Cited by 365Long-Term Effects of COVID-19Intensive Care Unit Cognitive DisordersCOVID-19 Clinical Research Studies

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Cognitive impairments four months after COVID-19 hospital discharge: pattern, severity and association with illness variables.

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Miskowiak, KW, Johnsen, S, Sattler, SM, Nielsen, S, Kunalan, K, Rungby, J, Lapperre, T, Porsberg, CM·2021·European Neuropsychopharmacology

DOI 10.1016/j.euroneuro.2021.03.019PMC PMC8006192

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Abstract

The ongoing Coronavirus Disease 2019 (COVID-19) pandemic has affected more than 100 million people and clinics are being established for diagnosing and treating lingering symptoms, so called long-COVID. A key concern are neurological and long-term cognitive complications. At the same time, the prevalence and nature of the cognitive sequalae of COVID-19 are unclear. The present study aimed to investigate the frequency, pattern and severity of cognitive impairments 3-4 months after COVID-19 hospital discharge, their relation to subjective cognitive complaints, quality of life and illness variables. We recruited patients at their follow-up visit at the respiratory outpatient clinic, Copenhagen University Hospital, Bispebjerg, approximately four months after hospitalisation with COVID-19. Patients underwent pulmonary, functional and cognitive assessments. Twenty-nine patients were included. The percentage of patients with clinically significant cognitive impairment ranged from 59% to 65% depending on the applied cut-off for clinical relevance of cognitive impairment, with verbal learning and executive functions being most affected. Objective cognitive impairment scaled with subjective cognitive complaints, lower work function and poorer quality of life. Cognitive impairments were associated with d-dimer levels during acute illness and residual pulmonary dysfunction. In conclusion, these findings provide new evidence for frequent cognitive sequelae of COVID-19 and indicate an association with the severity of the lung affection and potentially restricted cerebral oxygen delivery. Further, the associations with quality of life and functioning call for systematic cognitive screening of patients after recovery from severe COVID-19 illness and implementation of targeted treatments for patients with persistent cognitive impairments.

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Items 101–200 of 363

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“(14) Multi-organ complications,(13, 15-18) including neuropsychiatric sequelae (up to 20%), are well-documented.”
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Cognitive Complaints Assessment and Neuropsychiatric Disorders After Mild COVID-19 Infection
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Long COVID neuropsychological follow-up: Is cognitive rehabilitation relevant?
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“In addition to cognitive measures, we used the Chalder fatigue scale 44 to assess fatigue, the generalized anxiety disorder 7-item scale 45 to assess anxiety, the Patient Health Questionnaire-9 46 to assess depression and memory failures of everyday test 47 to assess subjective memory complains.”
Influential
Addressing the ‘hypoxia paradox’ in severe COVID-19: literature review and report of four cases treated with erythropoietin analogues
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Self-citation
Relationship between Reaction Times and Post-COVID-19 Symptoms Assessed by a Web-Based Visual Detection Task
Maiorana, N. V., Aiello, E. N., Poletti, B., Carusi, F., Sandi, A. D., Guidetti, M., Prandin, R., Marceglia, S. R. F., Ticozzi, N., Silani, V., et al. (2023) · Healthcare · doi:10.3390/healthcare11030284 · Cited by 17
Long-term cognitive dysfunction after the COVID-19 pandemic: a narrative review
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“For instance, an investigative study on cognitive impairments 3 – 4 months post-COVID-19 hospital discharge found that 59 – 65% of subjects showed clinically signi ﬁ cant cognitive impairment [13] .”
Evaluation and treatment approaches for neurological post-acute sequelae of COVID-19: A consensus statement and scoping review from the global COVID-19 neuro research coalition
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Cognitive impairments in patients with subacute coronavirus disease: Initial experiences in a post-coronavirus disease clinic
Chang, J. G., Ha, E.-H., Lee, W., & Lee, S. Y. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.994331 · Cited by 17
Long COVID: The impact on language and cognition
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Prevalence of swallow, communication, voice and cognitive compromise following hospitalisation for COVID-19: the PHOSP-COVID analysis
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Cognitive impairment after recovery from COVID-19: Frequency, profile, and relationships with clinical and laboratory indices
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“…interval (from one month to 24 months) between the infection and the cognitive assessment represents another potential reason for discrepancies (Almeria et al., 2020; Becker et al., 2021; Evans et al., 2021; Hartung et al., 2022; Mattioli et al., 2022; Miskowiak et al., 2021; Voruz et al., 2022).”
