Post-COVID-19 cognitive symptoms in patients assisted by a teleassistance service: a retrospective cohort study

Front Public Health. 2024 Apr 16:12:1282067. doi: 10.3389/fpubh.2024.1282067. eCollection 2024.

Abstract

Introduction: Four years after the onset of the COVID-19 pandemic, the frequency of long-term post-COVID-19 cognitive symptoms is a matter of concern given the impact it may have on the work and quality of life of affected people.

Objective: To evaluate the incidence of post-acute COVID-19 cognitive symptoms, as well as the associated risk factors.

Methods: Retrospective cohort, including outpatients with laboratory-confirmed COVID-19 and who were assisted by a public telehealth service provided by the Telehealth Network of Minas Gerais (TNMG), during the acute phase of the disease, between December/2020 and March/2022. Data were collected through a structured questionnaire, applied via phone calls, regarding the persistence of COVID-19 symptoms after 12 weeks of the disease. Cognitive symptoms were defined as any of the following: memory loss, problems concentrating, word finding difficulties, and difficulty thinking clearly.

Results: From 630 patients who responded to the questionnaire, 23.7% presented cognitive symptoms at 12 weeks after infection. These patients had a higher median age (33 [IQR 25-46] vs. 30 [IQR 24-42] years-old, p = 0.042) with a higher prevalence in the female sex (80.5% vs. 62.2%, p < 0.001) when compared to those who did not present cognitive symptoms, as well as a lower prevalence of smoking (8.7% vs. 16.2%, p = 0.024). Furthermore, patients with persistent cognitive symptoms were more likely to have been infected during the second wave of COVID-19 rather than the third (31.0% vs. 21.3%, p = 0.014). Patients who needed to seek in-person care during the acute phase of the disease were more likely to report post-acute cognitive symptoms (21.5% vs. 9.3%, p < 0,001). In multivariate logistic regression analysis, cognitive symptoms were associated with female sex (OR 2.24, CI 95% 1.41-3.57), fatigue (OR 2.33, CI 95% 1.19-4.56), depression (OR 5.37, CI 95% 2.19-13.15) and the need for seek in-person care during acute COVID-19 (OR 2.23, CI 95% 1.30-3.81).

Conclusion: In this retrospective cohort of patients with mostly mild COVID-19, cognitive symptoms were present in 23.7% of patients with COVID-19 at 12 weeks after infection. Female sex, fatigue, depression and the need to seek in-person care during acute COVID-19 were the risk factors independently associated with this condition.

Keywords: cognitive dysfunction; memory disorders; mental fatigue; post-acute COVID-19 syndrome; risk factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brazil / epidemiology
  • COVID-19* / epidemiology
  • Cognitive Dysfunction / epidemiology
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Post-Acute COVID-19 Syndrome
  • Quality of Life
  • Retrospective Studies
  • Risk Factors
  • SARS-CoV-2
  • Surveys and Questionnaires
  • Telemedicine* / statistics & numerical data
  • Young Adult

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was supported in part by Minas Gerais State Agency for Research and Development (Fundação de Amparo à Pesquisa do Estado de Minas Gerais – FAPEMIG) [grant number APQ-01154-21], National Institute of Science and Technology for Health Technology Assessment (Instituto de Avaliação de Tecnologias em Saúde – IATS)/National Council for Scientific and Technological Development (Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq) [grant number 465518/2014-1], CAPES Foundation (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) [grant number 88887.507149/2020-00] and Brazilian Ministry of Education (MEC—27849*8). TP received a scholarship from Pró-Reitoria de Extensão from Universidade Federal de Minas Gerais (PROEX UFMG). BF and DP received scholarships from FAPEMIG though the Pró-Reitoria de Pesquisa Universidade Federal de Minas Gerais (editais PROBIC 09/2021 and 04/2023, respectively). MM was supported in part by CNPq [grant number 310561/2021-3]. The funding bodies played no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. LB and MM had full access to all the data in the study and had responsibility for the decision to submit for publication.