Cognitive, EEG, and MRI features of COVID-19 survivors: a 10-month study

J Neurol. 2022 Jul;269(7):3400-3412. doi: 10.1007/s00415-022-11047-5. Epub 2022 Mar 6.


Background and objectives: To explore cognitive, EEG, and MRI features in COVID-19 survivors up to 10 months after hospital discharge.

Methods: Adult patients with a recent diagnosis of COVID-19 and reporting subsequent cognitive complaints underwent neuropsychological assessment and 19-channel-EEG within 2 months (baseline, N = 49) and 10 months (follow-up, N = 33) after hospital discharge. A brain MRI was obtained for 36 patients at baseline. Matched healthy controls were included. Using eLORETA, EEG regional current densities and linear lagged connectivity values were estimated. Total brain and white matter hyperintensities (WMH) volumes were measured. Clinical and instrumental data were evaluated between patients and controls at baseline, and within patient whole group and with/without dysgeusia/hyposmia subgroups over time. Correlations among findings at each timepoint were computed.

Results: At baseline, 53% and 28% of patients showed cognitive and psychopathological disturbances, respectively, with executive dysfunctions correlating with acute-phase respiratory distress. Compared to healthy controls, patients also showed higher regional current density and connectivity at delta band, correlating with executive performances, and greater WMH load, correlating with verbal memory deficits. A reduction of cognitive impairment and delta band EEG connectivity were observed over time, while psychopathological symptoms persisted. Patients with acute dysgeusia/hyposmia showed lower improvement at memory tests than those without. Lower EEG delta band at baseline predicted worse cognitive functioning at follow-up.

Discussion: COVID-19 patients showed interrelated cognitive, EEG, and MRI abnormalities 2 months after hospital discharge. Cognitive and EEG findings improved at 10 months. Dysgeusia and hyposmia during acute COVID-19 were related with increased vulnerability in memory functions over time.

Keywords: COVID-19; Cognitive disturbances; EEG; Long COVID; MRI.

MeSH terms

  • Adult
  • Anosmia
  • COVID-19* / complications
  • Cognition
  • Cognitive Dysfunction* / diagnostic imaging
  • Cognitive Dysfunction* / etiology
  • Cognitive Dysfunction* / pathology
  • Dysgeusia
  • Electroencephalography
  • Humans
  • Magnetic Resonance Imaging
  • Neuropsychological Tests
  • Survivors