BackgroundResultInfluential
Cerebral Metabolic Rate of Glucose and Cognitive Tests in Long COVID Patients
Miskowiak, K. W., Bech, J. L., Henriksen, A. C., Johnsen, S., Podlekareva, D. N., & Marner, L. (2022) · Brain Sciences · doi:10.3390/brainsci13010023 · Cited by 16
Self-citation
Characteristics of a Danish Post-COVID Cohort Referred for Examination due to Persistent Symptoms Six Months after Mild Acute COVID-19
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Risk and Protective Factors of Psychological Distress in Patients Who Recovered From COVID-19: The Role of Cognitive Reserve
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Post-COVID-19 syndrome among hospitalized COVID-19 patients: a cohort study assessing patients 6 and 12 months after hospital discharge
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“Further research is needed to provide a better understanding of all neurological disorders associated with COVID-19 and their cognitive manifestations 36,37 .”
Background
Neurocognitive and psychiatric post-coronavirus disease 2019 conditions: pathogenic insights of brain dysfunction following severe acute respiratory syndrome coronavirus 2 infection
García-Grimshaw, M., Sankowski, R., & Valdés‐Ferrer, S. I. (2022) · Current Opinion in Neurology · doi:10.1097/wco.0000000000001046 · Cited by 15
“In another study, residual pulmonary dysfunction 3– 4months after discharge was associated with cognitive impairment [94].”
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Kognitive Störungen und Schlafstörungen bei Long-COVID
Schilling, C., Meyer‐Lindenberg, A., & Schweiger, J. I. (2022) · Der Nervenarzt · doi:10.1007/s00115-022-01297-z · Cited by 14
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A Prospect to Ameliorate Affective Symptoms and to Enhance Cognition in Long COVID Using Auricular Transcutaneous Vagus Nerve Stimulation
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Method
COVID-19 and cognitive performance: a Mendelian randomization study
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Characterization of neurocognitive deficits in patients with post-COVID-19 syndrome: persistence, patients’ complaints, and clinical predictors
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Virtual pulmonary rehabilitation approaches in patients with post COVID syndrome: a pilot study
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“The prevalence of fatigue and cognitive dysfunction, including memory and attention deficits, is high in individuals with PCS [59–61].”
Background
Clinical management of COVID-19
World Health Organization (2025) · World Health Organization eBooks · doi:10.2471/b09467 · Cited by 18
Post-Acute COVID-19 Syndrome for Anesthesiologists: A Narrative Review and a Pragmatic Approach to Clinical Care
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European Working Group on SARS-CoV-2: Current Understanding, Unknowns, and Recommendations on the Neurological Complications of COVID-19
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“In hospitalized COVID-19 patients, overall cognitive impairment and executive dysfunction correlated with level of pulmonary function and severity of current respiratory symptoms (Miskowiak et al, 2021).”
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Síndrome pós-COVID-19 entre hospitalizados por COVID-19: estudo de coorte após 6 e 12 meses da alta hospitalar
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“However, impaired EF was prevalent, irrespective of the clinical severity, with pulmonary function and respiratory symptoms post-recovery being associated with greater impairments [54,47].”
Self-reported neurocognitive symptoms during COVID-19 lockdown and its associated factors in a sample of psychiatric patients. Results from the BRIS-MHC study
Montejo, L., Solé, B., Verdolini, N., Martínez‐Arán, A., Bonnín, C. D. M., Raduà, J., Martín‐Villalba, I., Williams, E., García‐Rizo, C., Mezquida, G., et al. (2021) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2021.07.006 · Cited by 12
Cognitive Impairment in Convalescent COVID-19 Patients Undergoing Multidisciplinary Rehabilitation: The Association with the Clinical and Functional Status
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Cognitive phenotyping of post-infectious SARS-CoV-2 patients
Aiello, E. N., Radici, A., Mora, G., & Pain, D. (2022) · Neurological Sciences · doi:10.1007/s10072-022-06130-8 · Cited by 12
“Nonetheless, it must be noted that contrasting evidence has recently emerged as for ICU admission, namely that admitted patients may have worse cognitive outcomes [7].”
Background
Cognitive and psychological outcomes and follow-up in severely affected COVID-19 survivors admitted to a rehabilitation hospital
TANTI, A. D., Conforti, J. M., Bruni, S., Gaetano, K. D., Cappalli, A., Basagni, B., Bertoni, D., & Saviola, D. (2023) · Neurological Sciences · doi:10.1007/s10072-023-06665-4 · Cited by 14
Post-COVID syndrome and work ability 9-12 months after a SARS-CoV-2 infection among over 9000 employees from the general population
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“Interestingly, post-COVID cognitive impairment [30] or post-COVID fatigue and a reduced cognitive function were associated with not being able to return to work in 77 employees [31] , yet no similar association was found with post-COVID depression and anxiety [31] .”
