# P-1652. Cognitive performance long after COVID infection: results of a cross-sectional pilot study

## TL;DR

This study found that Long COVID patients report lower quality of life and functional issues years after infection, but objective cognitive tests show no significant differences compared to controls.

## Contribution

This is the first cross-sectional pilot study to assess cognitive performance in Long COVID patients years after infection using a comprehensive battery of objective tests.

## Key findings

- Long COVID participants reported significantly worse self-perceived functional status and quality of life compared to controls.
- Objective neurocognitive test results showed no significant differences between Long COVID patients and controls.
- Persistent symptoms like anxiety, fatigue, and cognitive function were reported more in Long COVID patients.

## Abstract

Previous studies found neurocognitive deficits in 20-50% of Long COVID patients, although the objectively measured prevalence of these impairments is typically lower than the subjectively reported one. It is not clear whether these deficits are long-lasting. Our main goal was to objectively assess cognitive performance in people with Long COVID years after initial infection versus controls.

Study design: cross-sectional pilot enrolling a convenience sample of adults ≥ 18 years old recruited from a large Midwest university and its affiliated state county. Cases: people with at least one persistent post-COVID symptom ≥ 6 months after laboratory-confirmed initial infection. Controls: people without known prior COVID-19 infection. Outcome measures: Cognitive performance, assessed via a complex battery of neuropsychological and functional cognition tests, and quality-of-life variables assessed via patient-report on clinically validated instruments (Table 1). Statistical analysis: Univariable and multivariable logistic regression adjusted for the interaction between age and education. A two-sided p-value < 0.05 was considered statistically significant.

We enrolled 132 post-COVID cases and 42 controls. The average time from initial infection was 2.4 years (range 6 months – 4.8 years). Figure 1 shows the distribution of cases according to the major circulating strain at the time of initial infection. Table 2 shows differences in baseline characteristics among cases and controls. Table 3 shows the neurocognitive testing results for cases and controls. Table 4 shows differences in other quality of life outcomes among cases and controls.

Long COVID participants scored significantly worse on instruments rating self-perceived functional status, percent of retained daily activities, anxiety, fatigue, and cognitive function, suggesting persistently disrupted instrumental activities of daily living and lower quality of life years after initial infection. On most of the objective neurocognitive testing, however, there were no significant differences between Long COVID patients and controls.

All Authors: No reported disclosures