Neurocognitive effects related to COVID-19




SARS-CoV-2; COVID-19; Cognitive damage; Central nervous system.


Introduction: The literature has shown increasing evidence of SARS-CoV-2 neurotropism and its ability to interact with neurons, glial cells and lymphocytes present in the Central Nervous System (CNS) leading to possible functional changes. Methodology: This article is a systematic literature review, descriptive and qualitative analysis that describes the direct relationship between COVID-19 and its impacts on the cognition of infected patients. Results And Discussion: A variety of neurological manifestations identified after SARS-CoV-2 infection were observed, which were described up to 6 months after the acute phase of infection. Regarding the affected area, although the pattern of neurocognitive symptoms is heterogeneous, there is a predominance of hypoactivity in the frontoparietal region and in the limbic circuit, fundamental structures in the cognitive aspects. Furthermore, these neurocognitive damages seem to be associated with the degree of impairment during acute infection, due to the decrease in oxygen supply to the CNS. Despite this, these cognitive changes are often cited as a direct consequence of immune hyperactivation, responsible for triggering an imbalance of neurochemical systems and neurotoxicity, in addition to the direct action of the virus on glial cells and neurons. Conclusion: We observed that there is a strong relationship between SARS-CoV-2 infection and neurocognitive changes in infected patients, with involvement of brain structures intrinsically involved in this function. Despite recent findings on the subject, further studies should be carried out to clarify the pathophysiology of these changes and propose therapeutic and preventive alternatives to improve the quality of life of these patients.


Albu, S., Zozaya, N. R., Murillo, N., García-Molina, A., Chacón, C. A. F., & Kumru, H. (2021). What’s going on following acute covid-19? Clinical characteristics of patients in an out-patient rehabilitation program. NeuroRehabilitation, 48(4), 469-480.

Almeria, M., Cejudo, J. C., Sotoca, J., Deus, J., & Krupinski, J. (2020). Cognitive profile following COVID-19 infection: Clinical predictors leading to neuropsychological impairment. Brain, behavior, & immunity-health, 9, 100163.

Amalakanti, S., Arepalli, K. V. R., & Jillella, J. P. (2021). Cognitive assessment in asymptomatic COVID-19 subjects. Virusdisease, 32(1), 146-149.

Blazhenets, G., Schröter, N., Bormann, T., Thurow, J., Wagner, D., Frings, L., ... & Hosp, J. A. (2021). Slow but evident recovery from neocortical dysfunction and cognitive impairment in a series of chronic COVID-19 patients. Journal of Nuclear Medicine, 62(7), 910-915.

Borsche, M., Reichel, D., Fellbrich, A., Lixenfeld, A. S., Rahmöller, J., Vollstedt, E. J., ... & Moser, A. (2021). Persistent cognitive impairment associated with cerebrospinal fluid anti-SARS-CoV-2 antibodies six months after mild COVID-19. Neurological research and practice, 3(1), 1-3.

Brown, E. E., Kumar, S., Rajji, T. K., Pollock, B. G., & Mulsant, B. H. (2020). Anticipating and mitigating the impact of the COVID-19 pandemic on Alzheimer's disease and related dementias. The American Journal of Geriatric Psychiatry, 28(7), 712-721.

Campos, L. R., Cardoso, T. M., Martinez, J. C. D. F. F., de-Almeida, R. G., Silva, R. M., Fonseca, A. R., & Sztajnbok, F. R. (2020). Síndrome inflamatória multissistêmica pediátrica (MIS-C) temporalmente associado ao COVID-19. Residência Pediátrica, 10(2), 348-353.

