The effects of COVID-19 on cognitive performance in a community-based cohort: a COVID symptom study biobank prospective cohort study.
| Title: | The effects of COVID-19 on cognitive performance in a community-based cohort: a COVID symptom study biobank prospective cohort study. |
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| Authors: | Cheetham NJ; Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.; Penfold R; Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.; Edinburgh Delirium Research Group, Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom.; Giunchiglia V; Department of Brain Sciences, Imperial College London, United Kingdom.; Bowyer V; Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.; Sudre CH; MRC Unit for Lifelong Health and Ageing, Department of Population Health Sciences, University College London, London, United Kingdom.; Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom.; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; Canas LS; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; Deng J; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; Murray B; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; Kerfoot E; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; Antonelli M; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; Rjoob K; MRC Unit for Lifelong Health and Ageing, Department of Population Health Sciences, University College London, London, United Kingdom.; Molteni E; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; Österdahl MF; Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.; Harvey NR; Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.; Trender WR; Department of Brain Sciences, Imperial College London, United Kingdom.; Malim MH; Department of Infectious Diseases, King's College London, London, United Kingdom.; Doores KJ; Department of Infectious Diseases, King's College London, London, United Kingdom.; Hellyer PJ; Centre for Neuroimaging Sciences, King's College London, London, United Kingdom.; Modat M; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; Hammers A; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; King's College London & Guy's and St Thomas' PET Centre, King's College London, London, United Kingdom.; Ourselin S; School of Biomedical Engineering & Imaging Sciences, King's College London, London, United Kingdom.; Duncan EL; Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.; Guy's & St Thomas's NHS Foundation Trust, London, United Kingdom.; Hampshire A; Department of Brain Sciences, Imperial College London, United Kingdom.; Steves CJ; Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom.; Guy's & St Thomas's NHS Foundation Trust, London, United Kingdom. |
| Source: | EClinicalMedicine [EClinicalMedicine] 2023 Jul 21; Vol. 62, pp. 102086. Date of Electronic Publication: 2023 Jul 21 (Print Publication: 2023). |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: The Lancet Country of Publication: England NLM ID: 101733727 Publication Model: eCollection Cited Medium: Internet ISSN: 2589-5370 (Electronic) Linking ISSN: 25895370 NLM ISO Abbreviation: EClinicalMedicine Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [London] : The Lancet, [2018]- |
| Abstract: | Background: Cognitive impairment has been reported after many types of infection, including SARS-CoV-2. Whether deficits following SARS-CoV-2 improve over time is unclear. Studies to date have focused on hospitalised individuals with up to a year follow-up. The presence, magnitude, persistence and correlations of effects in community-based cases remain relatively unexplored.; Methods: Cognitive performance (working memory, attention, reasoning, motor control) was assessed in a prospective cohort study of participants from the United Kingdom COVID Symptom Study Biobank between July 12, 2021 and August 27, 2021 (Round 1), and between April 28, 2022 and June 21, 2022 (Round 2). Participants, recruited from the COVID Symptom Study smartphone app, comprised individuals with and without SARS-CoV-2 infection and varying symptom duration. Effects of COVID-19 exposures on cognitive accuracy and reaction time scores were estimated using multivariable ordinary least squares linear regression models weighted for inverse probability of participation, adjusting for potential confounders and mediators. The role of ongoing symptoms after COVID-19 infection was examined stratifying for self-perceived recovery. Longitudinal analysis assessed change in cognitive performance between rounds.; Findings: 3335 individuals completed Round 1, of whom 1768 also completed Round 2. At Round 1, individuals with previous positive SARS-CoV-2 tests had lower cognitive accuracy (N = 1737, β = -0.14 standard deviations, SDs, 95% confidence intervals, CI: -0.21, -0.07) than negative controls. Deficits were largest for positive individuals with ≥12 weeks of symptoms (N = 495, β = -0.22 SDs, 95% CI: -0.35, -0.09). Effects were comparable to hospital presentation during illness (N = 281, β = -0.31 SDs, 95% CI: -0.44, -0.18), and 10 years age difference (60-70 years vs. 50-60 years, β = -0.21 SDs, 95% CI: -0.30, -0.13) in the whole study population. Stratification by self-reported recovery revealed that deficits were only detectable in SARS-CoV-2 positive individuals who did not feel recovered from COVID-19, whereas individuals who reported full recovery showed no deficits. Longitudinal analysis showed no evidence of cognitive change over time, suggesting that cognitive deficits for affected individuals persisted at almost 2 years since initial infection.; Interpretation: Cognitive deficits following SARS-CoV-2 infection were detectable nearly two years post infection, and largest for individuals with longer symptom durations, ongoing symptoms, and/or more severe infection. However, no such deficits were detected in individuals who reported full recovery from COVID-19. Further work is needed to monitor and develop understanding of recovery mechanisms for those with ongoing symptoms.; Funding: Chronic Disease Research Foundation, Wellcome Trust, National Institute for Health and Care Research, Medical Research Council, British Heart Foundation, Alzheimer's Society, European Union, COVID-19 Driver Relief Fund, French National Research Agency.; (© 2023 The Authors.) |
| Competing Interests: | NJC is supported by NIHR via their institution; CHS is supported by Alzheimer's Society via their institution and is Scientific Advisor to BrainKey; WRT is a part time employee H2 Cognitive Designs, who market the online testing platform used in this study; PJH is the Chief Executive and Co-founder of H2 Cognitive Designs LTD, who market the online testing platform used in this study; M. Modat reports funding support from UK Department of Health and Social Care, UKRI, EPSRC and Wellcome Trust via their institution; SO is supported by French National Research Agency, Wellcome Trust, EPSRC and UK Department of Health and Social Care; A. Hampshire is an owner/director of Future Cognition Ltd and co-owner and co-director of H2 Cognitive Designs, which provide cognitive assessment services and software for third parties; CJS is supported by UKRI, Wellcome Trust and Chronic Disease Research Foundation via their institution, and declares a consultancy contract with ZOE Ltd. All other authors make no disclosures. |
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| Grant Information: | United Kingdom WT_ Wellcome Trust; MR/W005611/1 United Kingdom MRC_ Medical Research Council |
| Contributed Indexing: | Keywords: COVID-19; COVID-19 recovery; Cognition; Cognitive impairment; Long COVID; SARS-CoV-2 |
| Entry Date(s): | Date Created: 20230901 Latest Revision: 20250530 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC10466229 |
| DOI: | 10.1016/j.eclinm.2023.102086 |
| PMID: | 37654669 |
| Database: | MEDLINE |
Journal Article