Cited by 248Long-Term Effects of COVID-19Intensive Care Unit Cognitive DisordersCOVID-19 Clinical Research Studies

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Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19

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Jaywant, Abhishek, Vanderlind, W. Michael, Alexopoulos, George S., Fridman, Chaya B., Perlis, Roy H., Gunning, Faith M.·2021·Neuropsychopharmacology

DOI 10.1038/s41386-021-00978-8PMC PMC7884062

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Abstract

Early reports and case series suggest cognitive deficits occurs in some patients with COVID-19. We evaluated the frequency, severity, and profile of cognitive dysfunction in patients recovering from prolonged COVID-19 hospitalization who required acute inpatient rehabilitation prior to discharge. We analyzed cross-sectional scores from the Brief Memory and Executive Test (BMET) in a cohort of N = 57 COVID-19 patients undergoing inpatient rehabilitation, calculating the frequency of impairment based on neuropsychologist diagnosis and by age-normed BMET subtests. In total, 43 patients (75%) were male, 35 (61%) were non-white, and mean age was 64.5 (SD = 13.9) years. In total, 48 (84%) were previously living at home independently. Two patients had documented preexisting cognitive dysfunction; none had known dementia. Patients were evaluated at a mean of 43.2 (SD = 19.2) days after initial admission. In total, 50 patients (88%) had documented hypoxemic respiratory failure and 44 (77%) required intubation. Forty-six patients (81%) had cognitive impairment, ranging from mild to severe. Deficits were common in working memory (26/47 [55%] of patients), set-shifting (21/44 [47%]), divided attention (18/39 [46%]), and processing speed (14/35 [40%]). Executive dysfunction was not significantly associated with intubation length or the time from extubation to assessment, psychiatric diagnosis, or preexisting cardiovascular/metabolic disease. Attention and executive functions are frequently impaired in COVID-19 patients who require acute rehabilitation prior to discharge. Though interpretation is limited by lack of a comparator group, these results provide an early benchmark for identifying and characterizing cognitive difficulties after COVID-19. Given the frequency and pattern of impairment, easy-to-disseminate interventions that target attention and executive dysfunctions may be beneficial to this population.

