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Post-acute sequelae of COVID-19 (PASC) refer to the persistence of symptoms—either new or unresolved—for an extended period following the initial SARS-CoV-2 infection. Within this context, Post-COVID Neurological Syndrome (PCNS) defines the cognitive and neurological complications associated with PASC, including notable impairments in attention and memory that have previously been well-documented in adults. However, despite growing reports of similar symptom profiles in children and adolescents, cognitive changes associated with PASC in pediatric populations remain underexplored. This paper discusses the outcomes of a systematic review and meta-analysis addressing this gap by synthesizing available research on the prevalence of clinically significant changes in cognitive abilities such as attention, and learning and memory, in pediatric PASC. We searched literature across four key research databases in November 2024, and categorized study outcomes according to cognitive domains. Studies were included if they assessed cognition using standardized cognitive tests or parent-report measures in children or adolescents with a confirmed PASC diagnosis and were rated using the Joanna Briggs Institute Checklist for risk of bias. Our findings revealed that a startling 35% to 55% of children with PASC were either at risk of, or met clinical thresholds for, impairment in complex attention, learning and memory, working memory, and executive function, consistent with immunologically induced “brain fog.” These cognitive domains are critical for development and everyday functioning, suggesting that PCNS may significantly disrupt educational and psychosocial outcomes if left undetected. This review offers compelling evidence that cognitive complications are a common and clinically relevant feature of pediatric PASC, reflecting underlying changes in the brain following infection. Further research is needed to clarify the effects of infection severity, repeated illness, and sociodemographic risk factors. Our findings highlight the urgent need for structured screening protocols, multidisciplinary care pathways, and greater clinical and educational awareness to ensure that affected children receive rapid and appropriate support, with individualized long-term care strategies.

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Brain Fog in the Young Insights from a Meta-analytic Review of Cognitive Impairment in Pediatric PCNS

  • 章节

  • 发表日期：

    2026年

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  • Melanie J. Murphy,
  • Lauren Falcone,
  • Nina Riddell

摘要

Post-acute sequelae of COVID-19 (PASC) refer to the persistence of symptoms—either new or unresolved—for an extended period following the initial SARS-CoV-2 infection. Within this context, Post-COVID Neurological Syndrome (PCNS) defines the cognitive and neurological complications associated with PASC, including notable impairments in attention and memory that have previously been well-documented in adults. However, despite growing reports of similar symptom profiles in children and adolescents, cognitive changes associated with PASC in pediatric populations remain underexplored. This paper discusses the outcomes of a systematic review and meta-analysis addressing this gap by synthesizing available research on the prevalence of clinically significant changes in cognitive abilities such as attention, and learning and memory, in pediatric PASC. We searched literature across four key research databases in November 2024, and categorized study outcomes according to cognitive domains. Studies were included if they assessed cognition using standardized cognitive tests or parent-report measures in children or adolescents with a confirmed PASC diagnosis and were rated using the Joanna Briggs Institute Checklist for risk of bias. Our findings revealed that a startling 35% to 55% of children with PASC were either at risk of, or met clinical thresholds for, impairment in complex attention, learning and memory, working memory, and executive function, consistent with immunologically induced “brain fog.” These cognitive domains are critical for development and everyday functioning, suggesting that PCNS may significantly disrupt educational and psychosocial outcomes if left undetected. This review offers compelling evidence that cognitive complications are a common and clinically relevant feature of pediatric PASC, reflecting underlying changes in the brain following infection. Further research is needed to clarify the effects of infection severity, repeated illness, and sociodemographic risk factors. Our findings highlight the urgent need for structured screening protocols, multidisciplinary care pathways, and greater clinical and educational awareness to ensure that affected children receive rapid and appropriate support, with individualized long-term care strategies.