Result
Prevalence and co-occurrence of cognitive impairment in children and young people up to 12-months post infection with SARS-CoV-2 (Omicron variant)
Foret-Bruno, P., Shafran, R., Stephenson, T. J., Nugawela, M. D., Chan, D., Ladhani, S. N., McOwat, K., Mensah, A. A., Simmons, R., Fox‐Smith, L., et al. (2024) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2024.05.001 · Cited by 13
“…impairment has been reported several months after SARS-CoV-2 infection, with reported deficits in verbal and executive function, attention, and memory(Becker et al. (2021); Graham et al., 2021; Hampshire et al., 2021; Jennings et al., 2022; Lamontagne et al., 2021; Miskowiak et al., 2021).”
Cognitive rehabilitation in post-COVID-19 condition: A study protocol for a randomized controlled trial
Hagen, B. I., Lerdal, A., Søraas, A. V. L., Landrø, N. I., Bø, R., Småstuen, M. C., Becker, J., & Stubberud, J. (2022) · Contemporary Clinical Trials · doi:10.1016/j.cct.2022.106955 · Cited by 11
Effects of Aerobic Training in Patients with Subacute COVID-19: A Randomized Controlled Feasibility Trial
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“However, not only critical but also patients with severe COVID-19 can present multiorgan involvement, with cardiovascular, neurological, or skeletal muscular manifestations in addition to lung disease [10,11].”
Background
Best Practices in Oral Care
Quinn, B. (2023) · Critical Care Nurse · doi:10.4037/ccn2023507 · Cited by 10
Understanding Patient-Reported Outcome Measures Used in Adult Survivors Experiencing Long-Term Effects After COVID-19 Infection: A Rapid Review
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Long COVID: From olfactory dysfunctions to viral Parkinsonism
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“61 66 Long ‐ term cardiovascular sequelae in the aftermath of COVID ‐ 19 infections heightens the chances of cerebrovascular disorders, and dysrhythmias.”
Research evidence on the management of the cognitive impairment component of the post-COVID condition: a qualitative systematic review
Melillo, A., Perrottelli, A., Caporusso, E., Coltorti, A., Giordano, G. M., Giuliani, L., Pezzella, P., Bucci, P., Mucci, A., Galderisi, S., et al. (2024) · European Psychiatry · doi:10.1192/j.eurpsy.2024.1770 · Cited by 15
“Another factor to be taken into account is that many of the included studies recruited subjects based on self-reported CI, but employed objective assessment tools for the pre – post evaluation of treatment efficacy [112 – 115].”
Background
Mental, cognitive and physical outcomes after intensive care unit treatment during the COVID-19 pandemic: a comparison between COVID-19 and non-COVID-19 patients
van Houwelingen, F., van Dellen, E., Visser‐Meily, J. M. A., Valkenet, K., Heijnen, G. H., Vernooij, L. M., Kerckhoffs, M. C., & Slooter, A. J. C. (2023) · Scientific Reports · doi:10.1038/s41598-023-41667-4 · Cited by 11
Is COVID-19 Infection a Multiorganic Disease? Focus on Extrapulmonary Involvement of SARS-CoV-2
Duloquin, G., Pommier, T., Georges, M., Giroud, M., Guénancia, C., Béjot, Y., Laurent, G., & Rabec, C. A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13051397 · Cited by 12
“This was found both in patients with moderate and severe COVID-19 [41].”
Background
Social impact of brain fog and analysis of risk factors: Long COVID in Japanese population
Shigematsu, L., Kimura, R., Terai, H., Mimura, Y., Ito, D., Bun, S., Namkoong, H., Asakura, T., Chubachi, S., Masaki, K., et al. (2024) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.52139 · Cited by 10
Long-term brain fog and cognitive impairment in previously hospitalized COVID-19 patients
Junco, B., Samano, D., Karakeshishyan, V., Bass, D., Sobczak, E., Swafford, E. P., Saavedra, A. B., Rooks, J. D., Baumel, B. S., Ramos, A. R., et al. (2024) · PLoS ONE · doi:10.1371/journal.pone.0309102 · Cited by 9
Cognitive function and brain structure in COVID-19 survivors: The role of persistent symptoms
Vakani, K., Norbury, R., Vanova, M., Ratto, M., Parton, A. D., Antonova, E., & Kumari, V. (2024) · Behavioural Brain Research · doi:10.1016/j.bbr.2024.115283 · Cited by 9
“With an incidence rate of > 50 %, this has been one of the most prevalent long-COVID symptom in many previous studies [33,48,61,64,74].”
Cognitive reserve moderates the effect of COVID-19 on cognition: A systematic review and meta-analysis of individual participant data
Foreman, L. M., Child, B., Saywell, I., Collins‐Praino, L. E., & Baetu, I. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106067 · Cited by 12
“7 Miskowiak studies (Miskowiak et al., 2022; Miskowiak et al., 2021); data from four months post-COVID was used. study-level variables extracted for studies for which IPD was not obtained underwent comparative analysis with those for which IPD was obtained, as reported in Section 3.7.3.”