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Postcovid Syndrome – The New Reality
Хорева, М. А. (2022) · Neuroscience and Behavioral Physiology · doi:10.1007/s11055-022-01286-4 · Cited by 4
The Infected Lungs and Brain Interface in COVID-19: The Impact on Cognitive Function
Joaquim, L. D. S., Giustina, A. D., Machado, R. S., Metzker, K. L. L., Bonfante, S., Danielski, L. G., Goldim, M. P. D. S., & Petronilho, F. C. (2022) · NeuroImmunoModulation · doi:10.1159/000526653 · Cited by 4
Changes in psychological and cognitive variables as well as cortisol levels in recovered Covid-19 patients: a longitudinal study
Afzali, A., Hatef, B., Sahraei, H., Meftahi, G. H., Khaleghi, A., & Jahromi, G. P. (2023) · Current Psychology · doi:10.1007/s12144-022-04211-7 · Cited by 5
“Another study has shown that 81% of hospital discharged Covid-19 patients had cognitive defects, mostly related to attention and working memory while delayed memory and recognition were less impaired (Jaywant et al., 2021).”
Auditory and Vestibular Findings in Brazilian Adults Affected by COVID-19: An Exploratory Study
Alcarás, P. A. D. S., Corazza, M. C. A., Vianna, L., de Araújo, C. M., Corazza, L. A., Zeigelboim, B. S., & de Lacerda, A. B. M. (2023) · Audiology and Neurotology · doi:10.1159/000531207 · Cited by 4
Therapeutic challenges in central nervous system viral infections: advancing mesenchymal stem cell-based strategies for treating neuroinflammation and promoting tissue repair
Carbone-Schellman, J., Fontecilla-Escobar, J., Sales-Salinas, N., Chaparro-Pico, W. F., Molina‐Berríos, A., Ruete, M. C., González, P. A., Machuca, M. A., Opazo, M. C., Ezquer, M., et al. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1677433 · Cited by 3
Neuropsychological Profile of Hospitalized Patients Due to COVID-19: Clinical and Inflammatory Correlates
Tsiaras, Y., Kitsakis, N., Papadopoulou, E., Karanikas, E., Kourbetis, D., & Aretouli, E. (2023) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acad038 · Cited by 3
SARS-CoV-2 Omicron Variants Show Attenuated Neurovirulence Compared with the Wild-Type Strain in Elderly Human Brain Spheroids
Chen, W., Jiang, X., Liang, W. P., Bai, H., Xu, M., Liu, Z., Yi, L., Liu, Y., Huang, Y., Zhang, Y., et al. (2024) · Research · doi:10.34133/research.0376 · Cited by 3
“Notably, WT or Omicron infection is associated with neurodegenerative disorders, such as AD and PD. Patients with COVID-19 and survivors may suffer from a neurodegenerative syndrome, which includes symptoms such as memory loss, delirium, and cognitive deficits [55,56].”
Background
Neuroinvasive and neurovirulent potential of SARS-CoV-2 in the acute and post-acute phase of intranasally inoculated ferrets
Benavides, F. F. W., Kroeze, E. J. B. V., Leijten, L. M. E., Schmitz, K. S., van Run, P., Kuiken, T., de Vries, R. D., Bauer, L., & van Riel, D. A. J. (2025) · PLoS ONE · doi:10.1371/journal.pone.0311449 · Cited by 3
“Neuroinvasive and potential of SARS-CoV-2 in ferrets”
Cognitive Behavioral Psychotherapy after COVID-19: Opportunities and Prospects
Витальевич, С. А., Seryy, A. V., Варич, Л. А., Bryukhanov, Y. I., & Zhikharev, A. Y. (2022) · Bulletin of Kemerovo State University · doi:10.21603/2078-8975-2022-24-4-420-429 · Cited by 3
Outcome of severe COVID-19: spotlight on fatigue, fatigability, multidomain complaints and pattern of cognitive deficits in a case series without prior brain dysfunction and without COVID-19-related stroke and/or cardiac arrest
Beaud, V., Crottaz‐Herbette, S., Dunet, V., Knebel, J., Bart, P., & Clarke, S. (2024) · Journal of Medical Case Reports · doi:10.1186/s13256-023-04300-6 · Cited by 3
“Patients with prior cognitive impairment were explicitly excluded in some [16, 23] but not in other studies [11].”
Result
Assessment of visuospatial functions in post-Covid 19 patients: Beyond the traditional paradigm
Paz-Rodríguez, F., Lozano-Tovar, S., Rodríguez‐Agudelo, Y., Cruz-Narciso, B., Rodríguez-Rodríguez, M. S., García-Santos, A., López-González, D., Soto-Moreno, F. J., González-Navarro, M., González-Alonso, K., et al. (2024) · Behavioural Brain Research · doi:10.1016/j.bbr.2024.115095 · Cited by 4
Cognitive Disorders and Neuropsychiatric Sequellae Associated with COVID-19
Kostenko, E. G., Moscow, R. F., Ахматовна, Э. М., Petrova, L. V., & Pogonchenkova, I. V. (2021) · Doctor Ru · doi:10.31550/1727-2378-2021-20-5-6-12 · Cited by 3
The impact of a home-based personalized computerized training program on cognitive dysfunction associated with Long COVID: a before-and-after feasibility studyPreprint
Duñabeitia, J. A., Mera, F., Baró, O., Jadad-Garcia, T., & Jadad, A. R. (2022) · medRxiv · doi:10.1101/2022.09.28.22280467 · Cited by 3
“In addition, this study confirms the findings of previous studies in terms of the severity of the cognitive dysfunction associated with Long COVID, across cognitive domains such as memory, attention, reasoning or coordination (Graham et al., 2021; Jaywant et al., 2021; Woo et al., 2020).”
