Psychological and Cognitive Effects of Long COVID: A Narrative Review Focusing on the Assessment and Rehabilitative Approach

Abstract

Long COVID is a clinical syndrome characterized by profound fatigue, neurocognitive difficulties, muscle pain, weakness, and depression, lasting beyond the 3–12 weeks following infection with SARS-CoV-2. Among the symptoms, neurocognitive and psychiatric sequelae, including attention and memory alterations, as well as anxiety and depression symptoms, have become major targets of current healthcare providers given the significant public health impact. In this context, assessment tools play a crucial role in the early screening of cognitive alterations due to Long COVID. Among others, the general cognitive assessment tools, such as the Montreal Cognitive assessment, and more specific ones, including the State Trait Inventory of Cognitive Fatigue and the Digit Span, may be of help in investigating the main neurocognitive alterations. Moreover, appropriate neurorehabilitative programs using specific methods and techniques (conventional and/or advanced) through a multidisciplinary team are required to treat COVID-19-related cognitive and behavioral abnormalities. In this narrative review, we sought to describe the main neurocognitive and psychiatric symptoms as well as to provide some clinical advice for the assessment and treatment of Long COVID.

What is current care for people with Long COVID in England? A qualitative interview study

“…The disruptions observed in social circles and routines align with the observations made in other studies, 36 37 highlighting the persistent challenges people living with Long COVID face as they navigate the unpredictable nature of Long COVID symptoms. Our study additionally echoes the experiences of those with cognitive impairments and reduced energy levels from Long COVID, resonating with other findings 38 39 that have documented the diverse impacts of Long COVID on professional functioning and adjustments required in work environments. 38 39 Notably, our findings indicated that the uncertainty caused by the lack of an effective treatment along with debilitating symptoms and the potential disruption across various aspects of daily life, makes living with long COVID especially challenging.…”

Greater Role of Cognitive Impairment Over Fatigue in Post-COVID-19 Quality of Life: A Post-Hoc Analysis of a Randomized Controlled Trial

“…It may be conjectured that the greater impact of cognitive impairment on HRQOL stems from the significant involvement of cognition in workplace/academic/social interactions, which is known to be more pronounced in individuals living with PCC. 12,13 Moreover, such a decline in cognitive function may also lead to attenuated hedonic function, which would be predicted to further decrease HRQoL in persons with PCC. For example, in other disease states such as MDD, it is established that cognitive function—specifically processing speed and executive function—and anhedonic function are dissociable phenomena but also highly overlapping.…”

COVID-19 as a polymorphic inflammatory spectrum of diseases: a review with focus on the brain

“…There was a high rate of coagulopathy reported in COVID-19 patients, with an astonishing rate of venous thromboembolism and pulmonary embolism at 42% and 17%, respectively, in severe cases (Wu et al, 2021). Arterial thrombotic events occur at various sites including coronaries, extremities and importantly, the brain (De Roquetaillade et al, 2021). Neurovascular inflammatory thrombotic events may cause severe damage to the brain at this early stage of COVID-19 with ominous consequences.…”

“…Of the infected, some patients (as high as 19%, according to the Centers for Disease Control and Prevention (CDC) assessed on November 19, 2022), failed to recover completely, with the lingering symptoms now commonly named as ‘Long COVID’, which seemed to be unrelated to the severity of the acute COVID-19 infection (Asadi-Pooya et al ., 2021; Crook et al ., 2021; Fernández-de-Las-Peñas et al ., 2021; Raveendran et al ., 2021; Sykes et al ., 2021; Yong, 2021; De Luca et al ., 2022). A high proportion of long COVID symptoms appeared to be of a neuropsychiatric nature (Aiyegbusi et al ., 2021; Taquet et al ., 2021; Xie et al ., 2022).…”