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Related Experiment Video

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Cognitive Trajectories After Hospitalization for COVID-19: A 36-Month Longitudinal Study.

Maria Paula Maziero1, Eunyoung A Lee1, Gabriela D Colpo1

  • 1Department of Neurology, John P. and Katherine G. McGovern Medical School, University of Texas Health Science Center at Houston, Houston.

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Summary

Long COVID can cause lasting cognitive issues, with some patients experiencing delayed decline even years after infection. Understanding these long-term neurological effects is crucial for patient care.

Keywords:
BrainCheckCognitive ImpairmentLong COVIDPostacute Sequelae of COVID-19 (PASC)SARS-CoV-2

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Cognitive Science

Background:

  • Neurological symptoms, particularly cognitive impairment, are common in post-acute sequelae of COVID-19 (PASC).
  • Cognitive trajectories in individuals with PASC remain poorly defined.
  • Long-term cognitive changes following severe COVID-19 hospitalization require further investigation.

Purpose of the Study:

  • To determine long-term cognitive changes in individuals hospitalized with COVID-19.
  • To characterize distinct cognitive trajectories over 36 months post-hospitalization.
  • To identify factors associated with different cognitive outcomes in PASC.

Main Methods:

  • A cohort of 630 patients hospitalized with severe COVID-19 was assessed.
  • 214 patients completed follow-up assessments over 36 months using the BrainCheck digital platform.
  • Linear mixed-effects models analyzed longitudinal cognitive changes and associated factors.

Main Results:

  • Four distinct cognitive trajectories were identified over 36 months.
  • 48% maintained normal cognition, 7% declined, 14% improved, and 32% had persistent impairment.
  • Hispanic ethnicity was associated with poorer cognitive outcomes, varying by domain.

Conclusions:

  • Some individuals experience stable or improving cognition, while others show persistent impairment.
  • A subset of patients exhibited delayed cognitive decline, suggesting progressive PASC-associated mechanisms.
  • Chronic cerebral inflammation may contribute to progressive cognitive impairment post-COVID-19 infection.