TOPLINE

Adults who reported worsening memory or concentration following SARS-CoV-2 infection showed no objective cognitive deficits on standardized neuropsychological testing compared to those without such complaints, a study showed. However, adults with these complaints had significantly higher depression and anxiety symptoms and elevated levels of an inflammation marker, soluble CD14 (sCD14), and they were more likely to carry the apolipoprotein E (APOE) epsilon 4 allele.

METHODOLOGY

• Researchers compared 32 adults with self-reported worsening memory or concentration following SARS-CoV-2 infection (cases; mean age, 42.81 years; 50% men) to 34 adults who did not report such changes (control individuals; mean age, 37.58 years; 38.2% men), all assessed more than 12 weeks post-infection.
• Participants with a history of COVID-related hospitalization, Axis I psychiatric diagnoses, head injury, neurological disorders, or positive urine toxicology screening were excluded from the study.
• A total of 62 participants (29 cases, 33 control individuals) completed neuropsychological testing using the MATRICS Consensus Cognitive Battery and California Verbal Learning Test-Third Edition; scores were condensed into one objective cognition factor.
• All 66 participants completed self-report measures of depression using the Beck Depression Inventory (BDI) Cognitive-Affective domain and anxiety using the Beck Anxiety Inventory (BAI) and underwent blood-based genotyping of APOE epsilon 4 and quantification of sCD14.
• Researchers ran separate depression and anxiety models, entering mood scores first, then objective cognition, and then APOE epsilon 4 status and sCD14 levels together.

TAKEAWAY

• Cases and control individuals did not differ significantly on objective cognitive performance, but cases scored significantly higher on the BDI Cognitive-Affective subscale (mean score, 5.53 vs 1.35; P < .001) and BAI total score (mean score, 12.06 vs 2.38; P < .001).
• Cases had a significantly higher proportion of APOE epsilon 4 carriers than control individuals (41% vs 6%; P < .001) and elevated sCD14 levels (P = .023).
• In the final model with BDI, depression scores (P = .012) and APOE epsilon 4 status (P = .043) were significant independent predictors, whereas objective cognition and sCD14 were not.
• In the final model with BAI, only anxiety was a significant independent predictor (P = .004), whereas APOE epsilon 4 status, sCD14 levels, and objective cognition did not reach significance.

IN PRACTICE

"Our finding that depressive and anxiety symptoms, but not objective cognitive performance, predict subjective cognitive decline in our post-COVID sample may have implications for treatment. Because well-established, evidence-based treatments exist for depression and anxiety, addressing these symptoms may be a reasonable first step before cognitive training or memory-enhancing medications are considered," the authors wrote.

SOURCE

The study was led by Kaitlyn Dal Bon and Samantha Abram, PhD, Veterans Affairs San Francisco Healthcare System. It was published online on October 27 in the Journal of Psychiatric Research.

LIMITATIONS

The study was limited by its small sample size and the lack of pre-COVID baseline data on cognitive, psychiatric, or biological factors. The study also lacked measures of higher-order cognitive processes. Recruitment timing resulted in a greater proportion of cases being infected earlier in the pandemic, likely with earlier viral variants. It was unclear whether the elevated inflammation reflected psychiatric symptoms or a specific consequence of COVID. Additionally, participants were not evaluated with formal structured diagnostic interviews.

DISCLOSURES

The study was funded by the Department of Veterans Affairs and the National Science Foundation. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.