Long COVID Is Associated with Severe Cognitive Limitations Among U.S. Adults, 2025, Neba et al

Long COVID Is Associated with Severe Cognitive Limitations Among U.S. Adults

Rolake Neba, Iman Mohamed, Theodora Iwudibia, Jahnavi Pinnamraju, Usha Sambamoorthi

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Abstract
Long COVID is characterized by persistent symptoms following the resolution of an acute COVID-19 infection. Long COVID may affect cognition due to possible ischemia, neuro-inflammation, and hypoxia related to COVID-19. The purpose of this study was to analyze the association of long COVID with severe cognitive limitations.

Utilizing data from the 20 September–2 October 2023 Census Household Pulse Survey among adults, COVID status was categorized as: (1) long COVID, (2) COVID-19, or (3) no COVID. The cognitive limitations were abstracted from the Washington Group Short Set on Functioning, as follows: No difficulty; Some difficulty; A lot of difficulty; and Cannot do at all; we combined “a lot of difficulty” or “unable to do” under the category “severe cognitive limitation”.

Rao–Scott Chi-square tests and multivariable multinomial logistic regressions that accounted for replicate weights were used to analyze the adjusted association of long COVID with cognitive limitations.

Overall, 15.1% had long COVID. A higher percentage of adults with long COVID (13.1% vs. 4.1%) reported severe cognitive limitations compared to no COVID (p < 0.001). In a fully adjusted logistic regression model, adults with long COVID were more likely to report at least a lot of difficulty in cognition (aOR = 1.64 95% CI = 1.38, 1.96) compared to no COVID.

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"This article belongs to the Section Long COVID and Post-Acute Sequelae.

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