Brain health after COVID-19, pneumonia, heart attack, or critical illness

Impaired brain health after SARS-CoV-2 infection remains common 3 years after the outbreak of COVID-19, echoing impairments seen in previous virus pandemics. The long-term effects of COVID-19 are associated with more than 200 symptoms, affecting 65 million individuals worldwide.

A new study in JAMA Network including 345 participants, patients hospitalized for COVID-19 performed worse than healthy controls on cognitive, psychiatric, and neurological tests. However, compared with hospitalized controls matched for age, sex, and severity of disease, the impairment of brain health was similar.

Researchers conducted a prospective cohort study with matched controls was conducted at 2 academic hospitals in Copenhagen, Denmark. The case cohort comprised patients with COVID-19 hospitalized between March 1, 2020, and March 31, 2021. Control cohorts consisted of patients hospitalized for pneumonia, myocardial infarction, or non–COVID-19 intensive care–requiring illness between March 1, 2020, and June 30, 2021, and healthy age- and sex-matched individuals.

Out of 345 participants, including 120 patients with COVID-19 ( 70 men [58.3%]), 125 hospitalized controls ( 73 men [58.4%]), and 100 healthy controls (46 men [46.0%]). Patients with COVID-19 also performed worse than healthy controls during all other psychiatric and neurological assessments. However, except for executive dysfunction (Trail Making Test Part B; relative mean difference, 1.15), the brain health of patients with COVID-19 was not more impaired than among hospitalized control patients. These results remained consistent across various sensitivity analyses.

Researchers concluded that this prospective cohort study suggests that post–COVID-19 brain health was impaired but, overall, no more than the brain health of patients from 3 non–COVID-19 cohorts of comparable disease severity. Long-term associations with brain health might not be specific to COVID-19 but associated with overall illness severity and hospitalization. This information is important for putting understandable concerns about brain health after COVID-19 into perspective.

Reference: Peinkhofer C, Zarifkar P, Christensen RHB, et al. Brain Health After COVID-19, Pneumonia, Myocardial Infarction, or Critical Illness. JAMA Netw Open. 2023;6(12):e2349659. doi:10.1001/jamanetworkopen.2023.49659