Exploring the experiences of cognitive symptoms in Long COVID: a mixed-methods study in the UK

OBJECTIVE: To explore the lived experiences and extent of cognitive symptoms in Long COVID (LC) in a UK-based sample. DESIGN: This study implemented a mixed-methods design. Eight focus groups were conducted to collect qualitative data, and the Framework Analysis was used to reveal the experiences and impact of cognitive symptoms. A self-report questionnaire was used to collect the quantitative data to assess the perceived change and extent of symptomology post COVID-19. SETTING: Focus groups were conducted in April 2023 online via Zoom and in-person at the University of Leeds, UK. PARTICIPANTS: 25 people with LC living in the UK participated in the study. Participants were aged 19-76 years (M=43.6 years, SD=14.7) and included 17 women and 8 men. RESULTS: Reduced cognitive ability was among the most prevalent symptoms reported by the study participants. Three key themes were identified from the qualitative data: (1) rich accounts of cognitive symptoms; (2) the impact on physical function and psychological well-being and (3) symptom management. Descriptions of cognitive symptoms included impairments in memory, attention, language, executive function and processing speed. Cognitive symptoms had a profound impact on physical functioning and psychological well-being, including reduced ability to work and complete activities of daily living. Strategies used for symptom management varied in effectiveness. CONCLUSION: Cognitive dysfunction in LC appears to be exacerbated by vicious cycle of withdrawal from daily life including loss of employment, physical inactivity and social isolation driving low mood, anxiety and poor cognitive functioning. Previous evidence has revealed the anatomical and physiological biomarkers in the brain affecting cognition in LC. To synthesise these contributing factors, we propose the Long-COVID Interacting Network of factors affecting Cognitive Symptoms. This framework is designed to inform clinicians and researchers to take a comprehensive approach towards LC rehabilitation, targeting the neural, individual and lifestyle factors.