Validity of the test for attentional performance in neurological post-COVID condition

Neurological post-COVID condition (PCC) often involves attentional deficits that impact daily functioning. Traditional paper-based tests, like the Trail-Making Test (TMT), may inadequately capture these impairments due to their short duration and dependence on numerical and alphabetic sequencing. This study evaluates the validity of three subtests of the computerized Test for Attentional Performance (TAP) as alternatives for detecting attentional impairments in PCC. In the ongoing NEURO LC-19 DE study, 108 subjects aged 18 to 79 years, with PCC-related cognitive complaints (n = 67, 73% f) and healthy controls (n = 41, 56% f) underwent neuropsychological testing. The prevalence of impairment and classification ability of the TAP subtests were evaluated alongside standard paper-based tests, including the TMT and Montreal Cognitive Assessment, using receiver operating characteristic (ROC) analysis and regression. The TAP subtests identified significant impairments in sustained attention and processing speed in one-third of PCC patients, surpassing traditional tests in sensitivity, and classifying PCC with an AUC of 78%. Omissions in sustained attention significantly differentiated groups (OR = 1.14, p = 0.016, 95% CI [1.02-1.26]). Fatigue correlated with poorer performance on speed and accuracy (r > 0.30, p < 0.05). Cognitive slowing is prevalent in neurological PCC but is scarcely captured by conventional assessments. The TAP's computerized format with automated norming and independence from alphanumeric stimuli shows promise in improving the discriminatory ability for identifying attentional deficits in PCC patients.