The Impact of COVID-19 Infection on Cognitive Function and the Implication for Rehabilitation: A Systematic Review and Meta-Analysis

Abstract

There is mounting evidence that patients with severe COVID-19 disease may have symptoms that continue beyond the acute phase, extending into the early chronic phase. This prolonged COVID-19 pathology is often referred to as ‘Long COVID’. Simultaneously, case investigations have shown that COVID-19 individuals might have a variety of neurological problems. The accurate and accessible assessment of cognitive function in patients post-COVID-19 infection is thus of increasingly high importance for both public and individual health. Little is known about the influence of COVID-19 on the general cognitive levels but more importantly, at sub-functions level. Therefore, we first aim to summarize the current level of evidence supporting the negative impact of COVID-19 infection on cognitive functions. Twenty-seven studies were included in the systematic review representing a total of 94,103 participants (90,317 COVID-19 patients and 3786 healthy controls). We then performed a meta-analysis summarizing the results of five studies (959 participants, 513 patients) to quantify the impact of COVID-19 on cognitive functions. The overall effect, expressed in standardized mean differences, is −0.41 [95%CI −0.55; −0.27]. To prevent disability, we finally discuss the different approaches available in rehabilitation to help these patients and avoid long-term complications.

A Scoping Review on Long COVID-19: Physiological and Psychological Symptoms Post-Acute, Long-Post and Persistent Post COVID-19

“…Our findings in this review are consistent with findings of other investigators, who reported symptoms affecting physical and mental health. They reported post COVID-19 psychological and neuropsychological concerns (anxiety and depression, PTSD, sleep and cognition deficits), even in people who had never had a mental health condition, which is similar to our findings [ 49 , 50 ]. In another study conducted by Van Kessel et al, it was found that psychological, cognitive and social symptoms were associated more with post-acute COVID-19 syndrome and less with long COVID-19 haulers.…”

Impact of COVID‐19 infection on cognition and its association with neurological symptoms

“…Intriguing, hospitalization did not have a significant effect on test performance, and there was no statistical difference between NH patients, those who required hospitalization with or without oxygen and those that received ICU care. These results are consistent with previous reports of cognitive and neurological sequels 4 months after COVID‐19 infection (Mattioli et al., 2022 ) and where cognitive decline was independent of disease severity (Hadad et al., 2022 ; Houben & Bonnechère., 2022 ). Other studies also found no differences when considering treatment with mechanical ventilation or oxygen supply (Beaud et al., 2021 ; García‐Sánchez et al., 2022 ; Woo et al., 2020 ).…”

“…Hadad et al (2022) found that disease severity, premorbid condition, pulmonary function test, and hypoxia did not contribute to cognitive performance. In addition, there is not a clear link between the severity of the infection and the degree of cognitive impairment (Houben & Bonnechère, 2022).…”

Features of Psychopathological Symptoms in Combatants with Non-Psychotic Mental Disorders Who Had COVID-19

“…Виявлені у даному дослідженні гірші показники когнітивного функціонування в УБД з НПР узгоджуються з даними досліджень, що встановили наявність у комбатантів порушень когнітивного функціонування [26][27][28][29], а також з дослідженнями, які виявили несприятливий вплив COVID-19 на когнітивну сферу [30][31][32][33]…”