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Background <p>Cognitive dysfunction (“brain fog”) is a commonly reported post-COVID-19 symptom. Leveraging data from five general population cohorts across four European countries (Estonia, Iceland, Norway, and Sweden), we assessed long-term prevalence of impaired subjective cognitive function among individuals diagnosed with COVID-19 by acute illness severity.</p> Methods <p>The included cohorts consisted of adult participants recruited from March 2020 and followed with self-report measures of cognitive function and past COVID-19 infection (except one cohort consisting of clinically confirmed COVID-19 cases) through February 2023. In a cross-sectional analysis we contrasted the prevalence of impaired cognitive function among individuals with and without a COVID-19 diagnosis, overall and by illness severity up to 32&#xa0;months post-diagnosis. We adjusted for age, gender, education, relationship status, binge drinking, body mass index, previous psychiatric diagnosis, number of chronic medical conditions, and response period. In a longitudinal analysis, we assessed potential changes in cognitive function scores before and after COVID-19 diagnosis.</p> Results <p>The study population consisted of 153,841 participants (71% women), with 31,359 (20.4%) reporting a positive COVID-19 test. Overall, a COVID-19 diagnosis was not statistically significantly associated with increased prevalence ratio (PR) of impaired cognitive function (PR 1.30 [95% CI: 0.98–1.71]). Individuals bedridden due to COVID-19 for 1–6&#xa0;days (PR 1.38 [95% CI 0.96–1.99]) or ≥ 7&#xa0;days (2.59 [1.55–4.33]) had higher prevalence of impaired cognitive function compared to those never diagnosed, while individuals never bedridden had a lower prevalence to those never diagnosed with COVID-19 (0.89 [0.80–1.00]). These findings were corroborated in the longitudinal analysis where a pre- to post diagnosis decline in cognitive function was observed among individuals bedridden due to COVID-19 (<i>p</i> &lt; 0.0001).</p> Conclusions <p>The data indicates that a severe COVID-19 acute illness course is associated with impaired cognitive function up to 18–32&#xa0;months after COVID-19 diagnosis.</p>

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Acute COVID-19 severity and impaired cognitive function up to 32 months after diagnosis: an observational study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月11日

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  • Ingibjörg Magnúsdóttir,
  • Anders B. Nygaard,
  • Asle Hoffart,
  • Gillian Murphy,
  • Kadri Kõiv,
  • Mary M. Barker,
  • Anikó Lovik,
  • Anna Bára Unnarsdóttir,
  • Anna K. Kähler,
  • Arna Hauksdóttir,
  • Edda Bjork Thordardottir,
  • Elías Eyþórsson,
  • Elísabet U. Gísladóttir,
  • Emily E. Joyce,
  • Emma M. Frans,
  • Gunnar Tómasson,
  • Harpa Lind Hjördísar Jónsdóttir,
  • Harpa Rúnarsdóttir,
  • Hrönn Harðardóttir,
  • John Arne Dahl,
  • Jóhanna Jakobsdóttir,
  • Karl Trygve Kalleberg,
  • Kristjana Hrönn Ásbjörnsdóttir,
  • Merete Ellingjord-Dale,
  • Mette S. Istre,
  • Nils Inge Landrø,
  • Qing Shen,
  • Ragnhild Bø,
  • Reedik Mägi,
  • Runólfur Pálsson,
  • Sonja Hjellegjerde Brunvoll,
  • Sverre Urnes Johnson,
  • Arne Søraas,
  • Fang Fang,
  • Kelli Lehto,
  • Omid V. Ebrahimi,
  • Thor Aspelund,
  • Unnur Anna Valdimarsdóttir

摘要

Background

Cognitive dysfunction (“brain fog”) is a commonly reported post-COVID-19 symptom. Leveraging data from five general population cohorts across four European countries (Estonia, Iceland, Norway, and Sweden), we assessed long-term prevalence of impaired subjective cognitive function among individuals diagnosed with COVID-19 by acute illness severity.

Methods

The included cohorts consisted of adult participants recruited from March 2020 and followed with self-report measures of cognitive function and past COVID-19 infection (except one cohort consisting of clinically confirmed COVID-19 cases) through February 2023. In a cross-sectional analysis we contrasted the prevalence of impaired cognitive function among individuals with and without a COVID-19 diagnosis, overall and by illness severity up to 32 months post-diagnosis. We adjusted for age, gender, education, relationship status, binge drinking, body mass index, previous psychiatric diagnosis, number of chronic medical conditions, and response period. In a longitudinal analysis, we assessed potential changes in cognitive function scores before and after COVID-19 diagnosis.

Results

The study population consisted of 153,841 participants (71% women), with 31,359 (20.4%) reporting a positive COVID-19 test. Overall, a COVID-19 diagnosis was not statistically significantly associated with increased prevalence ratio (PR) of impaired cognitive function (PR 1.30 [95% CI: 0.98–1.71]). Individuals bedridden due to COVID-19 for 1–6 days (PR 1.38 [95% CI 0.96–1.99]) or ≥ 7 days (2.59 [1.55–4.33]) had higher prevalence of impaired cognitive function compared to those never diagnosed, while individuals never bedridden had a lower prevalence to those never diagnosed with COVID-19 (0.89 [0.80–1.00]). These findings were corroborated in the longitudinal analysis where a pre- to post diagnosis decline in cognitive function was observed among individuals bedridden due to COVID-19 (p < 0.0001).

Conclusions

The data indicates that a severe COVID-19 acute illness course is associated with impaired cognitive function up to 18–32 months after COVID-19 diagnosis.