of 49 and range of 38 to 59 years of age.