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Cognitive deficits in people who have recovered from COVID-19

Research output: Contribution to journalArticlepeer-review

Adam Hampshire, William Trender, Samuel R. Chamberlain, Amy E. Jolly, Jon E. Grant, Fiona Patrick, Ndaba Mazibuko, Steve CR Williams, Joseph M. Barnby, Peter Hellyer, Mitul A. Mehta

Original languageEnglish
Article number101044
JournalEClinicalMedicine
Early online date12 Jul 2021
DOIs
Accepted/In press2021
E-pub ahead of print12 Jul 2021
Published22 Jul 2021

Bibliographical note

Funding Information: AH is supported by the UK Dementia Research Institute Care Research and Technology Centre and Biomedical Research Centre at Imperial College London. WT is supported by the EPSRC Centre for Doctoral Training in Neurotechnology. SRC is funded by a Wellcome Trust Clinical Fellowship 110,049/Z/15/Z. JMB is supported by Medical Research Council (MR/N013700/1). MAM, SCRW and PJH are, in part, supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London Funding Information: All data are freely available in fully anonymised format for academic researchers on request to the corresponding author. We would like to thank the BBC2 Horizon team for their support in promoting this study. Funding Information: Dr. Hampshire reports grants from UK Dementia Research Institute, outside the submitted work and is Co-director and owner of H2CD Ltd, and owner and director of Future Cognition Ltd, which support online studies and develop custom cognitive assessment software respectively. Dr. Hellyer reports personal fees from H2CD Ltd, outside the submitted work. Dr. Chamberlain reports grants from Wellcome, personal fees from Elsevier, personal fees from Prometis (not current), outside the submitted work. Dr. Grant reports grants from Otsuka, grants from Biohaven, grants from Avanir, outside the submitted work. Dr. Patrick reports grants from H Lundbeck A/S, non-financial support from Astra Zeneca, non-financial support from Janssen, outside the submitted work. Dr. Mehta reports grants from H Lundbeck A/S, non-financial support from Astra Zeneca, non-financial support from Janssen, outside the submitted work. Dr. Williams has nothing to disclose. Dr. Mazibuko has nothing to disclose. Dr. Jolly has nothing to disclose. Mr. Trender has nothing to declare. Dr. Barnby has nothing to disclose. Publisher Copyright: © 2021 The Author(s) Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Background: There is growing concern about possible cognitive consequences of COVID-19, with reports of ‘Long COVID’ symptoms persisting into the chronic phase and case studies revealing neurological problems in severely affected patients. However, there is little information regarding the nature and broader prevalence of cognitive problems post-infection or across the full spread of disease severity. Methods: We sought to confirm whether there was an association between cross-sectional cognitive performance data from 81,337 participants who between January and December 2020 undertook a clinically validated web-optimized assessment as part of the Great British Intelligence Test, and questionnaire items capturing self-report of suspected and confirmed COVID-19 infection and respiratory symptoms. Findings: People who had recovered from COVID-19, including those no longer reporting symptoms, exhibited significant cognitive deficits versus controls when controlling for age, gender, education level, income, racial-ethnic group, pre-existing medical disorders, tiredness, depression and anxiety. The deficits were of substantial effect size for people who had been hospitalised (N = 192), but also for non-hospitalised cases who had biological confirmation of COVID-19 infection (N = 326). Analysing markers of premorbid intelligence did not support these differences being present prior to infection. Finer grained analysis of performance across sub-tests supported the hypothesis that COVID-19 has a multi-domain impact on human cognition. Interpretation: Interpretation. These results accord with reports of ‘Long Covid’ cognitive symptoms that persist into the early-chronic phase. They should act as a clarion call for further research with longitudinal and neuroimaging cohorts to plot recovery trajectories and identify the biological basis of cognitive deficits in SARS-COV-2 survivors. Funding: Funding. AH is supported by the UK Dementia Research Institute Care Research and Technology Centre and Biomedical Research Centre at Imperial College London. WT is supported by the EPSRC Centre for Doctoral Training in Neurotechnology. SRC is funded by a Wellcome Trust Clinical Fellowship 110,049/Z/15/Z. JMB is supported by Medical Research Council (MR/N013700/1). MAM, SCRW and PJH are, in part, supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London

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