LAUSR

Neurocognitive complaints have been observed in severe cases of post-COVID-19 diagnosis. However, limited information exists regarding specific neurocognitive deficits of patients reporting mild infection symptoms and persistent memory problems after infection. We report on a patient referred for worsening memory complaints 7-months after testing positive. Patient was a 74-year-old Caucasian female with a history of COVID-19. Relevant history was significant for sleep apnea, pulmonary embolism, hypertension, hyperlipidemia, and type-2 diabetes. Imaging pre-infection revealed mild cerebrovascular disease. Patient underwent a tele-neuropsychological evaluation to assess the extent of cognitive difficulties. Results indicated prominent difficulties were in the domains of immediate and delayed memory and executive functioning. Patient denied anxiety and depression on self-report measures, however, collateral information suggested she experienced a substantial increase in psychiatric symptoms following COVID-19. Activities of daily living (ADLs) were preserved, but she required increased assistance with complex ADLs. Post-infection cerebrovascular disease on imaging was documented as unchanged. Although specific cognitive impairments were noted, discernment of direct residual effects of COVID-19 is limited in cases without a pre-COVID-19 neurocognitive baseline and with pre-existing conditions affecting the brain, such as cerebrovascular disease. This case illustrates the rising conundrum of clinical cases with stable underlying medical conditions but presence of cognitive deficits post-infection. Caution is needed to avoid over-interpretation of cognitive test results and necessity for a thorough clinical history that includes duration and clinical characteristics of COVID-19. Future research is needed on larger group studies comparing pre and post-COVID-19 neurocognitive results of patients with varying levels of vascular risk factors.