Influential
Emerging Role of Mesenchymal Stromal Cell and Exosome Therapies in Treating Cognitive Impairment
Tew, V. K., Barathan, M., Nordin, F., Law, J. X., & Ng, M. H. (2025) · Pharmaceutics · doi:10.3390/pharmaceutics17030284 · Cited by 9
“Emerging evidence links COVID-19 to cognitive decline, likely through mechanisms involving inflammation and oxidative stress [33].”
Neuropsychological Outcomes of COVID-19: A Multicenter, Cross-Cultural Study of Patients Referred for Outpatient Assessment
Kay, C. D., Costa, A. S., Vannorsdall, T. D., Aduen, P. A., Vila‐Castelar, C., Burstein, S. M., Pollak, L. E., Leibel, D. K., Sherman, J. C., Bungenberg, J., et al. (2022) · COVID · doi:10.3390/covid2090092 · Cited by 9
Using Machine Learning Algorithms to Determine the Post-COVID State of a Person by Their Rhythmogram
Викторович, С. С., Kovalchuk, A. V., Eremin, E. V., Drugova, O. V., Заречнова, Н. В., Tsirkova, M., Permyakov, S., Parin, S. B., & Polevaya, S. A. (2023) · Sensors · doi:10.3390/s23115272 · Cited by 9
Post-COVID-19 Cognitive Decline and Apoe Polymorphism: Towards a Possible Link?
Tavares-Júnior, J. W. L., Oliveira, D. N., da Silva, J. B. S., Feitosa, W. L. Q., Sousa, A. V. M., Marinho, S. C., Cunha, L. C. V., Gaspar, S. D. B., Gomes, C. M. P., de Oliveira, L. L. B., et al. (2023) · Brain Sciences · doi:10.3390/brainsci13121611 · Cited by 10
“Older adults were more susceptible to severe COVID-19 manifestations throughout the pandemic, which also puts this population at risk of cognitive decline after such more clinically severe conditions and also after hospitalization [41].”
Background
Neurocognitive and Neuropsychiatric Sequelae in Long COVID-19 Infection
Almería, M., Cejudo, J. C., Deus, J., & Krupiński, J. (2024) · Brain Sciences · doi:10.3390/brainsci14060604 · Cited by 9
Moderate, Little, or No Improvements in Neurobehavioral Symptoms among Individuals with Long COVID: A 34-Country Retrospective Study
Ramos‐Usuga, D., Perrin, P. B., Bogdanova, Y., Olabarrieta‐Landa, L., Alzueta, E., Baker, F. C., Iacovides, S., Cortes, M., & Arango‐Lasprilla, J. C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191912593 · Cited by 9
“[17] evaluated the cognitive functioning of 29 individuals 3–4 months after hospital discharge for COVID-19 through the Trail Making Test (TMT) and the Screen for Cognitive Impairment in Psychiatry (SCIP).”
Method
Neuroprotective Agents with Therapeutic Potential for COVID-19
Zaa, C. A., Espitia, C., Reyes-Barrera, K. L., An, Z., & Velasco-Velázquez, M. A. (2023) · Biomolecules · doi:10.3390/biom13111585 · Cited by 9
“- Cognitive damage: COVID-19 can cause a cognitive deﬁcit, mainly in attention and executive function, and verbal learning; and the incidence is associated with the severity of COVID-19 [68,69].”
Background
Demyelination in Patients with POST-COVID Depression
Khodanovich, M. Y., Светлик, М. В., Kamaeva, D. A., Usova, A. V., Kudabaeva, M., Anan’ina, T. V., Wasserlauf, I. E., Pashkevich, V., Moshkina, M., Obukhovskaya, V. B., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13164692 · Cited by 8
Some of the workforce face post COVID after the acute phase of the illness: The employer’s supportive role
Babnik, K., Staresinic, C., & Lep, Ž. (2022) · Human Systems Management · doi:10.3233/hsm-220003 · Cited by 10
“A smaller study by Miskowiak et al. [21] found that between 59 and 65% of its patients demonstrated clinically signiﬁcant cognitive impairment, with verbal learning and executive functions being most affected, 3-4 months after hospital discharge.”
Is recovery just the beginning? Persistent symptoms and health and performance deterioration in post-COVID-19, non-hospitalized university students—a cross-sectional study
Latifi, A., & Jaroslav Flegr, A. (2023) · Biology Methods and Protocols · doi:10.1093/biomethods/bpad037 · Cited by 8
“Our results align with previous studies that have identified a correlation between COVID-19 severity and subsequent declines in physical health [35, 37–39], mental health challenges [7, 40, 41], and cognitive deficits [8, 42, 43].”
