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. 2024 Jul 5:11:1399145.
doi: 10.3389/fmed.2024.1399145. eCollection 2024.

Long COVID: cognitive, balance, and retina manifestations

Meritxell Carmona-Cervelló #  1 , Brenda Biaani León-Gómez #  1 , Rosalia Dacosta-Aguayo  1   2 , Noemí Lamonja-Vicente  1   3 , Pilar Montero-Alía  1   4 , Gemma Molist  1   5 , Aitana Ayet  1 , Carla Chacón  1   3 , Anna Costa-Garrido  1 , Victor M López-Lifante  1   4   6   7 , Valeria Zamora-Putin  1   6 , Liudmila Liutsko  1 , Rosa García-Sierra  1   4   8 , Antònia Fornés  1 , Eduard Moreno-Gabriel  1   4   9 , Marta Massanella  10   11   12 , Jose A Muñoz-Moreno  13   14 , M Carmen Rodríguez-Pérez  1   4 , Lourdes Mateu  2   11   12   13 , Anna Prats  13 , Maria Mataró  15   16   17 , Marc Boigues  18   19   20 , Bibiana Quirant  18   19   20 , Julia G Prado  2   10   11 , Eva Martínez-Cáceres  2   18   19 , Concepción Violán  1   2   3   7   21 , Pere Torán-Monserrat  1   2   4   22 ; APC Collaborative Group
Affiliations

Long COVID: cognitive, balance, and retina manifestations

Meritxell Carmona-Cervelló et al. Front Med (Lausanne). .

Abstract

Background: The neurological symptoms of Long COVID (LC) and the impact of neuropsychological manifestations on people's daily lives have been extensively described. Although a large body of literature describes symptoms, validating this with objective measures is important. This study aims to identify and describe the effects of Long COVID on cognition, balance, and the retinal fundus, and determine whether the duration of symptoms influences cognitive impairment.

Methods: This cross-sectional study involved LC volunteers with cognitive complaint from public health centers in northern Barcelona who participated between January 2022 and March 2023. This study collected sociodemographic characteristics, information on substance use, comorbidities, and clinical data related to COVID-19. We measured five cognitive domains using a battery of neuropsychological tests. Balance was assessed through posturography and retinal vascular involvement by retinography.

Results: A total of 166 people with LC and cognitive complaints participated, 80.72% were women and mean age was 49.28 ± 8.39 years. The most common self-reported symptoms were concentration and memory deficit (98.80%), brain fog (82.53%) and insomnia (71.17%). The 68.67% presented cognitive deficit in at least one domain, with executive functions being the most frequent (43.98%). The 51.52% of the participants exhibited a dysfunctional pattern in balance, and 9.2% showed some alteration in the retina. There were no statistically significant differences between cognitive impairment and symptom duration.

Conclusion: Our findings contribute to a more comprehensive understanding of the pathology associated with Long COVID. They highlight the diversity of self-reported symptoms, the presence of abnormal balance patterns, and some cognitive impairment. These findings underscore the necessity of addressing the clinical management of this condition in primary care through follow-up and the pursuit of multidisciplinary and comprehensive treatment.

Keywords: long COVID; neurological symptoms; neuropsychological assessment; postural balance; retina fundus.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Diagram of the study design and the information collected at each visit.
Figure 2
Figure 2
Differences between duration of cognitive symptoms self-reported (lack of concentration and memory, brain fog and nonspecific disorientation) and cognitive deficit by domain (n = 166).C&M, lack of Concentration and Memory. BF, Brain Fog. ND, Nonspecific Disorientation. Note: Symptom duration was divided into two groups: G1 (1 to 25 months) and G2 (26 to 36 months). The Figure shows the p-value of Chi-square analysis. We selected the most prevalent cognitive symptoms in our sample excluding the “Other cognitive symptoms” because it grouped more than one symptom.
See this image and copyright information in PMC

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