Neuropsychological consequences of COVID-19 : long COVID and the relationship with acute illness

Rationale and aims: Long COVID has a substantial impact on quality of life for many, with international prevalence related to the worldwide COVID-19 pandemic. However, acute illness severity may not always predict the neuropsychological consequences in long COVID. This may be due to unique neurotropic mechanisms of the virus. Research to date has explored up to 12 months post infection but assessment is largely limited to screening and relies on cognitive testing alone to draw conclusions. Therefore, this research project aimed to answer two research questions: 'what are the objectively measured cognitive and emotional consequences of COVID-19/ long COVID at 20-24 months?' and 'how does this relate to the subjective experience of illness from COVID-19 and illness severity?' Methodology: A two-part sequential explanatory mixed-methods design was used, firstly with inferential statistics to analyse data from cognitive testing and self-report mood measures. Participants (n=19) were assessed 20-24 months post infection. Results were compared between two groups: those that accessed a virtual hospital service (n=9) during the acute stages and those that accessed a long COVID service (n=10) at some stage after. Thematic analysis captured information from questionnaire responses to enhance findings. Discussion: Many appear to recover cognitive function toward the 2-year mark, but some specific deficit in visuospatial, psychomotor and executive function was observed, which appears to be irrespective of illness severity. These concerns, often in combination with pandemic related concerns, had a substantial impact on quality of life for participants. Implications: Due to the varied cognitive profile and substantial impact of long COVID, future research should utilise comprehensive cognitive testing in combination with accounts of participants' experiences of symptoms. Long COVID services could consider neuropsychological expertise for individualised assessment and therapy intervention.