Subjective memory impairment and long COVID: findings from the German Health Update 2023 Survey

Abstract Background Long COVID (LC) comprises manifold long-term health consequences following SARS-CoV-2 infection, posing significant public health challenges. Major health complaints include cognitive impairment, such as memory or concentration problems. This contribution examines subjective memory impairment (SMI) in association with self-reported LC among adults in Germany. Methods The study population consisted of 9.296 adults aged 18 years or older from the nationwide cross-sectional telephone German Health Update 2023 Survey (GEDA 2023, March 2023-February 2024), with information on self-reported prior SARS-CoV-2 infection and self-reported previous or current LC. SMI was defined as self-reported memory worsening with associated worries. We report weighted SMI prevalence by self-reported LC status and effect estimates from logistic regression, adjusted for sex, age, education level, partnership status, chronic conditions, depressive symptoms and social support. Results Overall, 16.1% (95% CI: 14.9-17.3) reported having SMI. Individuals with SARS-CoV-2 infection and current LC stated SMI more often (38.6% [31.8-45.5]) compared to individuals with infection and previous LC (17.3% [12.4-22.2]), participants with infection and no LC (13.8% [12.2-15.4]) or non-infected participants (15% [13.2-16.9]). In a multivariable regression model, current LC was associated with higher risk for SMI compared with non-infected participants (adjusted relative risk: 2.22). Previous LC or prior infection without LC had no significant effect. Conclusions Self-reported current LC was associated with a more than 2-fold higher risk of SMI compared with the non-infected group - irrespective of further known risks for cognitive decline like higher age or depressive symptoms. Further research is needed with regard to the duration of LC-associated memory impairment and its impact on everyday functioning and quality of life. Key messages • Self-reported LC is associated with a substantially higher risk of SMI compared to non-infected individuals – irrespective of further known risks for cognitive decline. • Our findings emphasize existing evidence on the significance of cognitive impairment as LC-associated core symptom.