Long-term consequences of COVID-19 on cognitive functioning up to 6 months after discharge: role of depression and impact on quality of life

Abstract

Neurologic and psychiatric symptoms have been reported in the months following the infection with COVID-19. A low-grade inflammation has been associated both with depression and cognitive symptoms, suggesting a link between these disorders. The aim of the study is to investigate cognitive functioning 6 months following hospital discharge for COVID-19, the impact of depression, and the consequences on quality of life. Ninety-two COVID-19 survivors evaluated at 1-month follow-up, 122 evaluated at 3 months and 98 evaluated at 6 months performed neuropsychological and psychiatric evaluations and were compared with a healthy comparison group (HC) of 165 subjects and 165 patients with major depression (MDD). Cognitive performances were adjusted for age, sex, and education. Seventy-nine percent of COVID-19 survivors at 1 month and 75% at 3- and 6-month follow-up showed cognitive impairment in at least one cognitive function. No significant difference in cognitive performances was observed between 1-, 3-, and 6-months follow-up. COVID-19 patients performed worse than HC but better than MDD in psychomotor coordination and speed of information processing. No difference between COVID-19 survivors and MDD was observed for verbal fluency, and executive functions, which were lower than in HC. Finally, COVID-19 survivors performed the same as HC in working memory and verbal memory. The factor that most affected cognitive performance was depressive psychopathology which, in turn, interact with cognitive functions in determining quality of life. Our results confirm that COVID-19 sequelae include signs of cognitive impairment which persist up to 6 months after hospital discharge and affect quality of life. Supplementary Information The online version contains supplementary material available at 10.1007/s00406-021-01346-9.

Psychological Symptoms in COVID-19 Patients: Insights into Pathophysiology and Risk Factors of Long COVID-19

“…According to Bonizzato et al, there seems to be a need for an adequate assessment of cognitive, behavioral, and psychological variables in post-COVID-19 patients [ 183 ]. This is consistent with the findings by Gouraud et al, who found a robust link between cognitive complaints and psychological distress [ 184 ], and Poletti et al, who found that depression is the best predictor of cognitive performance and of its improvement [ 185 ]. Hence, further research is critical to further describe a more granular-level picture of the long-term psychiatric functioning post-COVID-19.…”

Trajectory of cognitive impairments over 1 year after COVID‐19 hospitalisation: Pattern, severity, and functional implications

“…This is consistent with meta-analytic evidence suggesting patients’ cognitive impairments after COVID-19 persist over time ( Ceban et al, 2022 ). Our findings corroborate with 3 longitudinal studies that identified cognitive impairments both 6 ( Poletti et al, 2021 ) and 12 months ( Méndez et al, 2021 ; Ferrucci et al, 2022) after COVID-19 hospitalisation, with most pronounced impairments within verbal learning, memory and executive function ( Méndez et al, 2021 ). While Ferrucci and colleagues observed improvement in verbal memory, attention, and processing speed, cognitive functions were still affected after 1 year, with processing speed, visuospatial and verbal memory being most affected (Ferrucci et al, 2022).…”

“…Depressive symptoms were found in a previous study to be the main predictor of impaired cognitive performance 6 months after hospitalisation with COVID-19 ( Poletti et al, 2021 ). Our finding that cognitive impairments 3 months after hospitalisation were moderately associated with subsequent depressive symptomatology after 1 year provides preliminary evidence that the opposite may also be the case.…”

“…The duration of cognitive COVID and long-term impact on functioning and quality of life are unclear. One study of hospitalized patients ( n = 312) indicated little to no cognitive improvement within the first 6 months, with observations of cognitive impairments in 79% and 75% of patients after 3-months and 6-months, respectively ( Poletti et al, 2021 ). Another longitudinal study found that overall, 47 % of patients had cognitive impairments.…”

Mental health during the COVID-19 pandemic, impact of childhood trauma in psychiatric disorders, and predictable biomarkers for bipolar disorder

“…The most common sequelae were neurological and psychiatric symptoms. In this issue, Poletti and colleagues report cognitive functioning 6 months following hospital discharge for COVID-19 [ 3 ]. Neuropsychological and psychiatric evaluations were evaluated for COVID-19 survivors, healthy control group, and patients with major depressive disorder (MDD).…”