COVID-19 and Its Long-Term Neurological and Cognitive Implications: A Literature Review

Abstract

Introduction: COVID-19 is an infectious disease resulting from severe acute respiratory syndrome. Individuals with prior COVID-19 infection have had neurological complaints of impaired attention, fatigue, and “brain fog”. This review seeks to summarize the associations between COVID-19 infection and the development of the neurocognitive elements of post-acute COVID syndrome (PACS) which is relevant to healthcare workers for the efficient treatment and management of the long-term effects of COVID. Methods: Literature that examines the neurocognitive complaints caused by COVID-19 infection, including brain fog, attention deficits, psychiatric impairment, and fatigue were selected. Google Scholar and PubMed were the primary databases used to obtain relevant literature. After preliminary searching, 21 articles were analyzed as part of this review. Results: The following symptoms of PACS were persistently reported by a large majority (approximately ⅓ to ½) of patients: breathlessness, cough, fatigue, and brain fog. PACS neurological symptoms were more prevalent in females than in males. Reported psychiatric symptoms from prior COVID-19 infection were ADHD, depression, and insomnia. Discussion: The causes of these neurocognitive symptoms were attributed to neuroinflammation of the choroid plexus, intracerebral hemorrhagic lesions, and hypoactivity in the anterior and posterior cingulate cortex. These possible pathways were confirmed with magnetic resonance imaging (MRI) findings, computed tomography (CT) scans, and positron emission tomography (PET) scans. Conclusion: This paper will add to the evidence regarding the association between COVID-19 and the development of neurocognitive PACS. It is hoped that future research will build on a clearer understanding of the etiology of neurocognitive issues associated with viral infection.