Abstract
As cases of coronavirus disease 2019 (COVID-19) mount worldwide, attention is needed on potential long-term neurologic impacts for the majority of patients who experience mild to moderate illness managed as outpatients. To date, there has not been discussion of persistent neurocognitive deficits in patients with milder COVID-19. We present two cases of non-hospitalized patients recovering from COVID-19 with persistent neurocognitive symptoms. Commonly used cognitive screens were normal, while more detailed testing revealed working memory and executive functioning deficits. An observational cohort study of individuals recovering from COVID-19 (14 or more days following symptom onset) identified that among the first 100 individuals enrolled, 14 were non-hospitalized patients reporting persistent cognitive issues. These 14 participants had a median age of 39 years (interquartile range: 35–56), and cognitive symptoms were present for at least a median of 98 days (interquartile range: 71–120 following acute COVID-19 symptoms); no participants with follow-up evaluation reported symptom resolution. We discuss potential mechanisms to be explored in future studies, including direct viral effects, indirect consequences of immune activation, and immune dysregulation causing auto-antibody production.
Highlights
Viral infections can cause cognitive symptoms through direct viral effects on the central nervous system (CNS) or through indirect phenomena
For SARS-CoV-2 infection, current descriptions of cognitive issues focus on hospitalized patients with severe disease (Helms et al 2020; Varatharaj et al 2020)
We describe two patients with persistent neurocognitive symptoms following SARS-CoV-2 infection who were not hospitalized during acute illness
Summary
Viral infections can cause cognitive symptoms through direct viral effects on the central nervous system (CNS) or through indirect phenomena. We describe two patients with persistent neurocognitive symptoms following SARS-CoV-2 infection who were not hospitalized during acute illness. Extended author information available on the last page of the article reported cognitive symptoms in an observational cohort of SARS-CoV-2 infected patients in recovery.
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