Abstract summary 

This review aims to characterize the pattern of post-COVID-19 cognitive impairment, allowing better prediction of impact on daily function to inform clinical management and rehabilitation.A systematic review and meta-analysis of neurocognitive sequelae following COVID-19 was conducted, following PRISMA-S guidelines. Studies were included if they reported domain-specific cognitive assessment in patients with COVID-19 at >4 weeks post-infection. Studies were deemed high-quality if they had >40 participants, utilized healthy controls, had low attrition rates and mitigated for confounders.Five of the seven primary Diagnostic and Statistical Manual of Mental Disorders (DSM-5) cognitive domains were assessed by enough high-quality studies to facilitate meta-analysis. Medium effect sizes indicating impairment in patients post-COVID-19 versus controls were seen across executive function (standardised mean difference (SMD) -0.45), learning and memory (SMD -0.55), complex attention (SMD -0.54) and language (SMD -0.54), with perceptual motor function appearing to be impacted to a greater degree (SMD -0.70). A narrative synthesis of the 56 low-quality studies also suggested no obvious pattern of impairment.This review found moderate impairments across multiple domains of cognition in patients post-COVID-19, with no specific pattern. The reported literature was significantly heterogeneous, with a wide variety of cognitive tasks, small sample sizes and disparate initial disease severities limiting interpretability. The finding of consistent impairment across a range of cognitive tasks suggests broad, as opposed to domain-specific, brain dysfunction. Future studies should utilize a harmonized test battery to facilitate inter-study comparisons, whilst also accounting for the interactions between COVID-19, neurological sequelae and mental health, the interplay between which might explain cognitive impairment.

Authors & Co-authors:  Fanshawe Jack B JB Sargent Brendan F BF Badenoch James B JB Saini Aman A Watson Cameron J CJ Pokrovskaya Aleksandra A Aniwattanapong Daruj D Conti Isabella I Nye Charles C Burchill Ella E Hussain Zain U ZU Said Khanafi K Kuhoga Elinda E Tharmaratnam Kukatharmini K Pendered Sophie S Mbwele Bernard B Taquet Maxime M Wood Greta K GK Rogers Jonathan P JP Hampshire Adam A Carson Alan A David Anthony S AS Michael Benedict D BD Nicholson Timothy R TR Paddick Stella-Maria SM Leek Charles E CE

Study Outcome 

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