Result
Cognitive outcomes and psychological symptoms in an Italian cohort with post-acute COVID-19 condition (PACC)
Vergori, A., Duca, G. D., Borrelli, P., Brita, A. C., Pinnetti, C., Mastrorosa, I., Camici, M., Mondi, A., Mazzotta, V., Chinello, P., et al. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e39431 · Cited by 2
Assessment of Cognitive and Mood Changes in Older Survivors of COVID-19
Özdemir, Ç., & Taştemur, M. (2023) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000001702 · Cited by 2
Decision-making ability limitations and brain neural activity changes in healthcare workers after mild COVID-19
Gao, Y., Lin, K., Wang, B., Ji, W., Liu, J., Du, M., Wang, W., Li, Y., Du, X., Wang, Y., et al. (2024) · Neuroscience Research · doi:10.1016/j.neures.2024.02.001 · Cited by 2
“…patients hospitalized with acute COVID-19 had deficits in working memory, attention, and speed of information processing during the recovery period(Jaywant et al., 2021), and another study reported 14 patients with COVID-19 in early acute recovery had deficits in cognitive functioning, including…”
MethodResult
Characteristics of neurovegetative disorders in ischemic heart disease patients after coronavirus disease 2019 (COVID-19)
Manuilov, S. M., & Mykhailovska, N. S. (2024) · Zaporozhye Medical Journal · doi:10.14739/2310-1210.2024.2.297015 · Cited by 2
“За даними дослідження А. Jaywant et al., більшість пацієнтів, які перенесли COVID-19, мають помірний когнітивний де - фіцит, що здебільшого виявляють за порушенням уваги та виконавчих функцій [ 31 ].”
Multicentre, multitime, multidimension, prospective follow-up cohort study on patients during the first wave of COVID-19 in China: a study protocol
Wu, S., Luo, Z., Liu, H., Zhu, J., Zhu, Y., Hou, D., Wei, T., Liu, T., Zheng, C., Zhu, Z., et al. (2025) · BMJ Open · doi:10.1136/bmjopen-2023-083023 · Cited by 2
Neuropsychological and psychological dysfunctions associated with coronavirus disease 2019: a case report
Damianova, M. K. (2021) · Journal of Medical Case Reports · doi:10.1186/s13256-021-03104-w · Cited by 2
Alterações cognitivas decorrentes da COVID-19: uma revisão sistemática
Guesser, V. M., de Paiva, K. M., de Barros, V. N., Gonçalves, L. F., & Haas, P. (2022) · Revista Neurociências · doi:10.34024/rnc.2022.v30.13848 · Cited by 2
Cognitive consequences of COVID-19
Kicherova, O. A., Рейхерт, Л. И., Akhmetyanov, M. A., Deeva, M. V., & Makarova, D. V. (2022) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro20221221117 · Cited by 1
Respiratory, Cardiac, and Neuropsychiatric Manifestations of Postacute Sequelae of Coronavirus Disease 2019 in Lima, Peru
Rahman, R., Tovar, M. A., Peinado, J., Palomino, J. S., Ramirez, C., Llanos-Zavalaga, F., Peralta, E., Valderrama, G., Ramos, L., Cortez, L. I. S., et al. (2023) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofad320 · Cited by 1
Risk Factors for COVID-19 Infection in Adult Patients: A Retrospective Observational Study in Japan
Yoshida, A., Furumachi, K., Kumagai, E., & Hosohata, K. (2024) · Infection and Drug Resistance · doi:10.2147/idr.s440742 · Cited by 1
Demographics, Clinical Characteristics, and Outcomes of a Post-Coronavirus-19 Sample After Cognitive Rehabilitation: A Case Series
Farr, E. M., Esterov, D., Kassmeyer, B. A., Lennon, R. J., & Bergquist, T. F. (2024) · Archives of Rehabilitation Research and Clinical Translation · doi:10.1016/j.arrct.2024.100409 · Cited by 1
Comprehensive neuropsychological assessment and predictors of cognitive functioning at six months after COVID-19 in patients treated in the ICU, regular hospital ward, or isolated at home
Pihlaja, R., Ollila, H., Tuulio‐Henriksson, A., Koskinen, S. K., Salmela, V. R., Tiainen, M., Hästbacka, J., & Hokkanen, L. (2025) · Applied Neuropsychology Adult · doi:10.1080/23279095.2025.2454352 · Cited by 1
“However, no consistent association was found between the length of ventilation and cognitive impairment in patients with COVID-19 (Almeria et al., 2023; García-Grimshaw et al., 2022; Jaywant et al., 2021).”
Executive Function Decline and Its Association With TNF ‐α in the Later Stages of Post‐Acute Sequelae of COVID
Varenya, A., Vijayalakshmi, K., & Mythri, R. B. (2025) · Journal of Neuroscience Research · doi:10.1002/jnr.70051 · Cited by 1
“Short term outcomes of post-COVID populations have been investigated to a certain extent with regards to cognitive sequelae (Jaywant et al. 2021; Woo et al. 2020).”
Alterations in Cortical Oscillatory Dynamics Following SARS-CoV-2 Infection: QEEG Biomarkers of Vulnerability to Attention and Seizure-Related Symptoms
Kopańska, M., Trojniak, J., Góral-Półrola, J., & Pąchalska, M. (2026) · Cells · doi:10.3390/cells15090790 · Cited by 1
“The loss of the ability to sustain selective attention or the slowing down of information processing directly translate into a significant reduction in operational capabilities [39,40].”