Result
Cognitive performance of post-covid patients in mild, moderate, and severe clinical situations
Serafim, A. D. P., Saffi, F., Soares, A. R. A., Morita, A. M., Assed, M. M., de Toledo, S., Rocca, C. C. D. A., & Durães, R. S. S. (2024) · BMC Psychology · doi:10.1186/s40359-024-01740-7 · Cited by 12
“Overall, the COVID-19 pandemic significantly elevated stress and anxiety levels in both the general population and in patients with more severe symptoms requiring hospitalization [26, 28, 36, 45–49].”
Background
Highlighting the Neuropsychological Consequences of COVID-19: Evidence From a Narrative Review
Megari, K., Thomaidou, E., & Chatzidimitriou, E. (2024) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/00469580241262442 · Cited by 8
“12,15,17 In addition, some studies detected processing speed deficits.”
Background
Association of Anxiety and Depression with Objective and Subjective Cognitive Decline in Outpatient Healthcare Consumers with COVID-19: А Cross-Sectional Study
Gomzyakova, N. A., Palchikova, E. I., Tumova, M. A., Kasyanov, E. D., & Sorokin, M. Y. (2022) · Consortium Psychiatricum · doi:10.17816/cp189 · Cited by 8
“The severity of the COVID-19 course depends on the level of hypoxemia, increased concentration of D-dimer in the acute period, residual pulmonary insufficiency, the level of C-reactive protein (CRP), and increased density of the white matter of the brain [17].”
Background
Cognitive Impairment and Risk Factors in Post-COVID-19 Hospitalized Patients
Khieukhajee, J., Rojana-udomsart, A., Srisarakorn, P., Wongsurit, T., & Aungsumart, S. (2023) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000531743 · Cited by 8
“However, previous studies reported con ﬂ icted results regarding the association between these clinical biomarkers and cognitive symptoms [6 – 9 , The level of education seems to be the only predictive factor for post-acute COVID-19 cognitive symptoms in our research.”
BackgroundResult
COVID-19 may Enduringly Impact Cognitive Performance and Brain Haemodynamics in Undergraduate Students
McNeill, R., Marshall, R., Fernando, S. A., Harrison, O. K., & Machado, L. (2024) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2024.12.002 · Cited by 11
Profiles of Individuals With Long COVID Reporting Persistent Cognitive Complaints
Fernandez, C. C., Didone, V., Slama, H., Dupuis, G., Fery, P., Delrue, G., Lesoinne, A., Collette, F., & Willems, S. J. (2025) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acaf064 · Cited by 9
“Similarly,tomeasurecognitivecomplaints,severalstudies usedquestionnairesthatassessawiderangeofcognitive symptoms(e.g.,CognitiveFailuresQuestionnaireorEveryday CognitionQuestionnaire;Miskowiaketal.,2021;Marquine etal.,2023).”
Neurocognitive Impairment in Post-COVID-19 Condition in Adults: Narrative Review of the Current Literature
Garmoe, W. S., Rao, K., Gorter, B. G., & Kantor, R. (2024) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acae017 · Cited by 7
Immune Response and Cognitive Impairment in Post-COVID Syndrome: A Systematic Review
Holland, J. F., Sheehan, D., Brown, S. A., O'Flanagan, S., Savinelli, S., O’Keeffe, F. M., & Bramham, J. (2024) · The American Journal of Medicine · doi:10.1016/j.amjmed.2024.09.022 · Cited by 7
Previously independent patients with mild-symptomatic COVID-19 are at high risk of developing cognitive impairment but not depression or anxiety
Gamberini, G., Masuccio, F. G., Cerrato, M., Strazzacappa, M., Ferraro, D., & Solaro, C. M. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.100 · Cited by 7
The Neuropathological Impacts of COVID-19: Challenges and Alternative Treatment Options for Alzheimer’s Like Brain Changes on Severely SARS-CoV-2 Infected Patients
Rahman, M. R., Akter, R., Neelotpol, S., Mayesha, I. I., & Afrose, A. (2023) · American Journal of Alzheimer s Disease & Other Dementias® · doi:10.1177/15333175231214974 · Cited by 8
“45,46,51-54 More importantly, COVID-19 induced neuronal damage is responsible for long-term cognitive impairments such as memory dif ﬁ culties, inability to concentrate and focus, temporal orientation, task-set shifting, proactive control, and executive dysfunction.”
Background
Cognitive reserve, depressive symptoms, obesity, and change in employment status predict mental processing speed and executive function after COVID-19
Ariza, M., Béjar, J., Barruè, C., Cano, N., Segura, B., NAUTILUS Project Collaborative Group, Bernia, J. A., Arauzo, V., Balagué‐Marmaña, M., Pérez-Pellejero, C., et al. (2024) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-023-01748-x · Cited by 9
“In contrast to previous research [9, 22, 110, 111], our model revealed no effect of age or gender.”
