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Background <p>Data on cognitive impairment in patients with Long-COVID remain controversial.</p> Methods <p>The study analyzed in patients followed for Long-COVID the frequency and risk factors for cognitive impairment (defined by a Montreal Cognitive Assessment [MoCA] score &lt; 24 points), its associations with subjectively reported cognitive and psychological symptoms, and the evolution of cognitive impairment and cognitive symptoms over time.</p> Results <p>At a mean interval of 259 days from COVID-19, the mean MoCA score recorded among 118 individuals was 25.5, with 32.2% of them showing scores &lt; 24 points. Eighty-five patients (72.0%) presented persisting symptoms, predominantly represented by fatigue (35.6%), dyspnea (28.8%) and cognitive symptoms (24.6%). A MoCA score &lt; 24 was significantly associated with older age, hospitalization during acute disease and female sex. Individuals with persisting cognitive symptoms had significantly lower MoCA scores compared to individuals without such symptoms, with a mean difference of 1.4 points. Anxiety and depression were not associated with lower MoCA scores. In a subsequent evaluation conducted in 66 individuals (55.9%) at an average interval of 959 days from COVID-19, the mean MoCA score decreased by 1.3 points (95%CI 0.5-2, <i>p</i> = 0.001), the frequency of a MoCA score &lt; 24 increased from 25.8% to 36.4% (<i>p</i> = 0.090), and the prevalence of cognitive symptoms increased from 27.3% to 53.0% (<i>p</i> = 0.002).</p> Discussion <p>Cognitive impairment in Long-COVID appeared common and persisting. Cognitive symptoms, unlike psychological symptoms, were associated with lower cognitive scores and tended to accumulate during follow-up. Advanced age, severity of acute SARS-CoV-2 disease and female sex should be considered as potential risk factors.</p>

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Cognitive impairment in long-COVID: frequency, trajectories and risk factors in a cohort study from Italy

  • 期刊论文

  • 发表日期：

    2026年4月21日

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  • Marco Floridia,
  • Liliana Elena Weimer,
  • Paolo Bonfanti,
  • Aldo Lo Forte,
  • Viola Cogliandro,
  • Valeria Bottaro,
  • Paola Andreozzi,
  • Silvia Zucco,
  • Guido Vagheggini,
  • Graziano Onder

摘要

Background

Data on cognitive impairment in patients with Long-COVID remain controversial.

Methods

The study analyzed in patients followed for Long-COVID the frequency and risk factors for cognitive impairment (defined by a Montreal Cognitive Assessment [MoCA] score < 24 points), its associations with subjectively reported cognitive and psychological symptoms, and the evolution of cognitive impairment and cognitive symptoms over time.

Results

At a mean interval of 259 days from COVID-19, the mean MoCA score recorded among 118 individuals was 25.5, with 32.2% of them showing scores < 24 points. Eighty-five patients (72.0%) presented persisting symptoms, predominantly represented by fatigue (35.6%), dyspnea (28.8%) and cognitive symptoms (24.6%). A MoCA score < 24 was significantly associated with older age, hospitalization during acute disease and female sex. Individuals with persisting cognitive symptoms had significantly lower MoCA scores compared to individuals without such symptoms, with a mean difference of 1.4 points. Anxiety and depression were not associated with lower MoCA scores. In a subsequent evaluation conducted in 66 individuals (55.9%) at an average interval of 959 days from COVID-19, the mean MoCA score decreased by 1.3 points (95%CI 0.5-2, p = 0.001), the frequency of a MoCA score < 24 increased from 25.8% to 36.4% (p = 0.090), and the prevalence of cognitive symptoms increased from 27.3% to 53.0% (p = 0.002).

Discussion

Cognitive impairment in Long-COVID appeared common and persisting. Cognitive symptoms, unlike psychological symptoms, were associated with lower cognitive scores and tended to accumulate during follow-up. Advanced age, severity of acute SARS-CoV-2 disease and female sex should be considered as potential risk factors.