NeuroCOVID Burden and Functional Impairment in Adults with Long COVID: A Secondary Analysis of an Italian Cohort

Background/Objectives: Long COVID is frequently characterized by neurological, cognitive, neuropsychiatric, and autonomic symptoms (NeuroCOVID). However, their impact on daily functioning remains insufficiently investigated. This study evaluated the association between NeuroCOVID burden and functional impairment among Italian Long COVID survivors. Methods: A secondary cross-sectional analysis was conducted on 250 adults using a validated Italian Long COVID questionnaire. A NeuroCOVID Burden Score (10 symptom domains) and a Functional Impairment Score (daily activities) were constructed and analyzed using correlation and multivariable linear regression. Results: The sample (mean age 33.2 years; 63.6% female) demonstrated high internal consistency for both scores. A strong positive correlation was found between NeuroCOVID burden and functional impairment (r = 0.703; p < 0.001). Conclusions: Persistent NeuroCOVID burden was strongly associated with greater limitations in daily activities. In multivariable regression, NeuroCOVID Burden Score remained independently associated with functional impairment (B = 0.671; 95% CI 0.566–0.776; p < 0.001), together with acute COVID-19 severity (B = 0.156; 95% CI 0.055–0.257; p = 0.003). The final model explained 52.5% of the variance in functional impairment (R2 = 0.525).