Comparison of lifestyle, cognitive function, mental health, and quality of life between hospitalized older adults with COVID-19 and non-COVID-19 in South Korea: a cross-sectional study
Jung, J. H., Park, J., & Park, K.-H. (2024) · BMC Geriatrics · doi:10.1186/s12877-023-04646-y · Cited by 7
“According to previous studies, there is a correlation between depression, anxiety, and overall cognitive function [43] and there was an interaction between depression and cognitive function on quality of life [44].”
Background
What We Know About Neurocognitive Outcomes in Long-/Post-COVID-19 Adults
Seibert, S., Hanke, A., Wieberneit, M., Bieler, L., Gräfenkämper, R., Klatt, K., & Widmann, C. N. (2024) · Zeitschrift für Neuropsychologie · doi:10.1024/1016-264x/a000395 · Cited by 9
Neurocognitive and emotional long-term effects of COVID-19 infections in children and adolescents: results from a clinical survey in Bavaria, Germany
Hauke-Gleißner, J., Jarvers, I., Jordan, S., Gerling, S., Kabesch, M., Brunner, R., & Kandsperger, S. (2025) · BMC Infectious Diseases · doi:10.1186/s12879-025-10813-w · Cited by 6
“Furthermore, there was an association between pulmonary dysfunction and cognitive deficits/deficits in executive functioning [24].”
Cognitive Slowing, Dysfunction in Verbal Working Memory, Divided Attention and Response Inhibition in Post COVID-19 Condition in Young Adults
Takács, J., Deák, D., Seregély, B., & Koller, Á. (2025) · Life · doi:10.3390/life15050821 · Cited by 6
“Our results are in line with previous studies [40,47,60], which revealed an association between cognitive dysfunction and reported cognitive complaints.”
Insights on the neurocognitive mechanisms underlying hippocampus-dependent memory impairment in COVID-19
Meyer, P., & Zaiser, A. (2025) · Scientific Reports · doi:10.1038/s41598-025-04166-2 · Cited by 7
“Unlike earlier studies 5,6,13,101,102 , our findings indicate no difference in alertness or in most tasks evaluating executive functions such as updating, inhibition and flexibility (assessed through the n-back task, the stop-signal task, the go/no-go task, and task switching).”
Understanding the neurological implications of acute and long COVID using brain organoids
García‐González, L., Martí-Sarrias, A., Puertas, M. C., Bayón-Gil, Á., Resa‐Infante, P., Martínez‐Picado, J., Navarro, A., & Acosta, S. (2023) · Disease Models & Mechanisms · doi:10.1242/dmm.050049 · Cited by 7
“…to acute or relapsed SARS-CoV-2 infection (Box 1) (Buskermolen et al., 2021; Tillett et al., 2021), and/or persistent inflammation of the brain parenchyma upon systemic infection (Bertuccelli et al., 2022; Davidson et al., 2021; Mattioli et al., 2022; Miskowiak et al., 2021; Sneller et al., 2022).”
Assessment of COVID-19-related olfactory dysfunction and its association with psychological, neuropsychiatric, and cognitive symptoms
Jegatheeswaran, L., Gokani, S. A., Luke, L., Klyvyte, G., Espehana, A., Garden, E. M., Tarantino, A., Al‐Omari, B., & Philpott, C. M. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1165329 · Cited by 6
Neurocognitive Changes in Patients with Post-COVID Depression
Khodanovich, M. Y., Naumova, A. V., Kamaeva, D. A., Obukhovskaya, V. B., Vasilieva, S., Schastnyy, E. D., Kataeva, N., Levina, A., Kudabaeva, M., Pashkevich, V., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13051442 · Cited by 6
“The association of the severity of COVID-19 with long-term neurological consequences is well documented [16,22,25,61–64].”
Background
Neuropsychological functioning and its correlates at 1 year follow‐up of severe COVID ‐19
Costas‐Carrera, A., Sánchez‐Rodríguez, M. M., Ojeda, A., Rodríguez-Rey, A., Martín‐Villalba, I., Primé‐Tous, M., Valdesoiro‐Pulido, F., Segú, X., Borràs, R., Clougher, D., et al. (2024) · Psychogeriatrics · doi:10.1111/psyg.13113 · Cited by 6
“2,10,12 Conversely, other factors such as cognitive reserve may protect from cognitive impairment after SARS-CoV-2 infection.”
