Cognitive impairment after long COVID-19: current evidence and perspectives

Front Neurol. 2023 Jul 31:14:1239182. doi: 10.3389/fneur.2023.1239182. eCollection 2023.

Abstract

COVID-19, caused by the SARS-CoV-2 virus, is a respiratory infectious disease. While most patients recover after treatment, there is growing evidence that COVID-19 may result in cognitive impairment. Recent studies reveal that some individuals experience cognitive deficits, such as diminished memory and attention, as well as sleep disturbances, suggesting that COVID-19 could have long-term effects on cognitive function. Research indicates that COVID-19 may contribute to cognitive decline by damaging crucial brain regions, including the hippocampus and anterior cingulate cortex. Additionally, studies have identified active neuroinflammation, mitochondrial dysfunction, and microglial activation in COVID-19 patients, implying that these factors may be potential mechanisms leading to cognitive impairment. Given these findings, the possibility of cognitive impairment following COVID-19 treatment warrants careful consideration. Large-scale follow-up studies are needed to investigate the impact of COVID-19 on cognitive function and offer evidence to support clinical treatment and rehabilitation practices. In-depth neuropathological and biological studies can elucidate precise mechanisms and provide a theoretical basis for prevention, treatment, and intervention research. Considering the risks of the long-term effects of COVID-19 and the possibility of reinfection, it is imperative to integrate basic and clinical research data to optimize the preservation of patients' cognitive function and quality of life. This integration will also offer valuable insights for responding to similar public health events in the future. This perspective article synthesizes clinical and basic evidence of cognitive impairment following COVID-19, discussing potential mechanisms and outlining future research directions.

Keywords: SARS-CoV-2; mitochondrial dysfunction; neurodegeneration; neuroinflammation; post-COVID cognitive impairment.

Grants and funding

The study was funded by the National Key R&D Program of the Ministry of Science and Technology ‘Modernization of TCM' (No. 2022YFC3501400), Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine (No. ZYYCXTD-C-202007), the National Natural Science Foundation of China (No. 82004434), Special Training Program for Outstanding Young Scientific and Technological Talents (Innovation) of China Academy of Chinese Medical Sciences (No. ZZ-14-YQ-001), Special Training Program for the National Natural Science Foundation of Xiyuan Hospital, and China Academy of Chinese Medical Sciences (No. XY20-08).