Ciolac, D., Crivorucica, I., Zota, E., Gorincioi, N., Efremova, D., Manea, D., ... & Groppa, S. A. (2021). Extensive cerebellar involvement and cognitive impairment in COVID-19-associated acute necrotizing encephalopathy. Therapeutic Advances in Neurological Disorders, 14, 1756286420985175.

de Albuquerque Britto, D. B. L., Rocha, M. F. B., de Britto Costa, L. F. S., de Britto Costa Filho, C. F., Tenorio, B. M., Maia, C. S., ... & Tenorio, F. D. C. A. M. (2020). Achados neurológicos, alterações sensoriais da função olfativa, gustativa e auditiva em pacientes com Covid-19: uma revisão literária. Revista Eletrônica Acervo Saúde, (46), e4174-e4174.

de Lima, N. S., da Costa, C. C. P., da Silva Reis, A. A., & da Silva Santos, R. (2021). Neurotropismo de SARS-CoV-2: Possíveis impactos da COVID-19 em portadores de Esclerose Lateral Amiotrófica. Research, Society and Development, 10(7), e28310716441-e28310716441.

de Morais, L. R., Silva, J. F., Fonseca, L. N., Vieira, M. H. G., de Resende, S. F. R., Simões, S. C., ... & Rodrigues, V. D. S. S. (2021). COVID-19 e o trato gastrointestinal: fisiopatologia e evolução clínica dos pacientes. Brazilian Journal of Health Review, 4(2), 4556-4569.

de Souza, M. M. S., & da Silva Santiago, M. D. (2021). Covid-19, distúrbios psiquiátricos e disfunções bioquímicas no encéfalo. Avanços em Medicina, 84-84.

Delorme, C., Paccoud, O., Kas, A., Hesters, A., Bombois, S., Shambrook, P., ... & Girault, N. (2020). COVID‐19‐related encephalopathy: a case series with brain FDG‐positron‐emission tomography/computed tomography findings. European journal of neurology, 27(12), 2651-2657.

Ermis, U., Rust, M. I., Bungenberg, J., Costa, A., Dreher, M., Balfanz, P., ... & Schulz, J. B. (2021). Neurological symptoms in COVID-19: a cross-sectional monocentric study of hospitalized patients. Neurological research and practice, 3(1), 1-12.

Ghosh, R., Dubey, S., Finsterer, J., Chatterjee, S., & Ray, B. K. (2020). SARS-CoV-2-associated acute hemorrhagic, necrotizing encephalitis (AHNE) presenting with cognitive impairment in a 44-year-old woman without comorbidities: a case report. The American journal of case reports, 21, e925641-1.

Graham, E. L., Clark, J. R., Orban, Z. S., Lim, P. H., Szymanski, A. L., Taylor, C., ... & Koralnik, I. J. (2021). Persistent neurologic symptoms and cognitive dysfunction in non‐hospitalized Covid‐19 “long haulers”. Annals of clinical and translational neurology, 8(5), 1073-1085.

Gubernatorova, E. O., Gorshkova, E. A., Polinova, A. I., & Drutskaya, M. S. (2020). IL-6: Relevance for immunopathology of SARS-CoV-2. Cytokine & growth factor reviews, 53, 13-24.

Guedj, E., Million, M., Dudouet, P., Tissot-Dupont, H., Bregeon, F., Cammilleri, S., & Raoult, D. (2020). 18F-FDG brain PET metabolism in post-SARS-CoV-2 infection: substrate for persistent/delayed disorders?.

Hellmuth, J., Barnett, T. A., Asken, B. M., Kelly, J. D., Torres, L., Stephens, M. L., ... & Peluso, M. J. (2021). Persistent COVID-19-associated neurocognitive symptoms in non-hospitalized patients. Journal of neurovirology, 27(1), 191-195.

Hosp, J. A., Dressing, A., Blazhenets, G., Bormann, T., Rau, A., Schwabenland, M., ... & Meyer, P. T. (2021). Cognitive impairment and altered cerebral glucose metabolism in the subacute stage of COVID-19. Brain, 144(4), 1263-1276.

Hugon, J., Msika, E. F., Queneau, M., Farid, K., & Paquet, C. (2022). Long COVID: cognitive complaints (brain fog) and dysfunction of the cingulate cortex. Journal of Neurology, 269(1), 44-46.

