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Subjective and objective working memory deficits in the post-acute phase of COVID-19 in a clinical trial population
Sofie Buer1,2, Bjørn I Hagen1, Arne Søraas3
1Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway.
Importance:
Cognitive difficulties are commonly reported following COVID-19, yet the relationship between subjective and objective working memory (WM) deficits remains unclear. Examining both types of measures may improve understanding of cognitive complaints in individuals with persistent post-COVID-19 symptoms.
Objective:
This cross-sectional study aimed to describe WM deficits in a clinical trial population with self-reported persistent cognitive difficulties >6 months following COVID-19, compare the frequency of scores exceeding clinical cutoffs on subjective versus objective measures, and explore how these frequencies vary according to demographic, clinical, and selected COVID-19-related characteristics.
Methods:
We used baseline data from a preregistered randomized controlled trial (Hagen et al., 2022). Participants (N = 129) with perceived executive function deficits aged 26-65 years, and at least one prior laboratory-confirmed SARS-CoV-2 infection were included. Subjective WM was assessed using the Behavior Rating Inventory of Executive Function-Adult Version, Working memory subscale. Objective WM was measured using Digit Span from the Wechsler Adult Intelligence Scale and Spatial Working Memory from Cambridge Neuropsychological Test Automated Battery. Participants also completed questionnaires on anxiety and depression, fatigue, and insomnia.
Results:
Participants more frequently exceeded the clinical threshold (T ≥ 65) for subjective WM deficits than for objective WM deficits (1.5 SD below normative mean). Higher levels of anxiety and depression were associated with a higher frequency of exceeding clinical thresholds for subjective, but not objective, WM deficits.
Conclusion:
In this selected clinical trial population of individuals with persistent self-reported cognitive difficulties following COVID-19, subjective WM deficits were more frequent than objective WM deficits. The findings reveal a low association between subjective and objective WM deficits in the post-acute phase of COVID-19 recovery and indicate that non-cognitive factors, particularly anxiety and depression symptoms, may be relevant when evaluating subjective WM complaints following COVID-19.
