The Impact of Long COVID on Cognitive Functioning

This study systematically examined whether long COVID negatively impacts subjective and objective measures of cognition in a community-based sample of 251 participants. Participants completed a battery of neurocognitive tasks (including assessments of short-term memory, working memory, episodic memory, processing speed, executive functioning, and reasoning) and provided self-ratings of their cognition (mental fatigue and subjective cognitive difficulties), depressive symptoms, the impact of symptoms on their life, and completed surveys assessing other psychosocial outcomes. Subgroups included individuals with no known lifetime history of COVID-19 illness (n = 66), those who had recovered from a short-term COVID infection (n = 119), and those who had been diagnosed with long COVID (n = 62). Analyses indicated that long COVID was associated with worse performance on measures of processing speed and executive functioning. In addition, those with a history of long COVID reported higher levels of mental fatigue and subjective cognitive difficulties compared to the other subgroups. Analyses within the long COVID subsample indicated that after controlling for covariates, depressive symptoms were significantly associated with mental fatigue and self-reported cognitive difficulties, and ratings of symptom impact also significantly predicted mental fatigue. These findings reinforce the value of incorporating both subjective and objective assessments when evaluating cognitive outcomes in long COVID, as each captures distinct aspects of functioning. Furthermore, these findings underscore the importance of assessing subjective cognitive concerns and functional symptom burden in clinical encounters, even when objective performance is generally unimpaired.