Neurocognitive Deficits in Long COVID: A Systematic Review and Meta-Analysis

AbstractBackground: Long COVID is characterized by persistent symptoms following SARS-CoV-2 infection, including neurocognitive impairments. Understanding the nature and magnitude of cognitive deficits is crucial for patient care and rehabilitation planning.Objectives: To systematically review and meta-analyze neurocognitive impairments in Long COVID patients compared to healthy controls.Methods: Following PRISMA 2020 and Cochrane COVID-19 guidance, we searched multiple databases for studies assessing neurocognitive function in adults with Long COVID (symptoms ≥12 weeks post-infection). Random-effects meta-analysis calculated Hedges g effect sizes.Results: Eight studies (n=365 Long COVID patients, n=365 controls) met inclusion criteria. Significant neurocognitive deficits were found: attention (g = -1.23, 95% CI: -1.45, -1.01), memory (g = -0.98, 95% CI: -1.18, -0.78), executive function (g = -0.89, 95% CI: -1.12, -0.66), and processing speed (g = -1.05, 95% CI: -1.28, -0.82). Moderate heterogeneity was observed across studies.Conclusions: Long COVID is associated with substantial neurocognitive impairments across multiple domains. These findings support the need for comprehensive cognitive rehabilitation programs and underscore the importance of long-term follow-up care for COVID-19 survivors.