Background
Cognitive impairment in long-COVID
Tozkir, J., Turkmen, Ç., & Topçular, B. (2024) · Ideggyógyászati Szemle · doi:10.18071/isz.77.0151 · Cited by 6
Significant cognitive impairment likely associated with COVID-19 infection with relatively nonsevere symptoms
Reeves, R. R., & Willoughby, S. G. (2022) · Journal of Osteopathic Medicine · doi:10.1515/jom-2021-0195 · Cited by 6
Network Analysis of Neurobehavioral Symptom Patterns in an International Sample of Spanish-Speakers with a History of COVID-19 and Controls
Perrin, P. B., Ramos‐Usuga, D., West, S. J., Merced, K., Klyce, D. W., Lequerica, A. H., Olabarrieta‐Landa, L., Alzueta, E., Baker, F. C., Iacovides, S., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20010183 · Cited by 6
The Impact of COVID-19 Lockdown Measures and COVID-19 Infection on Cognitive Functions: A Review in Healthy and Neurological Populations
Manfredini, A., Pisano, F., Incoccia, C., & Marangolo, P. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20064889 · Cited by 6
Cognitive function in recovered COVID-19 Lebanese patients with schizophrenia
Haddad, C., Chamoun, A., Sacre, H., Hallit, S. R., Salameh, P., & Calvet, B. (2023) · Annals of General Psychiatry · doi:10.1186/s12991-023-00435-4 · Cited by 7
COVCOG: Immediate and long-term cognitive improvement after cognitive versus emotion management psychoeducation programs - a randomized trial in covid patients with neuropsychological difficulties
Willems, S. J., Didone, V., Fernandez, C. C., Delrue, G., Slama, H., Fery, P., Goin, J., Libera, C. D., COVCOG Group, Moutschen, M. P., et al. (2023) · BMC Neurology · doi:10.1186/s12883-023-03346-9 · Cited by 6
“These long-term difficulties still mainly concern processing speed and attentional functions, followed by memory in verbal and visual-spatial modalities [3, 5, 7].”
BackgroundInfluential
Poor sleep quality may trigger cognitive deficits after recovery from COVID-19
Carnes, A., Piñol‐Ripoll, G., Ariza, M., Cano, N., Segura, B., Junqué, C., Béjar, J., Barruè, C., Garolera, M., & Nautilus Project Collaborative Group (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1382875 · Cited by 6
Long-term cognitive functioning following COVID-19: Negligible neuropsychological changes over time
Koch, D. W., Klinkhammer, S., Verveen, A., Visser, D., Nieuwkerk, P. T., Verwijk, E., van Berckel, B. N. M., Horn, J., Tolboom, N., Heugten, C. M. V., et al. (2025) · The Clinical Neuropsychologist · doi:10.1080/13854046.2025.2496212 · Cited by 5
“This suggests the impact of initial disease severity on cognition may be limited, in line with some studies showing no differences in cognitive functioning between severely and non-severely impacted individuals (Miskowiak et al., 2021; Woo et al., 2020).”
Neurological manifestations of postcovid syndrome
Kamchatnov, P. R., Cheremin, R. A., Skipetrova, L. A., & Chugunov, A. V. (2022) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro20221220317 · Cited by 5
Long COVID in Brain Health Research: A Call to Action
Rudroff, T. (2024) · Brain Sciences · doi:10.3390/brainsci14060587 · Cited by 5
“Mental health and cognition - COVID-19 is linked to high rates of sleep disturbance, anxiety, and mood disorders which impact cognition [10,13,23,45]; -”
Background
Alterações cognitivas e de memória na COVID-19: Revisão Integrativa da Literatura
Dias, B. C., Evangelista, L. C. R., Mazer, G. H. C., Ferraz, A. C. P. D. F., Tahan, V. C., & Higa, E. D. F. R. (2022) · New Trends in Qualitative Research · doi:10.36367/ntqr.13.2022.e708 · Cited by 5
Funciones cognitivas y salud mental en personas mayores durante la pandemia por COVID-19, factores de riesgo y factores protectores: una revisión sistemática cualitativa
Espinoza, C. S., & Martella, D. (2022) · Revista médica de Chile · doi:10.4067/s0034-98872022000600802 · Cited by 5
Cognitive Deficits among Individuals Admitted to a Post-Acute Pneumological Rehabilitation Unit in Southern Italy after COVID-19 Infection
Lagravinese, G., Castellana, G., Castellana, F., Genco, M., Petrelli, R., Ruccia, M., Aliani, M., Carone, M., Sardone, R., & Battista, P. (2023) · Brain Sciences · doi:10.3390/brainsci13010084 · Cited by 5
“In an outpatient clinic, a report examined cognitive performance in 29 COVID-19 patients 3–4 months after their hospital discharge and found no correlation between the severity of COVID-19 infection, oxygen supplies needed, and cognitive impairments [14,27].”
