Acute COVID-19 severity and impaired cognitive function up to 32 months after diagnosis: an observational study.
Cognitive dysfunction ("brain fog") is a commonly reported post-COVID-19 symptom. Leveraging data from five general population cohorts across four European countries (Estonia, Iceland, Norway, and Sweden), we assessed long-term prevalence of impaired subjective cognitive function among individuals diagnosed with COVID-19 by acute illness severity.
The included cohorts consisted of adult participants recruited from March 2020 and followed with self-report measures of cognitive function and past COVID-19 infection (except one cohort consisting of clinically confirmed COVID-19 cases) through February 2023. In a cross-sectional analysis we contrasted the prevalence of impaired cognitive function among individuals with and without a COVID-19 diagnosis, overall and by illness severity up to 32 months post-diagnosis. We adjusted for age, gender, education, relationship status, binge drinking, body mass index, previous psychiatric diagnosis, number of chronic medical conditions, and response period. In a longitudinal analysis, we assessed potential changes in cognitive function scores before and after COVID-19 diagnosis.
The study population consisted of 153,841 participants (71% women), with 31,359 (20.4%) reporting a positive COVID-19 test. Overall, a COVID-19 diagnosis was not statistically significantly associated with increased prevalence ratio (PR) of impaired cognitive function (PR 1.30 [95% CI: 0.98-1.71]). Individuals bedridden due to COVID-19 for 1-6 days (PR 1.38 [95% CI 0.96-1.99]) or ≥ 7 days (2.59 [1.55-4.33]) had higher prevalence of impaired cognitive function compared to those never diagnosed, while individuals never bedridden had a lower prevalence to those never diagnosed with COVID-19 (0.89 [0.80-1.00]). These findings were corroborated in the longitudinal analysis where a pre- to post diagnosis decline in cognitive function was observed among individuals bedridden due to COVID-19 (p < 0.0001).
The data indicates that a severe COVID-19 acute illness course is associated with impaired cognitive function up to 18-32 months after COVID-19 diagnosis.
The included cohorts consisted of adult participants recruited from March 2020 and followed with self-report measures of cognitive function and past COVID-19 infection (except one cohort consisting of clinically confirmed COVID-19 cases) through February 2023. In a cross-sectional analysis we contrasted the prevalence of impaired cognitive function among individuals with and without a COVID-19 diagnosis, overall and by illness severity up to 32 months post-diagnosis. We adjusted for age, gender, education, relationship status, binge drinking, body mass index, previous psychiatric diagnosis, number of chronic medical conditions, and response period. In a longitudinal analysis, we assessed potential changes in cognitive function scores before and after COVID-19 diagnosis.
The study population consisted of 153,841 participants (71% women), with 31,359 (20.4%) reporting a positive COVID-19 test. Overall, a COVID-19 diagnosis was not statistically significantly associated with increased prevalence ratio (PR) of impaired cognitive function (PR 1.30 [95% CI: 0.98-1.71]). Individuals bedridden due to COVID-19 for 1-6 days (PR 1.38 [95% CI 0.96-1.99]) or ≥ 7 days (2.59 [1.55-4.33]) had higher prevalence of impaired cognitive function compared to those never diagnosed, while individuals never bedridden had a lower prevalence to those never diagnosed with COVID-19 (0.89 [0.80-1.00]). These findings were corroborated in the longitudinal analysis where a pre- to post diagnosis decline in cognitive function was observed among individuals bedridden due to COVID-19 (p < 0.0001).
The data indicates that a severe COVID-19 acute illness course is associated with impaired cognitive function up to 18-32 months after COVID-19 diagnosis.
Authors
Magn煤sd贸ttir Magn煤sd贸ttir, Nygaard Nygaard, Hoffart Hoffart, Murphy Murphy, K玫iv K玫iv, Barker Barker, Lovik Lovik, Unnarsd贸ttir Unnarsd贸ttir, K盲hler K盲hler, Hauksd贸ttir Hauksd贸ttir, Thordardottir Thordardottir, Ey镁贸rsson Ey镁贸rsson, G铆slad贸ttir G铆slad贸ttir, Joyce Joyce, Frans Frans, T贸masson T贸masson, Hj枚rd铆sar J贸nsd贸ttir Hj枚rd铆sar J贸nsd贸ttir, R煤narsd贸ttir R煤narsd贸ttir, Har冒ard贸ttir Har冒ard贸ttir, Dahl Dahl, Jakobsd贸ttir Jakobsd贸ttir, Kalleberg Kalleberg, 脕sbj枚rnsd贸ttir 脕sbj枚rnsd贸ttir, Ellingjord-Dale Ellingjord-Dale, Istre Istre, Landr酶 Landr酶, Shen Shen, B酶 B酶, M盲gi M盲gi, P谩lsson P谩lsson, Brunvoll Brunvoll, Johnson Johnson, S酶raas S酶raas, Fang Fang, Lehto Lehto, Ebrahimi Ebrahimi, Aspelund Aspelund, Valdimarsd贸ttir Valdimarsd贸ttir
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