Introduction COVID-19 has affected millions worldwide and has been associated with persistent symptoms across various physiological systems. Among these, executive dysfunction (ED) has been frequently reported in long COVID, potentially compromising academic performance and autonomy in daily activities. This study aimed to evaluate Executive Functions (EF) in medical students during the long-term post-infection phase, specifically controlling for fluid intelligence ( g -factor) and psychiatric symptoms to distinguish potential viral sequelae from baseline characteristics. Methods A cross-sectional design was employed to evaluate 49 medical students (32 women). Data collection occurred between February and September 2023. Infected participants ( n = 26) were assessed on average 20.81 ± 7.35 months post-infection. Psychiatric symptoms were screened using the Depression, Anxiety, and Stress Scale (DASS-21). Additionally, the Paper Folding and Cutting (PFC) task served as a non-verbal proxy for fluid intelligence (PFC) task was administered as a non-verbal proxy measure for fluid intelligence ( g -factor) to establish a cognitive baseline. EFs were assessed using the 2-back test (working memory), Stroop Test (inhibitory control), and Wisconsin Card Sorting Test – WCST (cognitive flexibility). Results Participants had a mean age of 22.2 years. All were vaccinated prior to testing, with the majority having received three or more doses. Among the infected group, 17 were unvaccinated at the time of infection. Regarding cognitive performance, the infected group exhibited superior accuracy (lower error rates) in working memory and inhibitory control tasks. Similarly, in the WCST, infected participants required significantly fewer trials to complete the first category ( p = 0.012), indicating greater initial efficiency, while total categories completed remained similar between groups. Crucially, ANCOVA analyses revealed that this high-level performance was significantly accounted for by fluid intelligence ( g -factor) rather than limited by infection history. Scores on the DASS-21 did not differ significantly, suggesting that current psychiatric symptoms did not confound the cognitive outcomes. Conclusion Our findings demonstrate a robust preservation of executive domains, suggesting that high cognitive reserve buffers against neurocognitive sequelae approximately two years post-infection. Consequently, specialized cognitive monitoring may not be necessary for this population. Instead, educational resources should prioritize mental health support to address academic stressors.
Duarte et al. (Wed,) studied this question.