Cognitive symptoms after COVID-19

INTRODUCTION: SARS-CoV-2 infection frequently causes neurological symptoms. Cognitive alterations are among the most frequent symptoms, and may persist beyond the acute phase of infection. METHODS: We conducted a narrative review of the literature. RESULTS: Hospitalised patients, and especially critically ill patients, are at greater risk of developing cognitive symptoms. Post–COVID-19 cognitive symptoms, unlike those associated with other viral illnesses, have been observed in patients with mild infection, and present some atypical features. Cognitive symptoms may last longer in COVID-19 than in other infectious processes, and more frequently affect young people. Post–COVID-19 cognitive symptoms share common features with those described in chronic fatigue syndrome, including a similar profile with affective symptoms. Brief screening tests for cognitive impairment present suboptimal diagnostic performance, and standardised criteria are needed to ensure correct diagnosis. Post–COVID-19 cognitive impairment can have a significant impact on the patient's quality of life and functional independence, regardless of other post–COVID-19 symptoms. Currently, no specific treatments have been approved for post–COVID-19 cognitive impairment, although cognitive stimulation may be useful in some patients. CONCLUSIONS: Post–COVID-19 cognitive symptoms are common and are often associated with other systemic symptoms. Neuropsychological evaluation may be useful for diagnosis and to quantify their severity and long-term prognosis. Detailed, and individualised assessment of cognitive impairment may enable the design of treatment plans.