Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 20;14(1):3.
doi: 10.3390/brainsci14010003.

Frequency, Characteristics, and Correlates of Cognitive Complaints in a Cohort of Individuals with Post-Acute Sequelae of COVID-19

Cayla Muschel  1   2 , Sean T Lynch  1   3 , Rhea Dornbush  2 , Lidia Klepacz  1   2 , Sivan Shahar  1   4 , Stephen J Ferrando  1   2
Affiliations

Frequency, Characteristics, and Correlates of Cognitive Complaints in a Cohort of Individuals with Post-Acute Sequelae of COVID-19

Cayla Muschel et al. Brain Sci. .

Abstract

Background: Cognitive complaints are among the most frequent symptoms of post-acute sequelae of COVID-19 (PASC). This study aimed to investigate the frequency, characteristics, and clinical correlates of cognitive complaints (CC) in PASC, particularly in relation to objective neuropsychological (NP) performance.

Methods: Seventy-four participants underwent psychiatric, medical, and NP testing approximately 7 months after acute COVID-19. The Patient Assessment of Own Functioning Inventory (PAOFI) was used to characterize the frequency and severity of CC in domains of memory, language, and cognitive/executive function. The associations of CC with sociodemographic, medical, psychiatric, and NP variables were assessed utilizing correlational analysis, logistic regression, and pairwise comparisons of those categorized as having CC vs. not having CC.

Results: Taken together, approximately one-third of the study participants had clinically significant CC. Memory difficulty was the most frequent CC, although all categories were frequently endorsed. Memory and cognitive/executive complaints correlated with NP tests in these and multiple other NP domains. CC were more likely to be under-reported in those with diminished NP performance than over-reported in those without diminished performance. Acute COVID-19 symptom severity, elevated depressive symptoms, and NP tests of diminished attention and psychomotor processing speed were independent predictors of CC in logistic regression.

Conclusions: Cognitive complaints after acute COVID-19 should be taken seriously, as they are likely to reflect diminished NP performance, as well as medical, psychiatric, and functional burdens. However, patients with PASC may not accurately identify or characterize objective cognitive difficulties, so programs offering comprehensive care for patients with PASC should offer formal neuropsychological testing.

Keywords: COVID-19; brain fog; cognitive complaints; depression; neuropsychological performance.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

References

    1. Groff D., Sun A., Ssentongo A.E., Ba D.M., Parsons N., Poudel G.R., Lekoubou A., Oh J.S., Ericson J.E., Ssentongo P., et al. Short-Term and Long-Term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review. JAMA Netw. Open. 2021;4:e2128568. doi: 10.1001/jamanetworkopen.2021.28568. - DOI - PMC - PubMed
    1. Boldrini M., Canoll P.D., Klein R.S. How COVID-19 Affects the Brain. JAMA Psychiatry. 2021;78:682. doi: 10.1001/jamapsychiatry.2021.0500. - DOI - PMC - PubMed
    1. Pihlaja R.E., Kauhanen L.-L.S., Ollila H.S., Tuulio-Henriksson A.S., Koskinen S.K., Tiainen M., Salmela V.R., Hästbacka J., Hokkanen L.S. Associations of Subjective and Objective Cognitive Functioning after COVID-19: A Six-Month Follow-up of ICU, Ward, and Home-Isolated Patients. Brain Behav. Immun. Health. 2023;27:100587. doi: 10.1016/j.bbih.2023.100587. - DOI - PMC - PubMed
    1. Chelune G.J., Lehman R.A., Heaton R.K. Neuropsychological and Personality Correlates of Patients’ Complaints of Disability. In: Goldstein G., Tarter R.E., editors. Advances in Clinical Neuropsychology. Springer; Boston, MA, USA: 1996. pp. 95–126.
    1. Ferrando S.J. Diagnosis and Treatment of HIV-associated Neurocognitive Disorders. New Dir. Ment. Health Serv. 2000;2000:25–35. doi: 10.1002/yd.23320008705. - DOI - PubMed

LinkOut - more resources