Holland Jessica, Sheehan Diarmuid, Brown Sinead, O'Flanagan Susan, Savinelli Stefano, O'Keeffe Fiadhnait, Bramham Jessica
University College Dublin, Ireland.
Department of Psychology, St Vincent's University Hospital, Dublin, Ireland; University College Dublin, Ireland.
Am J Med. 2025 Apr;138(4):698-711.e2. doi: 10.1016/j.amjmed.2024.09.022. Epub 2024 Oct 2.
Altered immune response and cognitive difficulties have been demonstrated in studies of post-COVID syndrome, including differences in immune status and cognitive functioning in the months following infection. This review aimed to examine immune status and cognitive differences in post-COVID syndrome 12 or more weeks after COVID-19 infection. A further aim of this review was to explore a link between immune response and the cognitive deficits observed in this group.
A systematic review was carried out using PubMed, PsychInfo, EMBASE, and Web of Science electronic databases of observational studies 12+ weeks after COVID-19 infection, with assessment of immune status and cognitive function in post-COVID syndrome samples. This review protocol was recorded on PROSPERO with registration number CRD42022366920.
Following eligibility screening, 11 studies met inclusion criteria and were selected for our review. Six of eight studies that examined between-group differences in specific domains suggested impaired cognition in the post-COVID syndrome population, with the domain of executive function particularly affected. Of 11 studies with immune data, 7 studies reported increased markers of inflammation in the post-COVID syndrome group, when compared with an age- and sex-matched "healthy control" sample, or population norms. Finally, when immune function and cognition are examined together, 6 studies presented results indicating a significant association between elevated immune response and cognitive function in post-COVID syndrome.
This review highlights the frequency of cognitive difficulties months after COVID-19 infection and explores heightened immune response as a predictor of this change. Six studies suggest that immune status is a predictor of cognitive function, examining a marker of immune function and objective cognitive performance at 12 or more weeks following infection. Future studies of cognitive function in post-COVID syndrome are needed to explore this relationship and underlying mechanisms leading to changes in cognitive performance.
在新冠后综合征的研究中已证实免疫反应改变和认知困难，包括感染后数月免疫状态和认知功能的差异。本综述旨在研究新冠病毒感染12周或更长时间后新冠后综合征患者的免疫状态和认知差异。本综述的另一个目的是探索免疫反应与该组中观察到的认知缺陷之间的联系。
使用PubMed、PsychInfo、EMBASE和Web of Science电子数据库对新冠病毒感染12周及以上的观察性研究进行系统综述，评估新冠后综合征样本的免疫状态和认知功能。本综述方案已在PROSPERO上记录，注册号为CRD42022366920。
经过资格筛选，11项研究符合纳入标准并被选入我们的综述。八项研究中有六项在特定领域检查组间差异，结果表明新冠后综合征人群存在认知障碍，执行功能领域受影响尤为明显。在11项有免疫数据的研究中，7项研究报告称，与年龄和性别匹配的“健康对照”样本或人群标准相比，新冠后综合征组的炎症标志物增加。最后，当同时检查免疫功能和认知时，6项研究的结果表明，新冠后综合征中免疫反应升高与认知功能之间存在显著关联。
本综述强调了新冠病毒感染数月后认知困难的发生率，并探讨了免疫反应增强作为这种变化的预测因素。六项研究表明，免疫状态是认知功能的预测因素，研究了感染后12周或更长时间的免疫功能标志物和客观认知表现。未来需要对新冠后综合征的认知功能进行研究，以探索这种关系以及导致认知表现变化的潜在机制。
