Background: There is growing concern about possible cognitive consequences of COVID-19, with reports of 'Long COVID' symptoms persisting into the chronic phase and case studies revealing neurological problems in severely affected patients. However, there is little information regarding the nature and broader prevalence of cognitive problems post-infection or across the full spread of disease severity. Methods: We sought to confirm whether there was an association between cross-sectional cognitive performance data from 81,337 participants who between January and December 2020 undertook a clinically validated web-optimized assessment as part of the Great British Intelligence Test, and questionnaire items capturing self-report of suspected and confirmed COVID-19 infection and respiratory symptoms. Findings: People who had recovered from COVID-19, including those no longer reporting symptoms, exhibited significant cognitive deficits versus controls when controlling for age, gender, education level, income, racial-ethnic group, pre-existing medical disorders, tiredness, depression and anxiety. The deficits were of substantial effect size for people who had been hospitalised (N = 192), but also for non-hospitalised cases who had biological confirmation of COVID-19 infection (N = 326). Analysing markers of premorbid intelligence did not support these differences being present prior to infection. Finer grained analysis of performance across sub-tests supported the hypothesis that COVID-19 has a multi-domain impact on human cognition. Interpretation: Interpretation. These results accord with reports of 'Long Covid' cognitive symptoms that persist into the early-chronic phase. They should act as a clarion call for further research with longitudinal and neuroimaging cohorts to plot recovery trajectories and identify the biological basis of cognitive deficits in SARS-COV-2 survivors.

Using longitudinal neuroimaging, Cole et al. show that traumatic brain injury (TBI) results in progressive loss of brain tissue that continues for years after an injury. Tissue loss occurs predominantly in cerebral white matter and cortical sulci. Neuroimaging may be a feasible method for evaluating neuroprotective therapies after TBI.

SummaryNavigating to a safe place, such as a home or nest, is a fundamental behavior for all complex animals. Determining the direction to such goals is a crucial first step in navigation. Surprisingly, little is known about how or where in the brain this “goal direction signal” is represented. In mammals, “head-direction cells” are thought to support this process, but despite 30 years of research, no evidence for a goal direction representation has been reported [1, 2]. Here, we used fMRI to record neural activity while participants made goal direction judgments based on a previously learned virtual environment. We applied multivoxel pattern analysis [3–5] to these data and found that the human entorhinal/subicular region contains a neural representation of intended goal direction. Furthermore, the neural pattern expressed for a given goal direction matched the pattern expressed when simply facing that same direction. This suggests the existence of a shared neural representation of both goal and facing direction. We argue that this reflects a mechanism based on head-direction populations that simulate future goal directions during route planning [6]. Our data further revealed that the strength of direction information predicts performance. Finally, we found a dissociation between this geocentric information in the entorhinal/subicular region and egocentric direction information in the precuneus.