SEARCHNARRATIVE_REVIEWneurology, psychiatry

narrative_review·neurology, psychiatry, epidemiology, public health, internal medicine·PMC10617879

Long-term cognitive dysfunction after the COVID-19 pandemic: a narrative review

Annals of Medicine and Surgery · 15 authors, 12 centres

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TL;DR

This narrative review synthesizes existing literature on long-term cognitive dysfunction following SARS-CoV-2 infection, covering proposed mechanisms and management approaches. The review finds that cognitive impairment, including brain fog and memory and attention deficits, affects both hospitalized and non-hospitalized patients, but the exact pathogenesis remains unclear.

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This narrative review searched Medline, National Library of Medicine, Ovid, and Scopus databases for articles on long-term cognitive sequelae after SARS-CoV-2 infection, screening for duplicates and extracting relevant information. One-third of COVID-19 survivors showed evidence of cognitive impairment and motor deficits at hospital discharge. The review notes that both hospitalized and non-hospitalized patients may experience varying degrees of cognitive impairment ranging from fatigue and brain fog to prolonged deficits in memory and attention. However, the exact pathogenesis remains unclear, hindering development of adequate management strategies. The authors emphasize the importance of periodic long-term neurocognitive assessments and recommend comprehensive interdisciplinary approaches for assessing and managing cognitive dysfunction post-COVID-19.

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narrative_review

SPECIALTY

neurology

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ORIGINAL PAPER

PMC10617879

Long-term cognitive dysfunction after the COVID-19 pandemic: a narrative review

Annals of Medicine and Surgery

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ABSTRACT

Introduction: SARS-CoV-2, the virus responsible for the COVID-19 pandemic, has brought a conglomerate of novel chronic disabling conditions described as ‘Long COVID/Post-COVID-19 Syndrome’. Recent evidence suggests that the multifaceted nature of this syndrome results in both pulmonary and extrapulmonary sequelae,chronic dyspnoea, persistent fatigue, and cognitive dysfunction being the most common, debilitating symptoms. Several mechanisms engender or exacerbate cognitive impairment, including central nervous system and extra-central nervous system causes, although the exact mechanism remains unclear. Both hospitalized and non-hospitalized patients may suffer varying degrees of cognitive impairment, ranging from fatigue and brain fog to prolonged deficits in memory and attention, detrimental to the quality-of-life years post-recovery. The aim of this review is to understand the underlying mechanisms, associations, and attempts for prevention with early intervention of long-term cognitive impairment post-COVID-19. Methodology: A systematic search was conducted through multiple databases such as Medline, National Library of Medicine, Ovid, Scopus database to retrieve all the articles on the long-term sequalae of cognitive dysfunction after SARS-CoV-2 infection. The inclusion criteria included all articles pertinent to this specific topic and exclusion criteria subtracted studies pertaining to other aetiologies of cognitive dysfunction. This search was carefully screened for duplicates and the relevant information was extracted and analysed. Results/discussion: To date, the exact pathogenesis, and underlying mechanisms behind cognitive dysfunction in COVID-19, remain unclear, hindering the development of adequate management strategies. However, the proposed mechanisms suggested by various studies include direct damage to the blood-brain barrier, systemic inflammation, prolonged hypoxia, and extended intensive care admissions. However, no clear-cut guidelines for management are apparent. Conclusion: This review of the COVID-19 pandemic has elucidated a new global challenge which is affecting individuals’ quality of life by inducing long-term impaired cognitive function. The authors have found that comprehensive evaluations and interventions are crucial to address the cognitive sequelae in all COVID-19 patients, especially in patients with pre-existing cognitive impairment. Nevertheless, the authors recommend further research for the development of relevant, timely neurocognitive assessments and treatment plans.

CITATION EXPORT

Sanobar Shariff, Olivier Uwishema, Jocelyn Mizero et al.. Long-term cognitive dysfunction after the COVID-19 pandemic: a narrative review. Annals of Medicine and Surgery. (2023). https://doi.org/10.1097/MS9.0000000000001265

AUTHORS

15 · 12 CENTRES

Sanobar Shariff, Olivier Uwishema, Jocelyn Mizero, Vimala Devi Thambi, Abubakar Nazir, Ashraf Mahmoud, Ikshwaki Kaushik, Saadeddine Khayat, Abdulkadir Yusif Maigoro, Sara Awde, Zeina Al Maaz, Iktimal Alwan, Mahdi Hijazi, Jack Wellington, Lee Soojin

aOli Health Magazine Organization, Research and Education, Kigali, Rwanda
bYerevan State Medical University, Yerevan, Armenia
cClinton Global Initiative University, NY
dFaculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
eFaculty of Medicine, University of Ghana Medical School, Accra, Ghana
fR- endo Inc, Hamilton, NJ & Dr. NTR University Health Sciences
gDepartment of Medicine, King Edward Medical University, Lahore, Pakistan
hFaculty of Medicine, Kilimanjaro Christian Medical University College KCMUCo, Tanzania
iFaculty of Medicine, David Tvildiani Medical University, Tbilisi, Georgia
jFaculty of Medicine, Beirut Arab University, Beirut, Lebanon
kDepartment of Microbiology and Molecular Biology, College of Bioscience and Biotechnology, Chungnam National University, Daejeon, Korea
lFaculty of Medicine, Cardiff University School of Medicine, Cardiff University, Cardiff, UK