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Long COVID affects working memory: assessment using a single rapid online test
Aziz U R Asghar1,2,3, Hong Kiu Yuen2,4, Murat Aksoy1,2
1Department of Psychology, University of York, York, United Kingdom.
Objective:
Long COVID, or post-COVID-19 syndrome, is characterized by persistent symptoms following SARS-CoV-2 infection, including cognitive impairments such as "brain fog" that adversely affect quality of life. The aim of this study was to evaluate the impact of long COVID on working memory using a single, rapid, anonymous online survey and visual working memory quiz.
Methods:
We analyzed working memory scores in relation to reported long COVID status (clinically diagnosed, self-reported, and non-long COVID), age, number of COVID-19 infections, long COVID duration, and subjective ratings of brain fog severity and the overall life impact of symptoms. The study utilized the Rapid Objective Working Memory Assessment (ROWMA), a brief, gamified visual recognition task designed to maximize compliance and minimize fatigue.
Results:
A total of 1,064 participants aged 16 to over 85 years were recruited, with 39% reporting long COVID. Categorical regression revealed that long COVID status was the strongest predictor of working memory performance, followed by age and number of infections. Participants with long COVID performed significantly worse on the working memory quiz than non-long COVID controls, with the lowest scores observed in the clinically diagnosed group. Furthermore, working memory scores declined with age, particularly among those aged 35 and older, and decreased with multiple COVID-19 infections within the diagnosed group. Individuals in the diagnosed group reported the most severe brain fog and the greatest life impact, both of which strongly correlated with lower memory scores. Although longer long COVID duration was associated with lower memory performance, an exploratory analysis indicated this trend may have been influenced by the SARS-CoV-2 variant.
Conclusion:
Our results support the hypothesis that long COVID is associated with objective working memory impairment, particularly among individuals with a clinical diagnosis. These findings add to the growing body of evidence linking long COVID to objective cognitive difficulties. Moreover, the study advocates the use of rapid, single-task online cognitive assessments as a practical, scalable, and low-burden approach for evaluating working memory function in this population.