Background
Long-Lasting COVID-Associated Brain Fog: A Follow-Up Study
Asadi‐Pooya, A. A., Shahisavandi, M., Nemati, H., Karimi, A., Jafari, A., Nasiri, S., Mohammadi, S. S., Nemati, M., Rahimian, Z., & Bayat, H. (2023) · European Neurology · doi:10.1159/000529860 · Cited by 5
Quantitative sensory testing defines the trajectory of sensory neuropathy after severe COVID-19
Ponirakis, G., Odriozola, A., Ortega, L., Martinez, L., Odriozola, S., Torrens, A., Coroleu, D., Martínez, S., Sanz, X., Ponce, M., et al. (2023) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2023.111029 · Cited by 5
Long-Term Risk of Reduced Cognitive Performance and Associated Factors in Discharged Older Adults with COVID-19: A Longitudinal Prospective Study
Demir, E., Veizi, B. G. Y., & Naharcı, M. İ. (2024) · Annals of Geriatric Medicine and Research · doi:10.4235/agmr.23.0186 · Cited by 5
“6) Post-intensive care syndrome, which manifests as the loss of cognitive and physical functions in patients who survive intensive care, may be responsible for some cognitive impairments caused by COVID-19.”
Background
Cognitive performance in adults with post-COVID syndrome: Results from a German case-control study
Zülke, A. E., Luppa, M., Wirkner, K., Reusche, M., Sander, C., Büchner, R., Schomerus, G., Bergh, F. T., Lehmann, J., Witte, A. V., et al. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.06.036 · Cited by 5
Subjective and objective measures of cognitive function are correlated in persons with Post-COVID-19 Condition: a secondary analysis of a Randomized Controlled Trial
Kwan, A. T. H., Lakhani, M., Le, G. H., Singh, G., Teopiz, K. M., Ceban, F., Nijjar, C. S., Meshkat, S., Badulescu, S., Ho, R., et al. (2024) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-024-01877-x · Cited by 5
“…(subjective self reports on cognitive abilities versus objective performance on neuropsychological tests) are apparent in persons with PCC. [ 14, 15] However, the presence and magnitude of cognitive deficits reported are mixed, likely reflecting differences in method - ological approaches and…”
Cognition, function, and mood post-COVID-19: Comparative analysis using the health and retirement study
Su, H., Yang, P.-L., Eaton, T. L., Valley, T. S., Langa, K. M., Ely, E. W., & Thompson, H. J. (2024) · PLoS ONE · doi:10.1371/journal.pone.0315425 · Cited by 5
Cognitive Sequelae of COVID ‐19: Mechanistic Insights and Therapeutic Approaches
Chen, Y., Jan, J., Yang, C., Yen, T., Linh, T. T. D., Annavajjula, S., Satapathy, M. K., Tsao, S., & Hsieh, C. (2025) · CNS Neuroscience & Therapeutics · doi:10.1111/cns.70348 · Cited by 5
“CI , particularly in the realm of executive functioning, has been strongly associated with reduced quality of life and heightened psychological distress in these individuals [5].”
Особливості когнітивних порушень при COVID-19
Kopchak, O. O. (2021) · INTERNATIONAL NEUROLOGICAL JOURNAL · doi:10.22141/2224-0713.17.3.2021.231569 · Cited by 6

Authors: Miskowiak, K., Johnsen, S., Sattler, S., Nielsen, S., Kunalan, K., Rungby, J., Lapperre, T., & Porsberg, C.
Affiliations: Bispebjerg Hospital (DK)
University of Copenhagen (DK)
University of Antwerp (BE)
ORCID: Johnsen, S
Nielsen, S
Rungby, J
Lapperre, T
Venue: European Neuropsychopharmacology
Publisher: Elsevier BV
Published: 2021-05
Volume: 46
Pages: 39-48
ISSN: 0924-977X (ISSN-L)
DOI: 10.1016/j.euroneuro.2021.03.019
PMC: PMC8006192
OpenAlex: W3148312871
Cited by: 365
References: 45
Citations by year: 2026: 12 · 2025: 45 · 2024: 60 · 2023: 97 · 2022: 115 · 2021: 36
FWCI: 36.84
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
creativecommons.org/licenses/by/4.0/ (vor)
Locations: European Neuropsychopharmacology (publishedVersion, cc-by)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
Funders: Lundbeck Foundation
Topics: Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords: COVID-19 pandemic, long COVID, cognitive impairment, hospital discharge, subjective cognitive complaints, quality of life, executive function, verbal learning, D-dimer, pulmonary dysfunction, cerebral oxygen delivery, cognitive screening
MeSH terms: COVID-19, Aged, Denmark, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Middle Aged, Patient Discharge, Prospective Studies, Severity of Illness Index, Time Factors, Cognitive Dysfunction

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Cognitive impairments four months after COVID-19 hospital discharge: pattern, severity and association with illness variables.

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