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Cognitive and psychological functioning in individuals with long COVID: a comparative cross-sectional study

Maxime Boutet^1,2, Imane Salmam^1,3, Jean-Sébastien Roy^1,3

¹Centre interdisciplinaire de recherche en réadaptation et intégration sociale, CIUSSS de la Capitale-Nationale, Québec, Canada.

Disability and Rehabilitation

|June 23, 2025

Abstract

Purpose:

Although several studies have examined cognitive and psychological functioning in long COVID, few have included appropriate comparison groups and utilized both subjective and objective measures. First, this study compared objective cognitive performance and self-reported cognitive and psychological symptoms across individuals with long COVID, those recovered without persistent symptoms, and a Control Group with no history of COVID-19 infection. Second, the relationship between sociodemographic and disease characteristics and cognitive and psychological outcomes was explored in the Long COVID Group (LCG). Third, the association between cognitive and psychological outcomes and quality of life was examined in the LCG.

Methods:

Participants included 120 adults per group. The main outcome measures were three neuropsychological tests and self-report questionnaires on cognitive functioning, anxiety, depression, and quality of life.

Results:

Individuals with long COVID exhibited poorer attention and working memory performance, and reported higher cognitive, anxiety, and depression symptoms compared to the other groups. Within the LCG, better cognitive performance on a screening test and higher depressive symptoms were associated with poorer quality of life.

Conclusions:

These findings highlight poorer cognitive performance and higher cognitive and psychological symptoms in long COVID, suggesting the importance of comprehensive assessments and integrated rehabilitation strategies.

Keywords:

COVID-19 Cognition mental health neuropsychology post-acute COVID-19 syndrome quality of life

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