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Metacognition and cognitive dysfunction in post-COVID condition.

Silvia Oliver-Mas¹, Cristina Delgado-Alonso¹, María Díez-Cirarda¹

¹Department of Neurology, Hospital Clínico San Carlos, San Carlos Health Research Institute (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.

Frontiers in Psychology

|March 25, 2026

Summary

This summary is machine-generated.

Post-COVID condition (PCC) patients show impaired metacognition, affecting self-awareness of cognitive abilities. This impacts understanding cognitive complaints and developing rehabilitation strategies for long COVID.

Keywords:

COVID-19 cognitive impairment metacognition neuropsychological post-covid condition

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Area of Science:

Neuroscience
Cognitive Psychology
Clinical Psychology

Background:

Cognitive issues in post-COVID condition (PCC) lack clear mechanisms.
Metacognition, the ability to evaluate one's own cognition, is unexplored in PCC.
This study investigates metacognition in PCC patients with and without cognitive impairment.

Purpose of the Study:

To assess local and global metacognition in individuals with PCC.
To compare metacognitive abilities between PCC patients with and without objective cognitive impairment.
To explore the relationship between metacognition, fatigue, depression, and anxiety in PCC.

Main Methods:

Cross-sectional study of 74 PCC patients and 49 healthy controls (HC).
Comprehensive neuropsychological testing.
Local metacognition assessed via performance estimates; global metacognition via self-report instruments.

Main Results:

PCC patients exhibited reduced local and global metacognitive accuracy compared to HC.
Cognitively impaired PCC patients overestimated performance in attention, executive function, and memory.
Both PCC groups underestimated global cognitive abilities; metacognition correlated with fatigue/depression in cognitively preserved PCC patients.

Conclusions:

PCC is associated with impaired local and global metacognitive accuracy.
Metacognitive deficits in PCC vary based on objective cognitive impairment.
Assessing metacognition is crucial for understanding PCC cognitive complaints and guiding rehabilitation.