Excitotoxicity and Neurological Post-COVID-19 Syndrome: Exploring Possible Connections of Pathophysiological Mechanisms
Ureshino, R. P., de Sousa, L. A., Oliveira, R. B., Saullo, G. A., Zonaro, P. H., Newson, L. R., Prado, C. M., & Stilhano, R. S. (2026) · COVID · doi:10.3390/covid6050085 · Cited by 1
“Emerging evidence suggests that patients with COVID-19 also present neurological symptoms and complications [50,62,63], such as memory loss [64,65].”
A poszt-covid szindróma repülésbiztonsági jelentősége
Guth-Orji, Á. J. (2021) · Honvédorvos · doi:10.29068/ho.2021.1-2.5-19 · Cited by 1
ACCELERATED POPULATION AGING AS A CONSEQUENCE OF THE COVID-19 PANDEMIC (review)
Михайлович, К. И., Сагинбаев, У. Р., Рукавишникова, С. А., & Ахмедов, Т. А. (2023) · Успехи геронтологии · doi:10.34922/ae.2023.36.4.005 · Cited by 1
Clinical manifestations and possible predictors of the formation of post-COVID syndrome in neurological practice
Peretechikova, А. V., & Voskresenskaya, O. N. (2023) · Meditsinskiy sovet = Medical Council · doi:10.21518/ms2023-427 · Cited by 1
Assessing Functional Cognition and Health During COVID-19 Pandemic: Gender Differences Among Community-Dwelling Adults
Josman, N., Atiya, Y., Dagan, T., Issa, E., & Demeter, N. (2023) · Journal of Primary Care & Community Health · doi:10.1177/21501319231218801 · Cited by 1
Efeitos neurocognitivos relacionados à COVID-19
Pires, M. E. D. P., Sena, D. D. S., Rosa, M. A., Alves, I. C. S., Monteiro, V. V. C., Reis, A. D. S. D. S., Costa, P. B. C., & de Souza, L. O. (2022) · Research Society and Development · doi:10.33448/rsd-v11i11.34182 · Cited by 1
Factors associated with disability in patients after discharge from Intensive Care Units COVID-19
Caetano, I. D. A., Zander, L. R. M., Alves, F. B. T., dos Santos, C. B., & Fadel, C. B. (2022) · Rev Rene · doi:10.15253/2175-6783.20222381314 · Cited by 1
The features of cognitive impairments in patients with type 2 diabetes mellitus and comorbid post covid disorders
Kohut, A. O., Bobryk, M. I., Komisarenko, J., Khaustova, O. O., & Чабан, О. (2021) · Psychosomatic Medicine and General Practice · doi:10.26766/pmgp.v6i1.334 · Cited by 1
Disentangling the Cognitive, Physical, and Mental Health Sequalae of COVID-19Preprint
Wild, C. J., Norton, L. E., Menon, D. K., Ripsman, D., Swartz, R. H., & Owen, A. M. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4008565 · Cited by 1
Cognitive status and rehabilitation outcomes of patients in acute rehabilitation post Covid-19Preprint
Vahtra, M., Fahey, K., Malina, A. C., Dreyer, S. D., Roth, E. J., Grafman, J. H., Jayabalan, P. S., & Cohen‐Zimerman, S. (2022) · medRxiv · doi:10.1101/2022.09.10.22279806 · Cited by 1
Manifestaciones Cognitivas Persistentes Asociadas al COVID-19
Dávila-Marrero, E., Rivera Delpín, G., Rodríguez Mercado, A., Olivo Arroyo, R., & Montijo, J. A. (2021) · Dialnet (Universidad de la Rioja)
Cognitive Deficits in Patients with COVID-19 Infection during Their Hospital Stay: An Exploratory Study
Sahoo, S., Suman, A., Mehra, A., Nehra, R., Bhalla, A., Puri, G. D., & Grover, S. (2022) · Journal of Neurosciences in Rural Practice · doi:10.1055/s-0042-1743445
Editorial commentary: The nervous system, COVID-19 and cerebrovascular complications: A strange riddle of the time
Nampoothiri, M. (2022) · Trends in Cardiovascular Medicine · doi:10.1016/j.tcm.2022.05.001
COVID-19 Pandemic and Neurocognitive Process: New Scenarios for Understanding and Treatment
Öztürk, Ş., & Eren, F. (2022) · IntechOpen eBooks · doi:10.5772/intechopen.106687
Avaliação dos problemas cognitivos em pacientes psquiátricos Pós-COVID-19
Lehnen, C., Jardim, J. K. B., Zancanaro, V., & Henning, M. A. (2022) · Brazilian Journal of Development · doi:10.34117/bjdv8n11-390
Como o SARS-CoV-2 afeta a memória do paciente pós COVID-19: uma revisão integrativa
Prado, Y. L., Dias, A. E. N. D. R., de Souza, P. A. N., de Menezes, R. R., & Rodrigues, I. G. (2022) · Revista Master Ensino Pesquisa e Extensão · doi:10.47224/revistamaster.v7i14.352
Formes neurologiques du COVID long de l’adulte : approche critique
Chollet, F., Planton, M., Sailler, L., Almeida, S. D., Alvarez, M., & Pariente, J. (2023) · Bulletin de l Académie Nationale de Médecine · doi:10.1016/j.banm.2023.06.009
Cognitive Dysfunction in COVID-19
Kicherova, O. A., Рейхерт, Л. И., Akhmetyanov, M. A., Deeva, M. V., & Makarova, D. V. (2023) · Neuroscience and Behavioral Physiology · doi:10.1007/s11055-023-01474-w
Manifestações psicopatológicas e cognitivas associadas à infecção pelo vírus SARS-CoV-2
Damiano, R. F. (2023) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.5.2023.tde-29082023-114208
Module 11: Participating In Medical Treatment
Jaywant, A., Oberlin, L. E., Cherestal, S., Castellano, C. B., Wilkins, V. M., & Kanellopoulos, D. (2023) · Oxford University Press eBooks · doi:10.1093/med-psych/9780197699379.003.0012
Self-citation

