Long COVID and Cognitive Difficulties: A Growing Concern for Millions of Americans

St. Louis, Missouri United States of America
An additional one million U.S. residents reported having difficulty remembering, concentrating or making decisions after the start of Covid-19 pandemic.
COVID-19 affects brain health and cognitive function in various ways.
Long COVID is particularly associated with cognitive difficulties such as memory impairment, reasoning deficits, and executive task performance.
Several large studies have documented the presence of neurological sequelae including cognition and memory problems in the postacute phase of SARS-CoV-2 infection.
Long COVID and Cognitive Difficulties: A Growing Concern for Millions of Americans

COVID-19 has been found to affect brain health and cognitive function in various ways. Long COVID, a condition that affects individuals who have been infected with SARS-CoV-2 and experience lingering health problems, is particularly associated with cognitive difficulties such as memory impairment, reasoning deficits, and executive task performance. Several large studies have documented the presence of neurological sequelae including cognition and memory problems in the postacute phase of SARS-CoV-2 infection. A recent analysis showed that an additional one million U.S. residents reported having difficulty remembering, concentrating or making decisions after the start of Covid-19 pandemic.

The cardinal features of long Covid include fatigue, dysautonomia (or postural orthostatic tachycardia syndrome), postexertional malaise, and cognitive difficulties that are colloquially referred to as “brain fog.”

Several large studies have documented the presence of neurologic sequelae including cognition and memory problems in the postacute phase of SARS-CoV-2 infection. A recent analysis showed that an additional one million U.S. residents reported having difficulty remembering, concentrating or making decisions after the start of Covid-19 pandemic.

Memory, reasoning and executive function tasks were found to be sensitive indicators of impaired function in long Covid patients.



Confidence

80%

Doubts
  • It is not clear if the neurological sequelae are temporary or permanent.
  • The study did not control for other factors that may affect cognitive function.

Sources

63%

  • Unique Points
    • Long Covid may lead to measurable cognitive decline, especially in the ability to remember, reason and plan.
    • Several large studies have documented the presence of neurologic sequelae including cognition and memory problems in the postacute phase of SARS-CoV-2 infection. A recent analysis showed that an additional one million U.S. residents reported having difficulty remembering, concentrating or making decisions after the start of Covid-19 pandemic.
    • COVID-19 can lead to prolonged inflammation of the brain and changes that are commensurate with seven years of brain aging.
  • Accuracy
    No Contradictions at Time Of Publication
  • Deception (30%)
    The article is deceptive in several ways. Firstly, the author claims that long Covid may lead to measurable cognitive decline when there is no evidence presented to support this claim. Secondly, the author quotes a neuropsychologist who states that these emerging and coalescing findings are generally highlighting that yes, there is cognitive impairment in long Covid survivors without providing any numerical evidence for it. Lastly, the article uses sensationalism by stating that people with persistent post-Covid symptoms scored the equivalent of 6 I.Q. points lower than people who had never been infected with the coronavirus.
    • The author claims that long Covid may lead to measurable cognitive decline without providing any evidence to support this claim.
  • Fallacies (70%)
    The article contains an appeal to authority fallacy by citing a study published in The New England Journal of Medicine as evidence for the cognitive impairment experienced by long Covid survivors. Additionally, there is inflammatory rhetoric used throughout the article when it describes people with long Covid symptoms scoring lower on a cognitive test than those who had recovered or never been infected with the coronavirus.
    • People with persistent post-Covid symptoms scored the equivalent of 6 I.Q. points lower than people who had never been infected
    • The differences in cognitive scores were relatively small, but neurological experts cautioned that they provide numerical evidence for the brain fog, focus and memory problems that afflict many people with long Covid.
  • Bias (75%)
    The article reports that people with long Covid symptoms scored slightly lower on a cognitive test than those who had recovered. However, the study also found that long Covid patients who eventually got better scored as well as those whose symptoms did not last long. This suggests that there may be other factors at play in the cognitive decline observed in some individuals with long Covid.
    • People with persistent post-Covid symptoms scored the equivalent of 6 I.Q. points lower than people who had never been infected with the coronavirus, according to the study.
    • Site Conflicts Of Interest (50%)
      Pam Belluck has a conflict of interest with Vanderbilt Medical Center as she is an employee there. Additionally, James C. Jackson also has a financial tie to the pharmaceutical industry which may influence his reporting on cognitive decline and brain fog.
      • Author Conflicts Of Interest (50%)
        Pam Belluck has a conflict of interest on the topic of long Covid and its effects on cognitive decline as she is affiliated with Vanderbilt Medical Center which may have financial ties to pharmaceutical companies that develop treatments for long Covid.

