Although COVID-19 is primarily a respiratory virus, it also affects other organs and systems in the body, including the nervous system.1 The mechanisms of injury to the brain and nervous system include chronic inflammation, changes in the integrity of the blood-brain barrier, hypoxia, and coagulopathies resulting in the formation of blood clots.2,3
Long COVID and other terms, such as long haulers or post-COVID syndrome, have been used to describe symptoms persisting beyond 12 weeks that cannot be explained by another condition.4
Some individuals with long COVID report ongoing or continuous symptoms experienced during initial infection, whereas others report the onset of new symptoms not experienced during initial infection, or continuous remitting and relapsing of symptoms.5 Commonly reported neurocognitive and neuropsychiatric symptoms of long COVID can be found in the Table.6
Although some studies identify certain risk factors for developing long COVID, such as being hospitalized for COVID-19, female gender, obesity, increasing age, and the presence of 5 or more symptoms during the acute stage of illness, other studies report little relationship between the severity of the acute illness and the subsequent development of long COVID.5,7
Since the World Health Organization declared COVID-19 a pandemic in early March 2020, approximately 107 million cases have been reported in the United States, resulting in more than 6 million hospitalizations related to COVID-19.8
According to data from the Household Pulse Survey, which was launched by the Census Bureau at the beginning of the pandemic, approximately 30% of individuals diagnosed with COVID-19 go on to develop long COVID.9 As is now evident, individuals with long COVID frequently report neurocognitive and neuropsychiatric symptoms.