Jaywant, A., Vanderlind, W. M., Alexopoulos, G. S., Fridman, C. B., Perlis, R. H., & Gunning, F. M. (2021). Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19. Neuropsychopharmacology, 46(13), 2235-2240.

Kas, A., Soret, M., Pyatigoskaya, N., Habert, M. O., Hesters, A., Le Guennec, L., ... & Delorme, C. (2021). The cerebral network of COVID-19-related encephalopathy: a longitudinal voxel-based 18F-FDG-PET study. European journal of nuclear medicine and molecular imaging, 48(8), 2543-2557.

Lang, M., Buch, K., Li, M. D., Mehan, W. A., Lang, A. L., Leslie-Mazwi, T. M., & Rincon, S. P. (2020). Leukoencephalopathy associated with severe COVID-19 infection: sequela of hypoxemia?. American Journal of Neuroradiology, 41(9), 1641-1645.

Mak, I. W. C., Chu, C. M., Pan, P. C., Yiu, M. G. C., & Chan, V. L. (2009). Long-term psychiatric morbidities among SARS survivors. General hospital psychiatry, 31(4), 318-326.

Mattioli, F., Stampatori, C., Righetti, F., Sala, E., Tomasi, C., & De Palma, G. (2021). Neurological and cognitive sequelae of Covid-19: a four month follow-up. Journal of neurology, 268(12), 4422-4428.

Miskowiak, K. W., Johnsen, S., Sattler, S. M., Nielsen, S., Kunalan, K., Rungby, J., ... & Porsberg, C. M. (2021). Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables. European Neuropsychopharmacology, 46, 39-48.

Moldofsky, H., & Patcai, J. (2011). Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study. BMC neurology, 11(1), 1-7.

Ortelli, P., Ferrazzoli, D., Sebastianelli, L., Engl, M., Romanello, R., Nardone, R., ... & Versace, V. (2021). Neuropsychological and neurophysiological correlates of fatigue in post-acute patients with neurological manifestations of COVID-19: Insights into a challenging symptom. Journal of the neurological sciences, 420, 117271.

Pirker-Kees, A., Platho-Elwischger, K., Hafner, S., Redlich, K., & Baumgartner, C. (2021). Hyposmia is associated with reduced cognitive function in COVID-19: first preliminary results. Dementia and Geriatric Cognitive Disorders, 50(1), 68-73.

Woo, M. S., Malsy, J., Pöttgen, J., Seddiq Zai, S., Ufer, F., Hadjilaou, A., ... & Friese, M. A. (2020). Frequent neurocognitive deficits after recovery from mild COVID-19. Brain communications, 2(2), fcaa205.

Yesilkaya, U. H., Sen, M., & Balcioglu, Y. H. (2021). COVID-19-related cognitive dysfunction may be associated with transient disruption in the DLPFC glutamatergic pathway. Journal of Clinical Neuroscience, 87, 153-155.

Zhou, H., Lu, S., Chen, J., Wei, N., Wang, D., Lyu, H., ... & Hu, S. (2020). The landscape of cognitive function in recovered COVID-19 patients. Journal of psychiatric research, 129, 98-102.

Zhou, Y., Xu, J., Hou, Y., Leverenz, J. B., Kallianpur, A., Mehra, R., ... & Cheng, F. (2021). Network medicine links SARS-CoV-2/COVID-19 infection to brain microvascular injury and neuroinflammation in dementia-like cognitive impairment. Alzheimer's research & therapy, 13(1), 1-19.



How to Cite

PIRES, M. E. P.; SENA, D. de S. .; ROSA, M. A.; ALVES, I. C. S. .; MONTEIRO, V. V. C. .; REIS, A. da S. dos S. .; COSTA, P. B. C. .; SOUZA, L. O. de . Neurocognitive effects related to COVID-19. Research, Society and Development, [S. l.], v. 11, n. 11, p. e564111134182, 2022. DOI: 10.33448/rsd-v11i11.34182. Disponível em: Acesso em: 3 oct. 2022.



Health Sciences