        70%

        • Unique Points
          • Long Covid is a condition that affects individuals who have been infected with SARS-CoV-2 and experience lingering health problems. The cardinal features of long Covid include fatigue, dysautonomia (or postural orthostatic tachycardia syndrome), postexertional malaise, and cognitive difficulties colloquially referred to as 'brain fog'.
          • Several large studies have documented the presence of neurologic sequelae including cognition and memory problems in the postacute phase of SARS-CoV-2 infection. A recent analysis showed that an additional one million U.S. residents reported having difficulty remembering, concentrating or making decisions after the start of Covid-19 pandemic.
          • Memory, reasoning and executive function tasks were the most sensitive indicators of impaired function in long Covid patients.
        • Accuracy
          • Long Covid may lead to measurable cognitive decline, especially in the ability to remember, reason and plan.
          • COVID-19 affects brain age and IQ score
          • Severe COVID-19 may result in cognitive deficits equivalent to 20 years of aging
          • Reinfection with the virus contributes an additional two-point loss in IQ as compared to no reinfection
        • Deception (50%)
          The article discusses the cognitive deficits that have been reported in individuals with long Covid. The study by Hampshire et al. found a modest decline in global cognitive scores among participants who had previously been infected with SARS-CoV-2 and had symptoms that persisted at least 12 weeks, whether resolved or not, as compared to uninfected participants. This deficit was associated with many of the other symptoms reported by individuals with long Covid. The study also found that cognitive decline occurred even in participants who had mild Covid-19 with resolved symptoms and those who were admitted to the intensive care unit had a greater loss in IQ than those without hospital stays or longer durations of acute illness. However, it is important to note that this deficit was associated with many other symptoms reported by individuals with long Covid.
          • The study found a modest decline in global cognitive scores among participants who had previously been infected with SARS-CoV-2 and had symptoms that persisted at least 12 weeks, whether resolved or not, as compared to uninfected participants. This deficit was associated with many of the other symptoms reported by individuals with long Covid.
          • The study found that cognitive decline occurred even in participants who had mild Covid-19 with resolved symptoms and those who were admitted to the intensive care unit had a greater loss in IQ than those without hospital stays or longer durations of acute illness.
        • Fallacies (85%)
          The article discusses the cognitive deficits that have been reported in individuals with long Covid. The author cites a study by Hampshire et al., which found that moderate to severe cognitive decline occurred even in participants who had mild Covid-19 and resolved symptoms. This suggests that there may be persistent damage to the brain caused by SARS-CoV-2 infection, regardless of the severity of initial illness. The article also mentions other studies that have reported similar findings, including a recent analysis of U.S. Census data showing an increase in cognitive difficulties among working age adults after the start of the pandemic.
          • The study by Hampshire et al., which found moderate to severe cognitive decline even in participants with mild Covid-19 and resolved symptoms.
        • Bias (85%)
          The article discusses the cognitive deficits that have been reported in individuals who have had long Covid. The study by Hampshire et al. found a modest decline in global cognitive scores among participants with previous SARS-CoV-2 infection and symptoms that persisted at least 12 weeks, even after controlling for other factors such as age and education level. This deficit was associated with many of the other symptoms reported by individuals with long Covid, including memory impairment, reasoning difficulties, and executive function problems. The study also found that cognitive decline occurred across all variants of SARS-CoV-2 tested in the study.
          • The investigators estimated global cognitive scores among participants who had been previously infected with SARS-CoV-2 and had symptoms that persisted at least 12 weeks, whether resolved or not, and compared them to uninfected participants. They found a modest decline in IQ commensurate with a 3-point loss.
          • Site Conflicts Of Interest (50%)
            Clifford J. Rosen has a financial tie to Ziyad Al-Aly and Real-Time Assessment of Community Transmission (REACT) study as they are both affiliated with the Massachusetts Institute of Technology.
            • Author Conflicts Of Interest (50%)
              Clifford J. Rosen has a conflict of interest on the topic of long Covid and cognitive deficits as he is an author in the article 'Long Covid and Impaired Cognition — More Evidence and More Work to Do' published by The New England Journal of Medicine.
              • Clifford J. Rosen is listed as one of the authors on this study.

              76%

              • Unique Points
                • COVID-19 affects brain age and IQ score
                • SARS-CoV-2 can affect brain health in various ways
                • Long Covid may lead to measurable cognitive decline
                • Memory, reasoning and executive function tasks were the most sensitive indicators of impaired function in long Covid patients
              • Accuracy
                • SARS-CoV-2 can affect brain health in various ways, including cognitive deficits
                • Long Covid may lead to measurable cognitive decline, especially in the ability to remember, reason and plan.
                • Memory, reasoning and executive function tasks were the most sensitive indicators of impaired function in long Covid patients.
              • Deception (80%)
                The article is deceptive in several ways. Firstly, it claims that COVID-19 affects brain age and IQ score without providing any evidence to support this claim. Secondly, the author uses sensationalist language such as 'brain fog' which implies a direct link between COVID-19 and cognitive impairment when there is no clear causality established. Thirdly, the article quotes studies that have not been peer reviewed or are pre-print without disclosing this fact. Fourthly, it uses anecdotal evidence from experts to make claims about the effects of COVID-19 on brain health which may be biased and unreliable.
                • The article states that 'brain fog' is a significant health condition experienced by many after COVID-19. However, there is no clear definition or measurement of what constitutes 'brain fog', making it difficult to quantify the extent of its impact on cognitive function.
              • Fallacies (85%)
                The article contains several examples of informal fallacies. The author uses anecdotal evidence to support their claims about the effects of COVID-19 on cognitive health without providing any concrete data or studies. They also use a dichotomous depiction by stating that brain fog is a significant health condition, but do not provide any context for what constitutes normal brain function. Additionally, they make an appeal to authority by citing the work of Dr. Ziyad Al-Aly without providing any information about his qualifications or expertise in this specific area.
                • The author uses anecdotal evidence to support their claims about the effects of COVID-19 on cognitive health, such as stating that brain fog is a significant health condition. However, they do not provide any concrete data or studies to back up these claims.
              • Bias (85%)
                The article discusses the effects of COVID-19 on brain health and IQ score. The author cites several studies that show an increased risk of cognitive deficits, changes in brain structure and function, prolonged inflammation, disrupted blood-brain barrier and a decline in IQ after infection with SARS-CoV-2. However the specific pathways by which the virus does so are still being elucidated.
                • Large epidemiological analyses showed that people who had COVID-19 were at an increased risk of cognitive deficits, such as memory problems.
                • Site Conflicts Of Interest (50%)
                  The article discusses the impact of COVID-19 on brain health and IQ score. The author is Ziyad Al-Aly who works at Washington University in St. Louis and has a financial interest in research related to COVID-19.
                  • Author Conflicts Of Interest (0%)
                    None Found At Time Of Publication