Objectives: (a) To characterize the frequency of objective cognitive deficits and self-perceived cognitive difficulties and (b) to explore demographic and clinical predictors of cognitive dysfunction and cognitive complaints. Method: One hundred and ten adults diagnosed with COVID-19 between March and November 2020, aged ≤74 years underwent a brief neuropsychological evaluation 12 months after infection, which included: Brief Visuospatial Memory Test–Revised, California Verbal Learning Test, and Symbol Digit Modalities Test. T scores <38 were considered abnormal performance; cognitive dysfunction was defined as ≥2 abnormal tests. Participants also completed Broadbent’s Cognitive Failure Questionnaires (CFQ), Hospital Anxiety and Depression Scale, Modified Fatigue Impact Scale, and Short-Form Health Survey. CFQ ≥ 43 was considered indicative of cognitive complaints. Results: Twenty participants (18.2%) had cognitive dysfunction and 36 (33.3%) had cognitive complaints. Cognitive dysfunction was related to lower education, preinfection history of headache/migraine, and acute COVID-19 symptoms of headache and sleep disturbance. Cognitive complaints were more likely to occur in women, those with fewer years of education, and acute COVID-19 symptoms of headache and sleep disturbance. Cognitive complaints were also significantly related to symptoms of anxiety, depression, and fatigue. Sex and psychopathology were not significant predictors of cognitive dysfunction. Modest associations were found between CFQ total score and cognitive test performance. Discussion: A subset of individuals develops cognitive difficulties in the context of post-COVID syndrome. Results may support the protective effect of education, a known proxy of cognitive reserve. COVID-19 infection symptoms of headache and sleep disturbance appear to be risk factors for long-term cognitive difficulties.

Introduction Migraine is one of the most disabling neurological diseases and is aggravated by anxiety, stress, and sleep dysfunction. Recent studies have shown worsening of migraine associated with the COVID-19 infection and the pandemic more broadly. COVID-19 vaccination has also been associated with symptomatic headache, with high frequency among migraineurs. We aim to assess the impact of COVID-19 diagnosis and vaccine administration on migraine, during the SARS-CoV-2 pandemic. Methods An online questionnaire was sent to migraine patients followed in a neurology outpatient clinic. The survey inquired about migraine symptoms and treatment changes, as well as sleep changes, anxiety and depressive symptoms during the pandemic, after a COVID-19 diagnosis and/or vaccination. Results Out of the 185 patients included, 108 (58.4%) reported a change in headache pattern (42% before a COVID-19 diagnosis) and 72.2% needed to escalate treatment during the pandemic, regardless of infection. Migraine worsening was associated with higher rates of persistent symptomatic headache. A change in sleep pattern was more frequently reported in migraineurs after COVID-19 and in the group with worsening migraine. Abnormal levels of anxiety and depression were high among patients with worsening migraine, irrespective of COVID-19 diagnosis. After vaccination, 49 (27.1%) described a change in headache pattern, with worsening pattern in 29 (16%), 48% up to 3 weeks. Conclusion Worsening of migraine was more likely associated to psychosocial factors related to the pandemic rather than COVID-19 diagnosis per se. COVID-19 vaccination might have acted as an additional but less relevant and temporary trigger for migraine worsening.

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