Post COVID-19 Conditions and Neurocognitive Impairment—Current Findings and Clinical Implications

Despite the increasing evidence of neurocognitive impairment (NCI) in patients suffering from post-COVID-19 conditions (PCC), the interplay between patient-reported symptoms and objective findings remains poorly characterized. Valid diagnostic tests and sufficient treatment strategies are lacking. We conducted a narrative perspective synthesis of current findings of NCI, standardized assessments (e.g., MoCA, PCCIS), and their association with inflammatory parameters. We highlighted findings on the discrepancy of subjective versus objectively measured neurocognitive impairment. The “subjectivity-objectivity-gap” may contribute to patient stigmatization, impair therapy adherence and be associated with a suboptimal clinical outcome. Although established multimodal interventions, such as cognitive rehabilitation, psychoeducation, group therapy, and pharmacotherapy—show preliminary efficacy, adherence may be compromised when subjective experiences of NCI are invalidated. We summarized the current state of the literature regarding demographic and clinical risk factors such as advanced age, lower education, neuropsychiatric comorbidities and evidence on the possible underlying role of persistent neuroinflammation in NCI in PCC. This perspective emphasizes the need for evidence-based diagnostic algorithms that integrate both subjective and objective NCI, explicitly addressing the risk of stigmatization. Future research should focus on addressing the neurobiological basis of NCI, discrepant NCI findings and associated stigmatization, and incorporate these findings in clinical guidelines.