Nikhil Prasad Fact checked by:Thailand Medical News Team Sep 13, 2026 1 hour, 16 minutes ago
Cognitive problems following COVID-19 may linger far longer than patients realize, with new research finding that difficulties involving attention and psychomotor speed remained strikingly common during extended follow-up.
Researchers studying adults months and even years after COVID-19 found that approximately two-thirds showed objective impairment in attention and psychomotor functioning. Importantly, these problems showed virtually no overall improvement when participants were tested again roughly seven months later.
Computerized testing suggests attention and psychomotor difficulties may remain common long after COVID-19, even
when patients’ subjective complaints change
Researchers Track Cognitive Performance Over Time
The prospective study involved 102 adults aged 21 to 60 who had experienced COVID-19 between three and 35 months before their initial assessment. Their mean age was 40.2 years, and 70.6% were women.
Sixty-seven participants returned for follow-up after an average 6.69 months.
The researchers were from the Department of Neurology, Faculty of Medicine, Medical University of Plovdiv; Clinic of Neurology, University Hospital for Active Treatment “Sv. Georgi”; Department of Healthcare Management, Faculty of Public Health, Medical University of Plovdiv; and Department of Nursing Care, Faculty of Public Health, Medical University of Plovdiv, all in Plovdiv, Bulgaria.
Participants completed the computerized CogState cognitive battery, allowing investigators to assess attention, psychomotor function, learning, working memory, visual associative memory, and broader cognitive performance.
Attention Problems Refused to Disappear
The standout finding was the persistence of attention and psychomotor impairment. Among participants completing both assessments, 65.7% were impaired initially compared with 67.2% at follow-up—a difference that was not statistically significant.
The individual trajectories were particularly revealing. Among the 67 followed participants, 46.3% were impaired at both assessments.
Another 20.9% who were initially unimpaired developed impairment by follow-up, while 19.4% improved and just 13.4% remained unimpaired throughout.
These results suggest that post-COVID cognition does not necessarily follow a straightforward recovery path. Some people improve, others remain impaired, and some develop measurable problems later.
Memory Shows Signs of Improvement
Working memory produced a more encouraging signal. Impairment on the One Back test fell from 39.4% to 24.2% among participants with paired results. Eleven people moved from impaired to unimpaired performance, while only one moved in the opposite direction.
However, that improvement lost statistical significance after researchers corrected for multiple comparisons, meaning it should be considered exploratory rather than firm evidence of recovery.
Other learning and memory measures also showed modest improvements that failed to remain statistically significant after correction.
Wh
at Patients Feel May Not Tell the Whole Story
At baseline, 63.7% reported persistent post-COVID complaints. People reporting symptoms performed significantly worse across several objective cognitive measures. Yet those initial complaints did not predict cognitive performance at follow-up, even though attention and psychomotor impairment remained widespread.
For this
Thailand Medical News report, that disconnect is clinically important: asking patients whether they still experience “brain fog” may not reliably identify continuing measurable impairment.
Age was the strongest demographic factor associated with poorer visuospatial associative memory, but demographic and clinical variables explained only a modest proportion of cognitive differences, suggesting other factors remain unidentified.
Conclusions
The findings indicate that attention and psychomotor difficulties can remain measurable well into the post-COVID period, while some memory functions may follow different recovery trajectories. However, researchers cautioned that the study lacked pre-COVID cognitive measurements and an uninfected matched control group, preventing the deficits from being attributed definitively to SARS-CoV-2 infection.
The study findings were published in the peer reviewed journal: Brain Sciences.
https://www.mdpi.com/2076-3425/16/9/964
Read Also:
https://www.thailandmedical.news/articles/long-covid
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