Meta-analysis of Cognitive Function Following Non-severe SARS-CoV-2 Infection

Tara A Austin^{1

2

3}, Michael L Thomas⁴, Min Lu⁵, Cooper B Hodges⁶, Emily S Darowski⁷, Rachel Bergmans⁸, Sarah Parr^{9

10}, Delaney Pickell¹¹, Mikayla Catazaro^{9

10}, Crystal Lantrip^#^{9

10}, Elizabeth W Twamley^#^{11

12

13}

Affiliations

¹ The VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, Waco, TX, 76711, USA. tara.austin@va.gov.
² Center of Excellence for Stress and Mental Health, San Diego Healthcare System, San Diego, CA, USA. tara.austin@va.gov.
³ Research Service, VA San Diego Healthcare System, San Diego, CA, USA. tara.austin@va.gov.
⁴ Department of Psychology, Colorado State University, Colorado Springs, Fort Collins, USA.
⁵ University of Miami, Miami, FL, USA.
⁶ Department of Psychology, Brigham Young University, Provo, UT, USA.
⁷ Harold B. Lee Library, Brigham Young University, Provo, UT, USA.
⁸ Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA.
⁹ The VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, Waco, TX, 76711, USA.
¹⁰ Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.
¹¹ Center of Excellence for Stress and Mental Health, San Diego Healthcare System, San Diego, CA, USA.
¹² Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
¹³ Department of Psychiatry, University of California San Diego, San Diego, CA, USA.

^# Contributed equally.

PMID: 38862725
DOI: 10.1007/s11065-024-09642-6

Review

Meta-analysis of Cognitive Function Following Non-severe SARS-CoV-2 Infection

Tara A Austin et al. Neuropsychol Rev. 2025 Jun.

. 2025 Jun;35(2):354-380.

doi: 10.1007/s11065-024-09642-6. Epub 2024 Jun 12.

Authors

Affiliations

¹ The VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, Waco, TX, 76711, USA. tara.austin@va.gov.
² Center of Excellence for Stress and Mental Health, San Diego Healthcare System, San Diego, CA, USA. tara.austin@va.gov.
³ Research Service, VA San Diego Healthcare System, San Diego, CA, USA. tara.austin@va.gov.
⁴ Department of Psychology, Colorado State University, Colorado Springs, Fort Collins, USA.
⁵ University of Miami, Miami, FL, USA.
⁶ Department of Psychology, Brigham Young University, Provo, UT, USA.
⁷ Harold B. Lee Library, Brigham Young University, Provo, UT, USA.
⁸ Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA.
⁹ The VISN 17 Center of Excellence for Research on Returning War Veterans, 4800 Memorial Drive, Waco, TX, 76711, USA.
¹⁰ Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA.
¹¹ Center of Excellence for Stress and Mental Health, San Diego Healthcare System, San Diego, CA, USA.
¹² Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
¹³ Department of Psychiatry, University of California San Diego, San Diego, CA, USA.

^# Contributed equally.

PMID: 38862725
DOI: 10.1007/s11065-024-09642-6

Abstract

To effectively diagnose and treat subjective cognitive symptoms in post-acute sequalae of COVID-19 (PASC), it is important to understand objective cognitive impairment across the range of acute COVID-19 severity. Despite the importance of this area of research, to our knowledge, there are no current meta-analyses of objective cognitive functioning following non-severe initial SARS-CoV-2 infection. The aim of this meta-analysis is to describe objective cognitive impairment in individuals with non-severe (mild or moderate) SARS-CoV-2 cases in the post-acute stage of infection. This meta-analysis was pre-registered with Prospero (CRD42021293124) and utilized the PRISMA checklist for reporting guidelines, with screening conducted by at least two independent reviewers for all aspects of the screening and data extraction process. Fifty-nine articles (total participants = 22,060) with three types of study designs met our full criteria. Individuals with non-severe (mild/moderate) initial SARS-CoV-2 infection demonstrated worse objective cognitive performance compared to healthy comparison participants. However, those with mild (nonhospitalized) initial SARS-CoV-2 infections had better objective cognitive performance than those with moderate (hospitalized but not requiring ICU care) or severe (hospitalized with ICU care) initial SARS-CoV-2 infections. For studies that used normative data comparisons instead of healthy comparison participants, there was a small and nearly significant effect when compared to normative data. There were high levels of heterogeneity (88.6 to 97.3%), likely reflecting small sample sizes and variations in primary study methodology. Individuals who have recovered from non-severe cases of SARS-CoV-2 infections may be at risk for cognitive decline or impairment and may benefit from cognitive health interventions.

Keywords: COVID-19; Cognition; Cognitive decline; PASC; Post-acute sequalae of COVID-19; SARS-CoV-2.

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Conflict of interest statement

Declarations. Ethical Approval: N/A. No original data. Competing Interests: The authors declare no competing interests. Disclaimer: The views expressed herein are those of the authors and do not necessarily reflect the official policy or position of the Department of Veterans Affairs or the United States Government.

References

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Meta-analysis of Cognitive Function Following Non-severe SARS-CoV-2 Infection

Affiliations

Meta-analysis of Cognitive Function Following Non-severe SARS-CoV-2 Infection

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous