Neuropsychological functioning after COVID-19: Minor differences between individuals with and without persistent complaints after SARS-CoV-2 infection
The Clinical Neuropsychologist, vol. 39, pp. 347–362
Abstract
Objective: It is unclear how self-reported severe fatigue and difficulty concentrating after SARS-CoV-2 infection relate to objective neuropsychological functioning. The study aimed to compare neuropsychological functioning between individuals with and without these persistent subjective complaints. Method: Individuals with and without persistent severe fatigue (Checklist Individual Strength (CIS) fatigue ≥ 35) and difficulty concentrating (CIS concentration ≥ 18) at least 3 months after SARS-CoV-2 infection were included. Neuropsychological assessment was performed on overall cognitive functioning, attention, processing speed, executive functioning, memory, visuo-construction, and language (18 tests). T-scores −1.5 SD below population normative data (T ≤ 35) were classified as “impaired”. Results: 230 participants were included in the study, of whom 22 were excluded from the analysis due to invalid performance. Of the participants included in the analysis, 111 reported persistent complaints of severe fatigue and difficulty concentrating and 97 did not. Median age was 54 years, 59% (n = 126) were female, and participants were assessed a median of 23 months after first infection (IQR: 16–28). With bivariate logistic regression, individuals with persistent complaints had an increased likelihood of slower information processing speed performance on the Stroop word reading (OR = 2.45, 95%CI = 1.02–5.84) compared to those without persistent complaints. Demographic or clinical covariates (e.g. hospitalization) did not influence this association. With linear regression techniques, persistent complaints were associated with lower t-scores on the D2 CP, TMT B, and TMT B|A. There were no differences in performance on the other neuropsychological tests. Conclusions: Individuals with subjective severe fatigue and difficulty concentrating after COVID-19 do not typically demonstrate cognitive impairment on extensive neuropsychological testing.
Authors 24
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Anouk Verveen corresponding
Amsterdam UMC Location University of Amsterdam · Amsterdam Public Health
Affiliation as printed
Amsterdam Public Health
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam
Amsterdam Public Health, Amsterdam, The Netherlands
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Amsterdam Neuroscience · GGZ inGeest · Amsterdam UMC Location Vrije Universiteit Amsterdam
Affiliation as printed
Amsterdam Neuroscience
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam
GGz inGeest Specialized Mental Health Care
Radiology & Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam
Amsterdam Neuroscience, Amsterdam, The Netherlands
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
GGz inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
Radiology & Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Amsterdam Neuroscience · Amsterdam UMC Location Vrije Universiteit Amsterdam
Affiliation as printed
Amsterdam Neuroscience
Radiology & Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam
Amsterdam Neuroscience, Amsterdam, The Netherlands
Radiology & Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Utrecht University · Amsterdam UMC Location University of Amsterdam · University Medical Center Utrecht
Affiliation as printed
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam
Department of Radiology and Nuclear Medicine, Division of Imaging and Oncology, University Medical Center Utrecht
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
Department of Radiology and Nuclear Medicine, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Amsterdam Neuroscience · University of Amsterdam
Affiliation as printed
Amsterdam Neuroscience
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam
Psychology department, Brain and Cognition, University of Amsterdam
Amsterdam Neuroscience, Amsterdam, The Netherlands
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
Psychology department, Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
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Amsterdam UMC Location University of Amsterdam
Affiliation as printed
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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Maastricht University · VieCuri Medisch Centrum
Affiliation as printed
Department of Medical Psychology, VieCuri Medical Center
School for Mental Health and Neuroscience, Maastricht University
Department of Medical Psychology, VieCuri Medical Center, Venlo, The Netherlands
School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Amsterdam UMC Location University of Amsterdam
Affiliation as printed
Center for Experimental and Molecular Medicine, Amsterdam UMC location University of Amsterdam
Center for Experimental and Molecular Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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Amsterdam Neuroscience · Amsterdam UMC Location Vrije Universiteit Amsterdam
Affiliation as printed
Amsterdam Neuroscience
Radiology & Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam
Amsterdam Neuroscience, Amsterdam, The Netherlands
Radiology & Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Affiliation as printed
Department of Neuropsychology and Psychopharmacology, and Limburg Brain Injury Center, Faculty of Psychology, Neuroscience Maastricht University
Department of Neuropsychology and Psychopharmacology, and Limburg Brain Injury Center, Faculty of Psychology, Neuroscience Maastricht University, Maastricht, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Amsterdam Neuroscience
Affiliation as printed
Amsterdam Neuroscience
Intensive Care, Amsterdam UMC location University of Amsterdam
Amsterdam Neuroscience, Amsterdam, The Netherlands
Intensive Care, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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Affiliation as printed
Department of Medical, Health and Neuropsychology, Leiden University
Department of Medical, Health and Neuropsychology, Leiden University, Leiden, The Netherlands
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Amsterdam UMC Location University of Amsterdam
Affiliation as printed
Infectious Diseases, Amsterdam UMC location University of Amsterdam
Medical Microbiology & Infection Prevention, Amsterdam UMC location University of Amsterdam
Infectious Diseases, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
Medical Microbiology & Infection Prevention, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Amsterdam Public Health
Affiliation as printed
Amsterdam Public Health
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam
Amsterdam Public Health, Amsterdam, The Netherlands
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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National Institute for Public Health and the Environment
Affiliation as printed
Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM)
Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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University Medical Center Utrecht
Affiliation as printed
Occupational Health Office, Department of Human Resources, University Medical Center Utrecht
Occupational Health Office, Department of Human Resources, University Medical Center Utrecht, Utrecht, The Netherlands
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Amsterdam UMC Location University of Amsterdam · GGD Amsterdam · Amsterdam institute for Immunology and Infectious Diseases
Affiliation as printed
Department of Infectious Diseases, Public Health Service of Amsterdam
Infectious Diseases, Amsterdam Institute for Infection and Immunity
Infectious Diseases, Amsterdam UMC location University of Amsterdam
Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands
Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam, The Netherlands
Infectious Diseases, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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University Medical Center Utrecht
Affiliation as printed
Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Centre Utrecht
Department of Rehabilitation, Physical Therapy Science and Sports, University Medical Centre Utrecht, Utrecht, The Netherlands
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Amsterdam UMC Location University of Amsterdam
Affiliation as printed
Internal Medicine, Amsterdam UMC location University of Amsterdam
Internal Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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National Institute for Public Health and the Environment
Affiliation as printed
Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM)
Center for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Amsterdam Public Health
Affiliation as printed
Amsterdam Public Health
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam
Amsterdam Public Health, Amsterdam, The Netherlands
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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Amsterdam Neuroscience · Amsterdam UMC Location Vrije Universiteit Amsterdam
Affiliation as printed
Amsterdam Neuroscience
Radiology & Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam
Amsterdam Neuroscience, Amsterdam, The Netherlands
Radiology & Nuclear Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Utrecht University · University Medical Center Utrecht
Affiliation as printed
Department of Radiology and Nuclear Medicine, Division of Imaging and Oncology, University Medical Center Utrecht
Department of Radiology and Nuclear Medicine, Division of Imaging and Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
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Amsterdam UMC Location University of Amsterdam · Amsterdam Public Health
Affiliation as printed
Amsterdam Public Health
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam
Amsterdam Public Health, Amsterdam, The Netherlands
Department of Medical Psychology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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