Long COVID Cognitively Affects >20% of Patients

The study covered in this summary was published on MedRxiv.org as a preprint and has not yet been peer reviewed.

Key Takeaways

  • More than 20% of persons aged 18-65 years with PCR confirmed SARS-CoV-2 infection had lasting symptoms at 6-12 months post-COVID that considerably interfered with their daily life activities.

  • Individuals most likely to be affected were female, had suffered a more severe initial infection, and were more advanced in age, though younger patients were affected as well. The three most frequent symptom clusters were fatigue, neurocognitive impairment, and chest symptoms, but anxiety/depression, headache/dizziness, and pain syndromes were also prevalent.

Why This Matters

  • This study confirms that even young and middle-aged adults who suffered only mild acute SARS-CoV-2 symptoms may have lasting symptoms and sequelae long after their initial infection.

Study Design

  • This non-interventional, population-based retrospective cohort study, EPILOC (Epidemiology of Long Covid), used data from persons in four geographically defined regions in southern Germany, aged 18-65 years, with PCR-confirmed SARS-CoV-2 infection between October 2020 and March 2021.

  • Data was gathered via mailed questionnaires. Symptom frequencies (6-12 months after vs before acute infection, expressed as prevalence differences and prevalence ratios), symptom severity and clustering, risk factors and associations with general health recovery, and working capacity were analyzed.

Key Results

  • Concentration difficulties or memory problems, shortness of breath, chronic fatigue, and rapid physical exhaustion were prevalent in >20% of study subjects post-acute infection and considerably impaired general health and working capacity.

  • Approximately 25% of patients had symptoms not present prior to infection that moderately impaired activities of daily life and were associated with reduced health recovery or working capacity.


  • Symptoms and sequelae were self-reported and without medical validation.

  • Subjects analyzed (questionnaire respondents) were more likely to be older, female, and having higher education than the general population.

  • Only one specific method was used for symptom clustering and other methods might define different, larger clusters.

Study Disclosures

  • The authors have declared no competing interests.

  • This study was funded by the Baden-Württemberg Federal State Ministry of Science and Art and the German pension fund (Deutsche Rentenversicherung) Baden-Württemberg.

This is a summary of a preprint research study, “Prevalence, determinants, and impact on general health and working capacity of post-acute sequelae of COVID-19 six to 12 months after infection: a population-based retrospective cohort study from southern Germany,” written by Raphael S. Peter from the Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany, and colleagues on MedRxiv.org, provided to you by Medscape. This study has not yet been peer reviewed. The full text of the study can be found on MedRxiv.org.

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