Authors: Jaywant, A., Vanderlind, W. M., Alexopoulos, G. S., Fridman, C. B., Perlis, R. H., & Gunning, F. M.
Affiliations: NewYork–Presbyterian Hospital (US)
Weill Cornell Medicine (US)
Harvard University (US)
Corresponding author: Gunning, Faith M.
ORCID: Jaywant, Abhishek
Vanderlind, W. Michael
Alexopoulos, George S.
Perlis, Roy H.
Gunning, Faith M.
Venue: Neuropsychopharmacology
Publisher: Springer Science and Business Media LLC
Published: 2021-02-15
Volume: 46
Issue: 13
Pages: 2235-2240
ISSN: 0893-133X (ISSN-L)
1740-634X
DOI: 10.1038/s41386-021-00978-8
PMC: PMC7884062
OpenAlex: W3132403899
Cited by: 248
References: 45
Citations by year: 2026: 12 · 2025: 19 · 2024: 35 · 2023: 64 · 2022: 84 · 2021: 34
FWCI: 25.96
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Neuropsychopharmacology (publishedVersion)
medRxiv (acceptedVersion, cc-by-nc-nd)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
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, post-COVID cognitive impairment, cognitive impairment, inpatient rehabilitation, executive dysfunction, attention deficits, working memory, set-shifting, divided attention, processing speed, hypoxemic respiratory failure, intubation, hospitalized patients
MeSH terms: COVID-19, SARS-CoV-2, Cognition, Cross-Sectional Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Cognitive Dysfunction

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Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19

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