tetano
Editor, Senior Moderator
PLoS One
. 2024 Aug 29;19(8):e0309102.
doi: 10.1371/journal.pone.0309102. eCollection 2024. Long-term brain fog and cognitive impairment in previously hospitalized COVID-19 patients
Barbara Junco[SUP] 1 [/SUP], Daniel Samano Martin Del Campo[SUP] 1 2 [/SUP], Vela Karakeshishyan[SUP] 1 [/SUP], Danielle Bass[SUP] 1 [/SUP], Evie Sobczak[SUP] 1 [/SUP], Emily Swafford[SUP] 1 [/SUP], Ana Bolanos[SUP] 1 [/SUP], Joshua Rooks[SUP] 1 [/SUP], Bernard S Baumel[SUP] 1 [/SUP], Alberto R Ramos[SUP] 1 [/SUP], Tatjana Rundek[SUP] 1 [/SUP], Ayham Alkhachroum[SUP] 1 [/SUP]
Affiliations
Objectives: Limited research exists on COVID-19 associated brain fog, and on the long-term cognitive and psychiatric sequelae in racially and ethnically diverse patients. We characterize the neuropsychological sequelae of post-acute COVID-19 in a diverse cohort and investigate whether COVID-19 clinical severity remains associated with brain fog and cognitive deficits approximately 2 years post infection.
Methods: A cross-sectional study of patients with a history of COVID-19 hospitalization (March-September 2020). COVID-19 clinical severity was indexed using the National Early Warning Score 2 and a comprehensive neuropsychological tele-battery was administered 2 years post discharge. Pearson's r correlations assessed association, while independent sample t-tests examined group differences. Significant outcomes were further analyzed using multiple regression and ANCOVAs, adjusting for key covariates.
Results: In 41 adult patients (19 female, 30 Hispanic, 13 Black, mean age of 65 (SD = 15), COVID-19 level of severity was associated with greater number of endorsed brain fog symptoms (Pearson's r = .34, 95% CI [.04, .59]), worse overall cognitive functioning (global cognition: r = -.36, 95% CI [-.61, -.05]) and reduced performance on an attention and working memory task (digit span backwards: r = -.41, 95% CI [-.66, -.09]) at 2-year follow-up. Brain fog symptoms most associated with COVID-19 severity included difficulty focusing (r = .46, 95% CI [.18, .67]), detached (r = .41, 95% CI [.12, .64]) and feeling sleepy (r = .40, 95% CI [.11, .63]). Patients' cognitive performance was generally below average (global cognition z-score: M = -.96, SD = .66), with group differences based on sex and ethnicity evidenced on individual cognitive tests.
Discussion: This study emphasizes the importance of continued research on the long-term effects of COVID-19 infection on neuropsychological outcomes, particularly among underrepresented, health-disparate groups. Greater understanding of these associations could improve detection and treatment of those at increased risk of cognitive decline or impairment.
. 2024 Aug 29;19(8):e0309102.
doi: 10.1371/journal.pone.0309102. eCollection 2024. Long-term brain fog and cognitive impairment in previously hospitalized COVID-19 patients
Barbara Junco[SUP] 1 [/SUP], Daniel Samano Martin Del Campo[SUP] 1 2 [/SUP], Vela Karakeshishyan[SUP] 1 [/SUP], Danielle Bass[SUP] 1 [/SUP], Evie Sobczak[SUP] 1 [/SUP], Emily Swafford[SUP] 1 [/SUP], Ana Bolanos[SUP] 1 [/SUP], Joshua Rooks[SUP] 1 [/SUP], Bernard S Baumel[SUP] 1 [/SUP], Alberto R Ramos[SUP] 1 [/SUP], Tatjana Rundek[SUP] 1 [/SUP], Ayham Alkhachroum[SUP] 1 [/SUP]
Affiliations
- PMID: 39208280
- PMCID: PMC11361661
- DOI: 10.1371/journal.pone.0309102
Objectives: Limited research exists on COVID-19 associated brain fog, and on the long-term cognitive and psychiatric sequelae in racially and ethnically diverse patients. We characterize the neuropsychological sequelae of post-acute COVID-19 in a diverse cohort and investigate whether COVID-19 clinical severity remains associated with brain fog and cognitive deficits approximately 2 years post infection.
Methods: A cross-sectional study of patients with a history of COVID-19 hospitalization (March-September 2020). COVID-19 clinical severity was indexed using the National Early Warning Score 2 and a comprehensive neuropsychological tele-battery was administered 2 years post discharge. Pearson's r correlations assessed association, while independent sample t-tests examined group differences. Significant outcomes were further analyzed using multiple regression and ANCOVAs, adjusting for key covariates.
Results: In 41 adult patients (19 female, 30 Hispanic, 13 Black, mean age of 65 (SD = 15), COVID-19 level of severity was associated with greater number of endorsed brain fog symptoms (Pearson's r = .34, 95% CI [.04, .59]), worse overall cognitive functioning (global cognition: r = -.36, 95% CI [-.61, -.05]) and reduced performance on an attention and working memory task (digit span backwards: r = -.41, 95% CI [-.66, -.09]) at 2-year follow-up. Brain fog symptoms most associated with COVID-19 severity included difficulty focusing (r = .46, 95% CI [.18, .67]), detached (r = .41, 95% CI [.12, .64]) and feeling sleepy (r = .40, 95% CI [.11, .63]). Patients' cognitive performance was generally below average (global cognition z-score: M = -.96, SD = .66), with group differences based on sex and ethnicity evidenced on individual cognitive tests.
Discussion: This study emphasizes the importance of continued research on the long-term effects of COVID-19 infection on neuropsychological outcomes, particularly among underrepresented, health-disparate groups. Greater understanding of these associations could improve detection and treatment of those at increased risk of cognitive decline or impairment.