Assessment and Characterization of COVID-19 Related Cognitive Decline: Results from a Natural Experiment

The study titled “Assessment and Characterization of COVID-19 Related Cognitive Decline: Results from a Natural Experiment” focused on the impact of COVID-19 on cognitive function, particularly in patients with Post-Acute Sequelae of SARS-CoV-2 (PASC) or severe COVID-19. The study used a longitudinal cohort design, comparing cognitive performance in 276 COVID-19 patients with 217 controls across four domains sensitive to neuroinflammation or vascular disease, using data collected both before and after the pandemic began in 2015​​.

Key Findings:

  1. Cognitive Decline: Significant cognitive decline was observed post-COVID-19, equivalent to 10.6 years of normal aging and a 59.8% increase in the burden of mild cognitive impairment (MCI). This decline was more pronounced in participants with PASC or those who had severe COVID-19​​.
  2. Impact of PASC: Participants with PASC experienced significant decrements across all four cognitive domains, with the largest involving cognitive throughput and response speed​​.
  3. Severity of COVID-19: Cognitive impairment was greater in participants with more severe COVID-19, especially in cognitive throughput and processing speed​​.
  4. Differential Impact in PASC: The study found a differential impact of COVID-19 on cognitive function between individuals with and without PASC. For those with PASC, there were impacts on processing speed, visual memory, and reaction time, whereas for those without PASC, the impact was primarily on throughput​​.

Study Strengths and Limitations: The study employed the Cog State brief battery test to assess cognitive function, which is sensitive to neuroinflammation and vascular alterations. This method reduced administrator and observer bias and allowed for the adjustment of models for recognized risk variables for cognitive impairment. However, the study’s generalizability may be limited due to the demographic composition of the sample, primarily Caucasian men with at least some college education​​.

Conclusion: The study concluded that SARS-CoV-2 infection is associated with significant cognitive impairment, worsening in cases of PASC and severe disease. This impairment impacts daily, occupational, and social functioning. The authors emphasize the importance of evaluating and treating COVID-19 patients, especially those with PASC, for cognitive deterioration and understanding the long-term prognosis of these impairments​​.

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