Impact of physical activity on cognitive function in long COVID patients: a cross-sectional observational study

The COVID-19 pandemic has resulted in long-term sequelae known as long COVID, which is often characterized by cognitive dysfunctions that impair quality of life. Evidence suggests that physical activity may mitigate these impairments through neurobiological mechanisms that enhance neuroplasticity and cerebral perfusion.

This study examined the association between physical fitness and cognitive function in individuals who had recovered from COVID-19.

A cross-sectional observational study was conducted involving 34 adults who had been previously hospitalized for COVID-19. Cognitive performance was assessed using the Addenbrooke's Cognitive Examination-Revised (ACE-R), while cardiorespiratory fitness was evaluated through VO₂ max testing. Correlation analyses and generalized linear models adjusted for age, sex, and body mass index were applied to examine associations between physical fitness and cognitive domains.

Participants had a mean age of 52 ± 12 years, a BMI of 28.7 ± 4.4 kg/m², and a mean VO₂ max of 36 ± 9 mL/kg·min⁻¹. A strong positive correlation was observed between VO₂ max and the total ACE-R score (r = 0.653; p < 0.001), with the memory domain showing the strongest association (r = 0.739; p < 0.001). Higher physical activity levels, as assessed by the IPAQ, were also associated with better cognitive outcomes.

Physical fitness was significantly associated with better cognitive performance in post-COVID-19 patients. These findings support the inclusion of structured exercise programs in rehabilitation strategies to mitigate the cognitive sequelae of long COVID and underscore the importance of promoting physical activity as a public health intervention.